Most salaried professionals feel a sense of relief when they hear that their employer provides health insurance. It gives a basic feeling of security—that medical emergencies will be taken care of. But here’s the truth that many ignore: this insurance is often not enough. Relying only on your company’s health insurance can leave you vulnerable at a time of real need.
Let’s explore why depending only on corporate health plans can be risky and how a personal health insurance policy can offer a better financial cushion for your future.
Health Expenses Are Rising Fast, but Company Coverage Remains Limited
Healthcare in India has become significantly more expensive in the past decade. A single surgery or hospital admission can cost anywhere between Rs. 2 lakh to Rs. 15 lakh, depending on the condition and the city. However, most employer-provided health insurance policies come with a fixed sum insured—usually in the range of Rs. 2 lakh to Rs. 5 lakh.
While this may cover minor treatments, it falls short when it comes to major surgeries, critical illnesses like cancer, or long-term hospitalization. Treatments like chemotherapy, ICU admissions, or organ transplants can easily cross Rs. 10 lakh.
So, if your office policy only covers Rs. 3 lakh, you will have to pay the rest from your own pocket. This defeats the purpose of having health insurance in the first place.
Your Job Security Equals Your Health Coverage: Risk of Losing Insurance When You Need It Most
The biggest limitation of corporate health insurance is that it is job-dependent. Once you quit, retire, or get laid off, the policy expires immediately. If a medical emergency happens during this gap period, you will have no insurance coverage. This could cause a financial crisis.
Also, when you’re older or already suffering from a medical condition, it becomes harder to buy a new policy from the open market. Companies may either reject your application or offer very high premiums.
A personal health insurance policy, on the other hand, stays with you for life—irrespective of your job, employment status, or health condition (as long as you renew it timely).
Corporate Health Plans Often Don’t Cover Parents or Full Family Members
Most group health plans cover only the employee, spouse, and two dependent children. But what if you also have dependent parents or in-laws living with you? Or a larger family setup? In such cases, corporate policy won’t help.
Many working professionals in India support aging parents or extended family members. If they fall sick, you’ll have to bear all medical costs if they’re not included in your insurance coverage.
With personal health insurance, you can buy a family floater policy that includes parents, spouse, and even children. This gives peace of mind and complete financial coverage for your loved ones.
Hidden Limits and Clauses in Group Policies Can Surprise You
Corporate health insurance plans often come with restrictions. These include:
- Room rent limits – Some policies allow only general or semi-private rooms, and anything beyond that must be paid from your pocket.
- Capping on treatment types – For certain surgeries or diseases, the policy might cover only part of the cost.
- No OPD coverage – Most group policies don’t cover outpatient department (OPD) charges, which are quite common in India.
- Limited critical illness cover – Critical illnesses like heart attack, cancer, or kidney failure might not be fully covered.
These small clauses can result in big out-of-pocket expenses during treatment. Personal health plans, on the other hand, allow you to choose plans that have no sub-limits or offer wider coverage with optional riders.
India’s Medical Inflation Is Real and Dangerous
India is facing double-digit medical inflation. Every year, the cost of medicines, hospital stay, diagnostic tests, and surgeries is increasing. According to data from the National Health Authority, medical inflation is rising at around 12–14% annually in India.
Now, consider this: if you are 30 years old today and have a Rs. 5 lakh cover, it might be enough now. But by the time you’re 45 or 50, the same treatment could cost Rs. 15–20 lakh. Corporate insurance doesn’t grow with your age or inflation unless the employer increases the sum insured, which is rare.
This makes it crucial to have a personal policy with enough coverage that can be upgraded over time to match the rising costs.
Retirees Face Health Issues but No Insurance
One of the biggest challenges is post-retirement healthcare. Most company health insurance policies end the day you retire. Unfortunately, that’s also the age when most people start facing health issues.
Buying a new policy at the age of 60 or 65 becomes expensive and difficult. Insurance companies may reject your proposal, put exclusions on pre-existing diseases, or charge very high premiums.
If you had taken a personal policy earlier, you wouldn’t face this problem. You can continue the same policy into old age with much lower premiums and full benefits.
Government Schemes Are Not Enough for the Middle Class
Schemes like Ayushman Bharat are aimed at the economically weaker sections. They do not cover the middle class or upper-middle class who still struggle with high medical costs. Also, these government plans have limited hospital networks and don’t cover OPD or diagnostics, which form a major chunk of health expenses.
Corporate insurance is good while it lasts, but a personal health insurance plan is the only reliable way for middle-class families to prepare for any medical emergency—especially if you want private hospital treatment and quality care.
Benefits of Buying a Personal Health Insurance Plan Early
Buying a personal health policy early in life has many benefits:
- Lower premiums – Premiums are cheaper when you are young and healthy.
- No waiting period issues – Most policies have a 2-4 year waiting period for pre-existing diseases. If you buy early, this gets over sooner.
- More options and flexibility – You can choose features like OPD cover, maternity benefits, critical illness, daily hospital cash, and more.
- Tax benefits – You can claim up to Rs. 25,000 deduction under Section 80D (Rs. 50,000 for senior citizens).
What to Look for When Choosing a Personal Health Insurance Policy
Here are some important features to check before selecting your personal health plan:
- Adequate sum insured – Preferably Rs. 10–25 lakh, depending on your family and lifestyle.
- Cashless network hospitals – Make sure your nearest and preferred hospitals are part of the insurer’s cashless network.
- No sub-limits – Avoid policies with room rent capping or disease-wise limits.
- Lifelong renewability – This is a must-have feature to ensure coverage into old age.
- Restoration benefit – If the sum insured gets used in a year, it should restore for future use.
- Add-on riders – Like critical illness cover, maternity benefits, OPD cover, and daily cash benefits.
Don’t Wait for an Emergency to Take Action
Many people wake up to the importance of health insurance only after they or someone close faces a medical emergency. By then, it’s too late. A wise financial decision is to prepare before the need arises.
Corporate health insurance is a good starting point but not the end. Think of it as an appetizer—it can’t replace the full meal. A personal health insurance policy is what gives you real peace of mind and complete control over your healthcare needs.
