Difference between group health and individual health insurance

Group insurance vs individual insurance: explore the differences in coverage and benefits and how they help during medical emergencies.
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3 min
28-May-2025

Choosing between group insurance and individual insurance isn’t just a paperwork decision—it’s about securing your health the way you need it. Whether you're relying on an employer's plan or crafting a policy that travels with you, understanding the key differences ensures you're not left uncovered when it matters most.

With the cost of healthcare rising in India, even a single hospital visit can burn through your savings. Knowing which type of insurance offers you the right blend of affordability, flexibility, and security can be the difference between financial stress and peace of mind.

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Nutrition

Group health insurance

Group health insurance is offered by an employer or organization to its members. It covers multiple people under one master policy—usually employees and, sometimes, their families.

Here’s what makes it unique:

  • Lower premiums: Risk is shared among a large group.
  • No medical check-ups: Most policies skip pre-policy medical exams.
  • Immediate coverage: Waiting periods may be waived, especially for pre-existing conditions.
  • Limited flexibility: You may not be able to customize add-ons or increase the sum insured.
  • Ends with employment: Coverage lapses when you leave the company.

Not sure if your company plan is enough? Compare health plans starting at just Rs. 9.3/day for Rs. 10 lakh cover.
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Individual health insurance

Individual health insurance is a policy you buy on your own. You choose the coverage amount, add-ons (like maternity or critical illness), and the insurer.

Why choose individual insurance?

  • Custom coverage: Tailor plans to fit your life—be it post-retirement, self-employment, or family planning.
  • Portability: It stays with you, no matter where you work.
  • Add-on flexibility: You can enhance coverage with riders like OPD, annual health checkups, and more.

Confused between group and individual coverage? With Bajaj Finserv, you can stack both plans smartly—use group coverage for basics and individual insurance for large bills.
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Group health insurance vs individual health insurance

Category

Group Health Insurance

Individual Health Insurance

General Meaning

Covers employees under one master policy

Covers you and/or your family personally

Cost

Lower premiums

Higher premiums, but personalized

Enrollment

Through employer or group

Self-enrolled

Coverage

Uniform, fixed by employer

Fully customizable

Pre-existing Conditions

Usually covered from day one

Covered after a waiting period

Plan Termination

Ends when you leave job

Continues as long as you pay premiums

Who is Insured?

Employees and dependents (sometimes)

You and family members (if selected)

Purchaser

Employer or group

You

Control Over Plan

Employer decides terms

You have full control

Add-ons

Rarely available

Multiple optional add-ons

Claims

Cashless or reimbursement

Cashless or reimbursement

Eligibility Criteria

Usually for working professionals

Open to all above 18 years

Tax Benefits

Employer gets benefits

You can claim deduction under Section 80D

Maternity Benefits

Only if included

Can be opted as an add-on

No Claim Bonus

Not applicable

Increases sum insured over time

Medical Check-ups

Not required

May be needed for higher covers or age groups

Group health vs individual health insurance: Similarities

Despite their differences, both group and individual health insurance share these benefits:

  • Cover hospitalization, surgeries, and day-care procedures
  • Offer cashless claims at network hospitals
  • Provide tax savings under Section 80D
  • Include pre- and post-hospitalization expenses

Looking to switch or enhance your health cover? Get free quotes, compare plans side by side, and choose what fits—online in 2 minutes.
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Choosing the Right Plan

Here’s how to decide:

  • Choose group insurance if you're salaried and need basic cover without extra cost.
  • Choose individual insurance if you want lifelong coverage, add-ons, and independence from your job.
  • Choose both if you want comprehensive protection.

In India, with rising healthcare costs and dynamic job scenarios, many prefer maintaining a base individual plan along with group coverage. That way, even if your job changes, your health cover doesn’t.

Frequently asked questions

What is group health insurance?

Group health insurance is a policy that covers a group of people, such as employees of a company or members of an organization. Group health insurance policies are typically offered by employers, labour unions, and other organisations.

What is individual health insurance?

Individual health insurance is a policy that an individual purchases to cover themselves. This type of policy is personalised to the individual's needs and is not tied to a particular employer or organisation.

Which is more cost-effective, group health insurance or individual health insurance?

Group health insurance is generally more cost-effective than individual health insurance because the risk is spread across a larger group of people.

Can I purchase individual health insurance through the Health Insurance Marketplace?

Yes, you can purchase health insurance policies through a Health Insurance Marketplace. One such option is the Bajaj Finance Insurance Mall that offers multiple health insurance policies.

Can a person have both group health insurance and individual health insurance plans?

Yes, a person can have both group health insurance and individual health insurance plans. If a person has group health insurance through their employer or any other organisation, they can still opt for an individual health insurance plan for additional coverage. In such a case, the individual health insurance plan would function as a secondary insurance policy, covering any expenses not covered by the group health insurance policy.

What are the advantages of a group health insurance plan?

There are several advantages of a group health insurance plan. Firstly, the premium for a group health insurance plan is lower than an individual health insurance plan since it covers several individuals under the policy. Secondly, having a group health insurance plan benefits the employers or organisations, as it assures their employees or members financial security. People insured under the plan can avail the policy benefits during any medical emergencies. Lastly, group health insurance plans may provide additional benefits such as dental and vision coverage.

What are the advantages of an individual health insurance plan?

The advantages of individual health insurance plans depend on the specific policy chosen and the needs of the policyholder. Some advantages of an individual health insurance plan include the flexibility of choosing a policy that suits the policyholder's unique needs. You can avail of cashless facility at network hospitals and get treatment without worrying about immediate funds. Individual health insurance has a higher coverage limit compared to group health insurance plans. Additionally, individual health insurance plans may come with additional benefits such as accidental coverage and critical illness coverage.

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Disclaimer

*T&C Apply - Bajaj Finance Limited (‘BFL’) is a registered corporate agent of third party insurance products of Bajaj Allianz Life Insurance Company Limited, HDFC Life Insurance Company Limited, Future Generali Life Insurance Company Limited, Bajaj Allianz General Insurance Company Limited, SBI General Insurance Company Limited, ACKO General Insurance Limited, ICICI Lombard General Insurance Company Limited, HDFC ERGO General Insurance Company Limited, Tata AIG General Insurance Company Limited, The New India Assurance Company Limited, Cholamandalam MS General Insurance Company Limited, Niva Bupa Health Insurance Company Limited , Aditya Birla Health Insurance Company Limited, Manipal Cigna Health Insurance Company Limited and Care Health Insurance Company Limited under the IRDAI composite CA registration number CA0101. Please note that, BFL does not underwrite the risk or act as an insurer. Your purchase of an insurance product is purely on a voluntary basis after your exercise of an independent due diligence on the suitability, viability of any insurance product. Any decision to purchase insurance product is solely at your own risk and responsibility and BFL shall not be liable for any loss or damage that any person may suffer, whether directly or indirectly. Please refer insurer's website for Policy Wordings. For more details on risk factors, terms and conditions and exclusions please read the product sales brochure carefully before concluding a sale. Tax benefits applicable if any, will be as per the prevailing tax laws. Tax laws are subject to change. Tax laws are subject to change. BFL does NOT provide Tax/Investment advisory services.  Please consult your advisors before proceeding to purchase an insurance product. Visitors are hereby informed that their information submitted on the website may also be shared with insurers. BFL is also a distributor of other third-party products from Assistance Services providers such as CPP Assistance Services Pvt. Ltd., Bajaj Finserv Health Ltd. etc. All product information such as premium, benefits, exclusions, sum insured, value added services, etc. are authentic and solely based on the information received from the respective insurance company or the respective Assistance service provider company.

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