The medical sector has become so advanced now that it’s possible for some of the most serious diseases to be easily treated. But given the simultaneous rise in inflation rates, paying the doctor's fees, the cost of medicines and other hospital expenses for such treatments is not possible for a common person. Most of the general public is only able to afford to pay the rent and run the house from their salaries, leaving nothing for when there are serious medical expenses. Keeping this in mind, corporate health insurance was created.

Corporate medical insurance is a special health insurance plan that is provided by a company, institution or organization to the employees or members working for it. Some companies only cover the employee under such insurance plans, while some companies provide insurance coverage to the employee’s dependents as well. This article provides detailed information about corporate health insurance.

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  1. What is corporate health insurance
  2. Benefits of corporate health insurance - Benefits of Corporate Medical Insurance in Hindi
  3. What is covered in a corporate medical insurance plan
  4. What is not covered under corporate health insurance
  5. Why corporate health insurance is necessary

Corporate health insurance is also called group health insurance, in which coverage is provided for medical expenses to the people (members or employees) working in a single company or organization. Sometimes, the family members of the individual are also included in corporate medical insurance. Given the nature of this plan, it has also come to be called employee health insurance.

The premiums for corporate medical insurance are much lower compared to individual health insurance plans and the benefits can be even better than them. In corporate health insurance, even the employer (owner) can receive many benefits like tax deductions.

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Before buying a health insurance plan, it is very important to know the benefits it offers, so that you can be sure that the health insurance plan is right for you. However, the situation is a little different in a corporate medical insurance plan, as the plan is provided by your company or institution. Regardless, it is good to be informed of the benefits you are getting from this scheme. Some of them are mentioned below:

  • Increased coverage on health: In a group health insurance plan, some companies may allow the employee to choose between an individual or family health insurance plan. This gives them the benefit of not having to pay separately for health insurance for their family members. 
  • Coverage of pre-existing diseases: Some companies may provide coverage of medical expenses for pre-existing diseases to their employees. The policy may even cover some chronic diseases like diabetes and high blood pressure. All these coverages are available from the very first day after getting corporate medical insurance.
  • Maternity Coverage: Some companies offer higher maternity health insurance cover to take care of their female employees and dependents of male employees. The insurance plan covers the expenses incurred during the birth of a child and most companies also cover the newborn baby in the group health insurance plan without any waiting period.
  • Job satisfaction: Providing a health insurance plan to the employee shows that the company cares about their health and wellbeing. As a result, the employee remains satisfied with the job and feels valued by the company. Thus, corporate medical insurance enhances the confidence of an employee in the company, so that they stay in the company for a longer period of time.
  • Help in a sudden medical emergency: Corporate medical insurance helps you financially when there is a medical emergency. For example, if an employee of the company or a person dependent on them falls ill, then the insurance company bears their expenses. This is done so that the employee does not have to suffer financially and continues to do their job with confidence.
  • No waiting period: This is one of the most important benefits of group health insurance, which comes in handy at the time of an emergency. In most health insurance plans, you are given a waiting period, during which you are not able to avail the insurance. In corporate medical insurance, though, you do not have a waiting period. For example, if you have recently joined a company where you have got a group health insurance plan, then you can file a claim for a medical emergency immediately after getting the plan.
  • Attracting good employees: The corporate health insurance plan offered by the company or organization attracts new employees. When a company offers benefits such as group health insurance, it makes the company more attractive to job seekers, which makes it easier for the company to find good employees. Not only this, if a company provides group health insurance for its employee and their dependents, then the employee remains with the company for a long time.
  • Increase employee performance: When an employee is provided with benefits like health insurance by the company, their morale increases and, as a result, so does their performance also improves. This is because mental satisfaction is directly linked with the employee feeling safe. A mentally satisfied and happy employee tries to give their best performance towards the company.

(Read more: What does health insurance cover)

Inclusions are the most important part of any health insurance policy. When a person plans to buy a health insurance policy, it is the first area of inquiry as the decision to buy is usually based on which procedures and diseases are going to be covered by the policy. Generally, the following diseases are covered in a group health insurance plan:

  • Pre-existing diseases are covered from day one.
  • Maternity coverage is provided in most group health insurance plans. However, some companies may have a waiting period of 9 months. (Read more: Pregnancy)
  • Children get coverage right from the time of birth.
  • Some corporate health insurance plans also cover ambulance expenses.
  • Pre and post hospitalization expenses (pre and post hospitalization) are included.
  • Room rent coverage, day-care treatment, ICU admission as well as domiciliary medical expenses are covered.
  • Doctor and other staff fees are included in the policy. 
  • The cost of anaesthesia, oxygen, medicines, blood transfusion, operation theater and tests is covered in the plan.
  • Some corporate medical insurance plans also cover the expenses of radiotherapy, chemotherapy, pacemakers, etc.

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Most people do not think about the exclusions while buying medical insurance. In case of exclusions, when a medical problem caused to the insured is not included in the plan, then all the expenses have to be paid from their own pocket. This makes it important to know which diseases or procedures are not covered under the policy before signing up for it. Following are some of the medical expenses which are generally not covered in group health insurance:

  • In some companies, the parents of the employee are not covered under the corporate health insurance plan.
  • Non-allopathic treatments like homeopathy and Ayurveda are not covered. 
  • Medical expenses incurred for the treatment of any congenital disease cannot be claimed.
  • Treatment of AIDS, and other related health problems, is not included.
  • Treatment of illness caused by the consumption of alcohol, smoking or use of any other substances is not covered. 
  • Corporate health insurance provides benefits to the employee only as long as they work in the company. Some companies provide health coverage only to the employee, excluding all other members of the family.

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In view of the rise in inflation as well as the spread of serious diseases, it has become necessary to provide medical coverage to employees so that they can work without any worries. Apart from this, the following are some other factors that make corporate health insurance necessary:

  • Comprehensive coverage: Most corporate health insurance plans offer comprehensive coverage and benefits to the policyholders.
  • Option to change coverage: There is often an option provided to make changes in the health insurance policy offered by the companies to their employees. For example, an employer can opt for a health insurance plan that offers maternity cover or OPD coverage.
  • Low premium: Corporate health insurance premiums are relatively low when compared to individual and group health insurance plans. This is because the premium that the insured has to pay in an individual insurance policy is always higher than that of a group health insurance policy, considering the benefits accruing to the insured.

(Read more: Health insurance plans for family)

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