Group health insurance coverage

Before diving into the various coverages, let's understand what is group coverage in health insurance.

A group health insurance coverage refers to the amount and multiple benefits policyholders can avail themselves of from the policy. Coverage is the various treatments included in the policy. Some of the various healthcare expenses that are covered by the corporate health insurance policy are ambulance expenses, in-patient hospitalization expenses, pre-hospitalization, and post-hospitalization expenses, daycare procedures, etc.

What is covered in group health insurance?

Some of the common inclusions that a group health insurance policy provides are -

Coverage for pre-existing diseases since day 1

Right from day 1, all your pre-existing diseases are covered under your group health insurance policy.

Ambulance charges

With respect to the insurance policy, ambulance charges are covered as well.

Maternity coverage

Maternity coverage includes expenses for normal and cesarean deliveries up to the sum insured as per the policy.

Domiciliary and daycare expenses

Domiciliary expenses rise when the patient undergoes treatment at home. Daycare on the other hand includes the expenses that arise on hospitalization for less than 24 hours. These two expenses are covered under the group health insurance policy.

Pre and post-hospitalization

Pre and post-hospitalization expenses are covered which include various tests and diagnoses carried out pre and post-treatment.

In-patient department expenses

These are all the in-patient expenses that are covered under the group health insurance policy. For eg: childbirth, a serious illness that needs constant monitoring, major surgery, etc.

Covid-19 coverage

All hospitalization expenses related to covid-19 are covered by your group health insurance policy.

AYUSH treatment coverage

Most modern group health policies cover AYUSH treatments such as ayurveda, yoga, unani, siddha and homeopathy These are covered when taken at government-recognized or accredited AYUSH hospitals. This aligns perfectly with your existing AYUSH-focused content and employee wellness angle.

Room rent & ICU charges

This is a practical inclusion employees care about. Group health insurance generally covers

room rent (often with no cap or a high cap) and ICU charges during hospitalization. Room rent limits directly impact out-of-pocket expenses.

Cashless hospitalization

Group health insurance typically offers cashless treatment at a wide network of hospitals and pan-India hospital network access. This is often one of the biggest value drivers for employees.

OPD (Outpatient Department) expenses

Not all group policies include this by default, but many employers opt for it. OPD cover may include doctor consultations,diagnostic tests, medicines and minor procedures not requiring hospitalization. This is where most healthcare spending actually happens, especially for employees.