Employee Mediclaim Policy: Benefits and features

  • postauthorEditorial Staff
  • postdateMarch 6, 2023
  • postreadtime4 min read
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Group employee mediclaim policy is a type of health insurance plan which is used to cover a group of people in order to protect its members against illnesses, injuries or any medical conditions. Usually, the group consists of employees of an organisation however, it can also be used to cover certain kinds of groups like corporate bodies, institutions etc. This Mediclaim policy can be extended to the dependents of the current insured members.

Group employee policy has lots of benefits to offer. It is the best way to keep your employees safe and ensure their protection in the times of medical expenses as the group mediclaim policy covers the medical treatment costs incurred by an employee in the times of health emergencies. This policy helps them stay calm and helps them overcome financial burdens.

Apart from this, here are some other benefits of mediclaim policy justifying its importance, mentioned below.

Benefits of Employee Mediclaim Policy

  • Ease of cashless hospitalisation.
  • Handling the expenses arising out of hospitalisation.
  • Option for self purchase or for the entire family.
  • Helps you save money
  • Time saving and ease of buying through online health insurance companies.

Inclusions of Group Mediclaim Policy

A quality group Mediclaim policy will always cover you under a wide range of medical expenses. However, it can differ from policy to policy. Here is the list of common inclusions of a group health insurance policy.

Hospitalisation costs

  • Includes medical expenses incurred during the hospitalisation of the policyholder or the beneficiaries.
  • Covers expenses related to diagnostic procedures, OT charges, medicines, blood, x-ray, oxygen and consultations (when there is a need for hospitalisation).

Pre and Post-Hospitalisation Expenses

  • Medical expenses arising before 30 days of hospitalisation and up to 60 days post-discharge are covered. It differs according to the policy you opt for.

Day-Care Expenses

  • Advanced medical treatments which do not require hospitalisation for more than 24 hours are covered.

Hospital Room Expenses

  • Regular wards or Intensive Care Unit (ICU) costs are reimbursed or via cashless facility.

Exclusions of Group Mediclaim Policy

Most of the Mediclaim policies do not cover certain things. It again, depends on the policy you are opting for. Here are some of the very common group Mediclaim policy exclusions you will mostly find.

  • Pre-existing illness.
  • Dental treatments.
  • Birth control and hormonal treatments.
  • Plastic/Cosmetic surgery
  • Obesity treatments
  • Maternity expenses (can be included if opted as an add-on feature)
  • Non-medical/expenses made as per choice such as service charges, administrative charges, toiletries, etc.
  • Diseases contracted within a set period from the policy purchase date.

Must-have Features of group employee Mediclaim policy

The group employee mediclaim policy depends on a lot of factors and features. This includes the size of the group, type of group, the average age of the covered members, the sum insured and additional coverage options etc.

  • Eligibility of the Group: The Mediclaim policy is only available to the existing group of people who have already been formed as a team for specific purposes and not just for group Mediclaim policy, such group is not eligible for cover.
  • Size of the group: A group to apply for Mediclaim policy should meet the requirement of minimum number of members as per the guidelines and conditions of a policy. Different companies have different eligibility criteria for the same. As an employer of a recent startup if you’re wondering that you need 20-25 people to be eligible for a healthcare plan including insurance, don’t worry! Onsurity got your back. You just need 3 or more. Here’s how.
  • Renewal of the policy: Generally, the policy is renewed after a year. The policy is supposed to go under the renewal process to continue the insurance for team members.
  • Coverage limit: There is a coverage limit in every group Mediclaim policy. Commonly, very high coverage levels are not provided by a company since they do not underwrite individual health risk. The coverage in policy is provided according to the nature and composition of the group.
  • Expenditure/Payer: Premiums are generally paid by an employer but it depends on company’s guidelines. The members of the group can pay for it too especially in cases when the policy is extended to their family. The insurance company, however, collects a single premium irrespective of who pays it.
  • Claims Impact: A claim by a single member never affects the coverage of other members.
  • Reimbursement/Cashless group Mediclaim policy: Cashless claims or reimbursement can be availed for those treatments at a hospital which are covered under the insurance.

The Bottom Line

Group Mediclaim policy is beneficial for all the employees indeed. But do you know what’s even better than just getting a group Mediclaim policy for your team members?

That is – A comprehensive healthcare plan which includes multiple health benefits at the same time including health insurance for employees as one of them, making it a complete healthcare package so that your employees do not have to look for a single healthcare facility outside of this plan.

Onsurity’s healthcare plan is packed with all such benefits like group health insurance, doctor teleconsultations, discounted health checkups and medicines, fitness webinars and what not. It is perfectly designed for SMEs, startups and growing businesses.

It is the best choice for an employer to take care of their employees.

Contact us to get an instant quote or click on the button below.

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