Group Coverage Versus Individual Coverage Author:    Posted under: Health InsuranceHealth Insurance questions answeredHealth Insurance Types


Whenever we go to markets or outlet stores or bazaars, it is always cheaper to buy things in bulk or wholesale. It is like the more things you purchase, the bigger the discount you will get.

This also holds true in getting insurance. There are two ways you can be insured- as an individual or as part of a group.  Let us explore how similar or different they are.

As the term individual implies, this type of insurance provides single coverage for an individual or family. This also applies to those who are not insured under an employer. Even those with company or employee group coverage still opt to sign up for individual coverage in anticipation of the time that their group insurance runs out.

Insurers of individual coverage normally expect policyholders to turn in premium payments on a monthly basis. How much you pay for a premium depends on your coverage and the insurer you chose to sign up with. Sometimes, the insured party still needs to make additional payments apart from their monthly insurance premium in the event that a medical treatment required is not covered by the policy.

Some insurance provider may deny your application for insurance policy on the basis of whether you or your family is considered to be “high risk”.  What the insurers consider to be high risk are those with pre-existing conditions such as cancer among other illnesses.

It is expected that people who opt for individual coverage will go through a series of filling out forms and having medical check-up before the insurer can approve of your application.  This is especially for those with pre-existing conditions.

Group Coverage, on the other hand, refers to the insurance policy that employees get from their company. Specialized group of individuals such as freelancers can also avail of insurance through group coverage.

Since this is group insurance coverage, people tend to pay less premium than those under the individual coverage scheme. Insurers cannot deny group coverage because of medical issues. Being under the group insurance coverage, people are somehow guaranteed that they can be insured whether they are considered high risk or not.

The insurers also use different parameters in calculating the risk over the entire group. They (insurers) base their premium cost on gender and age regardless of their medical condition. But of course, if the medical treatment is not covered by your group plan or if your insurance runs out, you have to shoulder the rest of the expenses. This is where the additional individual insurance kicks in.

Insurance companies have different kinds of group coverage plans. It is just a matter of getting the one that will best fit your employees or group.

Both options have advantages and disadvantages. And also it will differ greatly if you are employed or not. The best way to determine which type is best for you, is for you to do some research and digging and find out for yourself which is better and not just rely on what your insurance sales rep tells you.

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