Have you looked into the details of employer health insurance offered by your employer? Who in your family is covered by this plan? Are your parents, spouse and children adequately covered? Did you discuss insurance coverage or read the company’s terms and conditions before agreeing to do the same? It’s time to figure out if things match up.
How long should I wait?
First, check what benefits your employer’s health insurance plan offers. Are there any unique benefits, such as coverage for the patient’s or a parent’s chronic disease immediately after joining, or the need to wait for a certain period of time to receive a claim for treatment costs at the hospital? Most health insurance plans are effective from the date of enrollment and cover the entire period of employment.
Sumit Ramani, Actuary and Co-Founder, ProtectMeWell.com“In a group policy, the risk of anti-selection is greatly reduced because, by definition, the group is not coming together with the primary purpose of purchasing insurance. happened to compensate them for their health risks, and all members of the group are generally insured, allowing both healthy and non-healthy people to participate in the pool. As a result, group medical insurance is more lenient in terms of underwriting and waiting periods for medical coverage, but existing sickness waiting periods apply to group insurance coverage. Some are waived for additional costs and/or post-medical underwriting, which means claims can be made as soon as the policy is purchased.”
While this may be seen as an intrinsic benefit, it may not be very useful given that not many employees insist on policies immediately after joining an organization. does not automatically entitle you to insurance. Aside from filling out a few forms and such, it involves a myriad of processes such as submitting family members’ names and other details.
If you want your entire family to be covered by your employer’s health insurance plan, don’t ask Human Resources to fill in your information. Please fill out the form yourself instead, as incomplete or inaccurate information may result in the rejection of your claim.
It makes sense to check if your insurance company mandates a waiting period before making a claim.
Who else is covered besides me?
All employers can be generous. That is, they may be willing to hastily leave their dependents to cover only their employees, just in case they need it. Many employers also negotiate insurance premiums. This means that part of the premium may be deducted from your salary. Ask your Human Resources representative about insurance premiums and whether you need to pay extra for family insurance.
Viral Bhatt, Founder, money mantra “First, check the cost of adding a family member. To do this, you need to assess the additional premiums required to add the family member to your employer’s health insurance plan. If the cost is reasonable. If it fits within your budget, it makes sense to add them in. Secondly, don’t neglect your family’s medical needs Consider your family’s health care needs. If you need it, adding it to your employer’s health insurance plan can save you long-term health care costs.Third, check the coverage and benefits offered. Please review the coverage and benefits you offer and determine if they meet your family’s needs.”
Numbers matter, and pennies paid extra can be pennies badly spent. To help you decide, do some preliminary calculations.
Did you receive your TPA card?
Have you requested a Third Party Administrator (TPA) card from your company? Did you know that you cannot receive cashless hospitalization or treatment without presenting a TPA card issued by your employer’s health insurance? If your company does not issue physical cards, you can request an e-card with valid ID. Therefore, until you have TPA cards for all family members, ask your employer’s human resources department for cards. Make sure all the information on the card is correct, including the range.
Check the list of hospitals in the network
You cannot simply walk into a hospital and expect to get treatment for your problem with the available insurance provided by your employer. Your insurance company has a relationship with a specific list of hospitals called networked hospitals, so you should check to see if your chosen hospital is on the list. This is because if you receive treatment at one of these hospitals, you will either receive non-cash benefits or be reimbursed for the amount spent on treatment. So make a list of these connected hospitals ahead of time and keep them handy. This allows you to go directly to the list and quickly access the closest list in the event of an unexpected hospitalization.
Does your health insurance offer special coverage?
You may be reluctant to disclose your medical history before being hired, but if you have a medical condition, you may want additional assurance that your health insurance meets your needs . To put an end to all your unnecessary worries, why not request a copy of your Benefits Illustration (BI) to understand the covered illnesses and the extent of coverage available along with any applicable conditions? For those who do not, the BI on pages 5-10 provides information to prospective or new policyholders about how insurance works under the specific conditions described in this document. It contains the details you need to keep.
Suresh Sadagopan, MD & Principal Officer, Ladder7 Wealth Planner Shares said, “It will be on the wording of the group insurance policy. If it is not clear, you can contact Human Resources who can clarify.”
You may purchase your own health insurance plan. You shouldn’t forego the benefits of employer-sponsored health insurance, but given that you can’t customize the latter, ask for changes to your policy, or expand coverage if you need it. , with certain limitations. Corporate health insurance should be considered an added benefit. Never fully trust payment for hospitalization and subsequent treatment.
Here are the benefits of health insurance.
