Group Health Insurance

Group Health Insurance (also known as GMC, corporate group health insurance, or employee health insurance) is a health insurance policy offered by employers to provide medical coverage to employees under a single master policy. Depending on the plan, coverage may also extend to spouses, children, and dependent parents.

A group health insurance plan covers hospital bills, cashless treatment at network hospitals, daycare procedures, surgeries, pre-hospitalisation and post-hospitalisation costs. Some plans go further, including maternity benefits, OPD consultations, and wellness perks such as health check-ups. Since the policy covers a larger group of people, group health insurance plans are often more cost-effective than individual health insurance policies.

• In-patient hospitalisation: This covers expenses incurred when an insured person is admitted to the hospital for treatment. To make a claim, the hospitalisation must be for at least 24 hours.
• Daily hospital cash benefit: Under this benefit, insured members can receive additional cash during hospitalisation, which can be used for food, medicines, travel, or other related expenses.
• Day Care treatment cover: Medical procedures that do not require 24-hour hospitalisation are covered under this. This includes procedures such as cataract surgery, tonsillectomy, and more.
• Road Ambulance: Expenses for ambulance services to or from the hospital can be claimed under this cover. Each insured member is eligible for up to Rs. 2,000 per event.
• Compassionate visit: If the insured person is hospitalised away from home, ACKO covers the transportation costs of an immediate family member from India to the hospital.
• EMI Protection: If an employee is unable to pay loan EMIs due to illness, they may claim the amount under the Group Medical Coverage. The number of EMIs covered will depend on the policy terms and conditions.
• Maternity cover: Expenses related to childbirth are covered as per the terms and conditions of the Employee Group Health Insurance Policy. This is among the valuable group health insurance benefits offered to employees and their families.
• Donor expenses: Hospitalisation expenses incurred by an organ donor can also be claimed under the Group Health Plan.
• COVID-19 cover: Expenses related to the treatment of COVID-19 may also be covered under the policy, subject to applicable terms and conditions.
• Modern treatments: Provide coverage for modern treatments and advanced medical procedures, including robotic surgeries and stem cell therapy. 

ACKO offers additional healthcare benefits and optional add-ons that help businesses customise employee healthcare coverage. Commonly chosen add-ons and benefits are: 

• OPD coverage: For doctor consultations and pharmacy expenses
• Maternity and newborn cover: This includes prenatal and postnatal expenses
• Preventive care & well-being: This includes desk yoga sessions, stress management workshops, nutrition counselling and preventive health screenings