Group Health Insurance

Group Health Insurance

When buying group health insurance, employers focus mainly on what is covered under the policy, overlooking the general exclusions. A group health insurance plan has a list of exclusions based on which the insurance company can deny coverage to employees and their family members. There are certain treatments and medical conditions for which the insurance company can reject the claim filed by the employee. Exclusions in group health insurance are important to be considered because they can lead to employee dissatisfaction as the employees will have to bear the medical expenses out of their pocket. Read on to know all about group health insurance exclusions.

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Coverage

Exclusion

Yes, group health insurance does cover pre-existing medical conditions. A master policy is issued in the name of the employer which automatically provides coverage to all employees. Several group health insurance providers offer coverage for pre-existing medical conditions from day one. However, each group health insurer offers different coverage and hence, it is best to check on the policy inclusions and exclusions before proceeding with the coverage.
Exclusions in group health insurance refer to the medical conditions for which the insurance company will not provide coverage. This means, for instance, if Rishi, having a group health policy of Rs. 5 lakhs requires to undergo a cosmetic treatment then, in this case, the insurance company will not provide any coverage as coverage for such treatments is not provided under group health cover. However, if Rishi meets with an accident