A group health insurance policy is the contract between the employer or policyholder and the insurance company who provides insurance coverage. The policy document outlines the features of the policy, inclusions, exclusions and all the terms and conditions and fine print of the policy.
Whereas other types of health insurance policies are issued for insuring individuals, spouses and dependent family members, group policies are meant for groups. They are issued for groups of employees, members of certain associations, cultural groups or groups of people who use the same financial products such as credit cards, bank accounts and so forth.
Employee health insurance is more or less the same as group health insurance and both terms are often used interchangeable. The only difference is that group health policies is a broader term than employee health insurance and may be issued for groups of people other than employees as well, in some cases: members of an association, users of certain financial products for instance.
A typical group health plan will cover hospitalization of all covered individuals: room rent, specialist consultations, diagnostic tests, prescription medications, nursing charges, surgical charges, anesthetist charges and so on. Costs incurred 30 days prior to hospitalization and 60 days post discharge, prosthetics, recovery aids and so may also be covered. Many group policies offer maternity expenses as standard features.
Yes, covered individuals and their families (if applicable) can avail cashless facilities from all network hospitals with which the insurance company has tie ups. However, non network hospital claims could be subject to co-pay in some cases.
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