Employer sponsored health cover. Is it enough?

When a company of repute employs a person, the company enrols the person in the Employer sponsored health insurance which is a part of the CTC (cost to company). The premium is deducted from the salary and paid to a health insurance provider, who does the health insurance for the entire office or a focussed section of the company.

It is noticed that when an employee is enrolled in the employer sponsored health cover, seldom has the employee taken additional coverage on personal capacity. Now, is it enough or not?

The answer is no. The reason being plenty let us discussed the important ones,

a.    The premium figure is limited to health coverage of 1 Lakhs to 3 Lakhs of rupees. It is seen that the health coverage taken by the employer is generally on the lower side as the premium money is deducted from the salary and deposited to the health insurance provider is on the lower side. With cost of hospitalisation is increasing day by day, there is no way health coverage of less than 5 Lakhs minimum is worth discussing.

b.    Issue between the employer and employee. All is well with the health coverage in place till the organisation starts faltering in performance and cannot afford to maintain the employees. Then there comes a time that the company winds up, with the health insurance disappearing. Same in the case of employee leaving the organisation, the employer covered health insurance also ends abruptly.

c.    Once an employee crossed the threshold of 45 years of age, every single health insurance provider makes medical test compulsory. Now these tests are exhaustive and cover a lot of diseases. If the test shows any pre existing disease, then the insurer will not cover the present ailment, which becomes a huge problem eventually.

d.    Eventual change over to personal health coverage becomes expensive when an employee quits and join another employer where there is no health coverage provided or the employee becomes entrepreneur himself. In this kind of a situation, getting a health coverage becomes not only tedious work but also expensive.

e.    When an employee takes new private health coverage, there is a waiting period of two to four years before the pre existing diseases can be treated. Thus effectively for the waiting period, there is no insurance cover and any emergency has to be dealt from the persons personal wealth.

Though we have seen that many employer of repute provides health coverage which is in a way noble, but in the recent times, when many employers are not providing health coverage and an employee also changes job frequently, there is a dire need of opting for a personal health insurance and not just wait for the company to provide health insurance.

As the employee can choose the coverage level and not at the fixed coverage level provided by the employer, the choice of insurance provider matters. The employee can study the inclusion and exclusions provided by insurance provider for taking an informed decision.