A group health insurance policy provided by your employer is also known as 'employer's health insurance' or 'corporate health insurance'. It is funded by your employer, who pays the premiums for these policies. These plans are amongst the most popular health insurance options for employees. One of the most common questions about a group health insurance policy is if its benefits can be transferred to individual coverage after a job change. So, read on to discover whether or not you can switch from group health insurance and how does individual health insurance transition works while changing health insurance plans.

Is Moving from Group to Individual Health Insurance Possible?

According to regulations from the Insurance Regulatory and Development Authority of India (IRDAI), employees covered under a group health insurance plan can transition to an individual health insurance policy. This transition is possible if the insured employee changes jobs or loses their job but wishes to continue receiving health insurance coverage. The individual must fulfil specific formalities outlined by the insurer and may also benefit from the waiting period accumulated under the existing employer's medical insurance policy. However, the acceptance of the health insurance plan conversion depends on the insurer, who retains the right to determine the terms, conditions, and premium amount of the new health insurance plan.

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Things to Keep in Mind During Group to Individual Health Insurance Switch

While there are some benefits of individual health insurance, here are some considerations that are crucial when contemplating a group to individual health insurance transition:

1. Underwriting

Every health insurance company has its own underwriting process. In this process, it analyses the risks posed in insuring an individual or individuals to determine the appropriate premium. If you request the insurer for switching health insurance coverage to an individual policy, it will assess your health from a risk perspective and then state whether it wants to insure you or not.

2. Medical Check-up

As a part of the health assessment process, you might be required to undergo some tests to gauge your current health condition before changing health insurance plans. The test results can significantly affect the payable health insurance premium for the individual policy. For instance, if your blood pressure, weight, sugar levels, etc., are on the risky side, then it can lead to a hike in the premium.

3. Inform Before the Policy Expiry

It’s advisable to notify the insurer about your desire for transitioning health insurance options from a group plan to an individual plan before the group policy expires. It’s recommended to start the switch soon once you decide to exit the company. Ideally, inform the insurer 30 to 45 days in advance to ensure a hassle-free switch.

4. Waiting Period

This is the duration of days you need to wait (to raise a claim) after suffering an illness for it to be covered under health insurance. Usually, group health insurance plans do not impose a waiting period. However, it might be a requirement in the case of an individual policy. In case of a switch, the period for which you were covered under the group plan can be considered as the waiting period for an individual plan. Ensure that this waiting period is credited when you switch to individual health insurance after group insurance.

5. Conversion Within the Same Company

Do remember that when you are moving from group to individual health insurance, the conversion must be done within the same insurance company. In other words, you must convert to an individual insurance policy with the same company with which you held a group insurance policy. It is not feasible to shift to another company to convert to an individual policy.

How to Switch from Group Health Insurance to Individual Health Insurance?

For moving from group to individual health insurance, follow these steps:

• Notify Your Group Insurance Company

Inform your group insurance company about your decision to switch to an individual health plan. Ensure you inform them at least 30-45 days before the expiry date of your current policy.

• Select a Suitable Plan

After informing your insurer, explore individual health plans that meet your needs. You may choose from various options with different features and benefits, including add-ons for enhanced coverage.

• Request the Application Form

Once you've chosen a plan, request the insurer to provide you with the application form. This can typically be done online or offline. You may also need to submit additional documents such as your claim history, current group plan details, and health profile. In some cases, a health check-up and relevant reports may be required.

• Complete Documentation

Ensure all required documentation is completed and submitted well in advance, preferably 30 to 45 days before your group plan expires. If the insurer requires any further information based on your submission, they will request the same accordingly.

• Payment of Premium

Unlike employer-paid group policies, you will be responsible for paying the premium for your individual plan. After submitting the application form and completing the underwriting process, you can make the premium payment using UPI, debit/credit card, or net banking. The premium amount will be determined based on the insurer's assessment of your health and the documents provided.

• Review Policy Terms and Conditions

Before making the payment, carefully review the terms and conditions of the policy. Clarify any doubts you may have with the insurer to ensure you understand the coverage and benefits provided.

 Conclusion

Moving from group to individual health insurance involves careful consideration and adherence to specific procedures. The acceptance of this conversion is at the discretion of the insurer, who determines the terms, conditions, and premium amount for the new policy. By following the steps and considerations outlined in this guide, individuals can effectively navigate the process of switching from group health insurance to an individual health insurance plan that best suits their personal healthcare needs and financial preferences. 

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