FAQs
Make informed decisions and build the best employee health benefits program for your workforce.
What are the benefits of Group Health Insurance?
Benefits typically include lower premium costs due to risk being spread across a large group and a comprehensive coverage options.
How is the premium for Group Health Insurance determined?
The premium is determined based on several factors, including the size of the group, the level of coverage selected, network of hospitals and the insurer's underwriting guidelines.
Are pre-existing conditions covered under Group Health Insurance?
Many group health plans cover pre-existing conditions, we advise clients to always declare any pre-existing conditions during onboarding.
What determines health insurance renewal premium?
Several factors determine renewal premiums. Factors such as medical loss ratio of the policy, claims history, medical inflation, change in benefits etc.
What is international health coverage?
International health coverage is a type of health insurance plan designed to cover medical expenses outside their home country. It provides access to healthcare services, including routine medical care, emergency care, hospital stays, and sometimes even wellness programs.
Can I use my international health coverage in multiple countries?
Yes, international health coverage is typically designed to work across multiple countries, allowing you to receive medical treatment wherever you are living or traveling. However, it's important to check if the plan has a global provider network and whether specific countries are excluded from coverage.
Will I have to pay out-of-pocket for medical services and seek reimbursement?
It depends on the healthcare provider and your plan. Some providers have direct billing agreements with your insurance company, meaning you won’t have to pay upfront. In other cases, you may need to pay for services upfront and then file a claim for reimbursement.
What is the difference between international health insurance and travel insurance?
Designed for long-term stays abroad, offering comprehensive health coverage for routine, emergency, and ongoing care. Travel Insurance: Short-term coverage for emergencies that occur while traveling, such as sudden illness or injury, but usually doesn’t cover routine or long-term healthcare needs.
What if I return to my home country? Will my coverage still be valid?
Some international health insurance plans provide global coverage, which includes both the host country and your home country. However, some plans may limit coverage in your home country or exclude it altogether, so be sure to review your policy terms regarding coverage at home.
Does international health insurance cover pre-existing conditions?
Coverage for pre-existing conditions depends on the policy:
Some plans cover pre-existing conditions right away.
Others may have waiting periods before pre-existing conditions are covered.
In some cases, pre-existing conditions may be excluded altogether.
Does international health coverage include medical evacuation?
Yes, many international health insurance plans include medical evacuation services. If you need specialized care that is unavailable locally, the plan will cover the cost of transporting you to the nearest appropriate medical facility. Some plans may also cover repatriation to your home country if necessary.
What is Community Health Insurance?
Community Health Insurance is a health insurance plan designed to provide coverage for members of a specific community, such as residents of a particular area, members of a cooperative, or individuals within a shared social group. These plans pool risk across the community, often resulting in lower premiums and more accessible healthcare options.
How does Community Health Insurance differ from other types of insurance?
Unlike individual or employer-based health insurance, community health insurance pools the risk across a specific community, often resulting in more affordable premiums and greater inclusivity for individuals who may otherwise be uninsured.
Is there a network of healthcare providers I must use?
Many community health insurance plans are tied to a primary healthcare clinic or hospital nearby.
Does the plan include preventive health services or wellness programs?
Many community health insurance plans include preventive health services like vaccinations, screenings, and health education programs to promote overall well-being in the community.
Are there any financial assistance available?
Some community health insurance plans offer financial assistance for low-income members or those unable to pay full premiums. These subsidies are often funded through community contributions, government support, or donor organizations.
What is Individual and Family Health Insurance?
Individual and Family Health Insurance is a type of health insurance that provides coverage for medical expenses to individuals or families. Unlike group health insurance, which is offered by an employer, these plans are purchased directly by the individual or family.
How does Individual and Family Health Insurance differ from employer-sponsored insurance?
Individual and family plans are purchased directly by the consumer often at a higher cost than employer-sponsored plans.
Are pre-existing conditions covered under Individual and Family Health Insurance?
Some plans may have waiting periods or specific exclusions for pre-existing conditions.
SME Health Insurance is a group health insurance plan specifically designed for small and medium-sized enterprises. It offers health coverage for the employees of a small business under a single policy, often at a lower cost than individual health insurance.
Employees of small and medium-sized businesses, typically with fewer than 20 employees.
Coverage typically includes hospitalization, outpatient care, prescription drugs, preventive services, and emergency care. Some plans may also offer additional benefits like dental, vision, mental health services, and wellness programs.
Yes, some SME health insurance plans offer flexibility in choosing different coverage levels for different employee categories, such as executives versus entry-level staff. This depends on the insurer and the specific plan selected.
Most SME health insurance plans cover pre-existing conditions, although some may have waiting periods. The specific terms will depend on the insurer’s policy.
Many SME health insurance plans have a network of providers. The provider network is dependent on the plan type and premium.
Yes, you can typically add or remove employees due to qualifying events, such as new hires or terminations. Most health insurers have an annual open enrollment period.
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