Group Health Insurance Vs Individual Health Insurance

Group Health Insurance Vs Individual Health Insurance

There are various types of health insurance policies, and you should select the one that best meets your needs. Group health insurance and individual health insurance are two popular types of health insurance. The coverage provided by these policies may be similar, but who is eligible to receive it is what distinguishes them. Let’s take a closer look at the distinctions between Corporate Group Health Insurance and Individual Health Insurance:

Group Health Insurance Vs. Individual Health Insurance

The following table compares Employee Group Health Insurance and Individual Health Insurance Plans:

ContentGroup Health InsuranceIndividual Health Insurance
General MeaningA group health insurance plan provides health insurance to a group of people.Individual health insurance policies provide coverage to policyholders.


Who is insured?The insured person and any dependent family members.Only one person, the policyholder.
Who is the purchaser?An employer typically purchases group health insurance (or the main member of the family for the Family Floater Insurance plan).The policyholder purchases individual health insurance.
What level of influence does the insured have over the plan?Control is restricted (The employer or the purchaser has control over the coverage and add-ons of the plan).Complete command (The policyholder can control the coverage and add-ons of the plan).
Option to buy Add-onsNone or very fewAny of the available add-ons can be purchased by the policyholder.
ClaimsTypically, claims are made through a third-party administrator.Claims can be filed with the insurance company directly.
Available Sum InsuredWhen compared to individual health insurance, the cost is low. It could range between Rs. 5 and Rs. 10 lakh.When compared to a group health policy, you have the option of selecting a higher sum insured. It could range between Rs. 5 and Rs. 15 lakh.
Eligibility Criteria


Should be a full-time employee of a company.For Eligibility Criteria, you have to be at least 18 years old.
Criteria for exitWhen an employee leaves the company or retires, the insurance plan ends.The policyholder turns 65. (Insurance has an age limit.)
Tax BenefitsNoYes
Pre-existing disease coverageMostly from the first day.Following the end of the waiting period.
Maternity BenefitsCoveredIt must be purchased as an add-on.
No Claim BonusInapplicableApplicable
Pre-purchase medical examinationsIt is not required.Required
Coverage for Critical IllnessNoIf the policyholder so desires.

Group Health Insurance


  • Better coverage at a lower cost
  • It is now easier to obtain coverage for pre-existing conditions.
  • Some brokers provide additional administration and claims assistance to corporate clients.


  • The employer, not the individual, determines benefits and limits.
  • Not all group plans are portable, so you will lose coverage if you quit your job.
  • The employer, not the employee, owns the plan.

Individual Health Insurance


  • More coverage customization options
  • Increased control over co-pays, deductibles, and benefit caps
  • Choose your preferred insurer.
  • It is portable; it is not dependent on your employment status.


  • Increased premiums
  • Additional fees or no coverage for pre-existing conditions
  • Some insurers and brokers are involved in the plan’s use.

In conclusion, Individual and group health insurance plans provide distinct benefits and functions. To ensure adequate financial support in times of need, one should always purchase health insurance as needed.

The new rules can cover a person with multiple health insurance policies. As a result, it is strongly recommended that you build a solid health insurance portfolio to avoid any unwanted financial risks in the event of a medical emergency. An individual plan, a group plan from the employer (if applicable), a family health insurance plan, and critical illness coverage are all recommended.

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