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Health Insurance Plans for Family

We are taught as kids, “Health is wealth”. However, with age, we tend to forget the seriousness of these three words. People don’t willingly fall sick, but each of us requires proper medical care at some point in life. The consultation fees, diagnostic tests, medicine costs, etc. prove to be quite burdensome even for treating the simplest of ailments. It can be further intensified if more than one person in your family gets affected. This is where the issue of family health insurance arises.

What is a family health insurance plan?

As the name suggests you can well understand that a family health insurance plan covers you as well as your family in the case of any medical contingency. This eases your overall tense recovery procedure, without worrying about money without compromising the quality of treatment.

Maintaining proper family health insurance coverage has become a necessity for every Indian family, because of the skyrocketing medical treatment costs. A couple of days of hospitalisation is enough to wipe off a significant part of your savings. So it is better to stay prepared for such emergencies beforehand for efficient finance management.

How is a family health insurance plan different from an individual health insurance plan?

The essential difference between floater health insurance and individual health insurance is that the former covers all the family members included in the plan and divides the entire sum insured as well as the premium among all the members included.

However, an individual health plan exclusively covers the concerned policyholder only. The premium amount and the sum insured remain dedicated to that individual alone.

You must remember that the coverage span of a family floater plan must be enough to cater to the standard requirements of all the family members. If the entire sum assured is used up by a single member, then despite the family floater policy, the other family members will be left with nothing.

What are the benefits of buying a health insurance plan for a family?

A hectic, stressful lifestyle clubbed with faulty eating habits and lack of proper physical exercise is raising the number of lifestyle diseases every day. The treatment costs of such ailments are on the rise. Therefore, a family floater health plan might act as a protective saviour here.

Some of the most highlighting benefits of purchasing family health insurance over individual insurance are:

  1. Entire family coverage:
    As the name suggests, a family health plan will cater to financial coverage of the treatment costs for all the members of the family included in the plan. Under standard circumstances, “family” includes yourself, your spouse, dependent parents, and dependent children. The scope of certain specific plans even extends up to dependent parents-in-law.

  2. Affordable premiums:
    When compared to an individual health insurance plan, family health insurance plans are far more affordable. This is because, for a family floater plan, you need to pay a lump sum premium that covers all the family members. You need not have to pay premiums separately for each member. This keeps it reasonable and budget-friendly.

  3. High coverage for each member:
    All the family members are permitted to use the entire amount of the sum insured if the need arises. This keeps the coverage limit quite high. This facility is possible if you choose to set a maximum coverage limit.

  4. Several plans allow maternity coverage:
    Welcoming a small new family member is not only a matter of happiness but that of responsibility too. Several family floater health insurance plans have been designed to cover maternity benefits, to ensure the best coverage for both the new baby and the mother. All maternity-related expenses are covered under this scheme.

  5. Choosing comprehensive coverage:
    Before settling For a befitting family floater health plan you need to thoroughly research different plans to ensure which one offers you the best inclusive coverage benefits. Then your family can effortlessly enjoy effective coverage.

  6. Effortless addition:
    Under the scope of a family floater health plan, you can easily add new family members. If you get newly married, or you welcome a new baby, you can easily add them under the purview of the chosen plan, depending on the prevalent terms and conditions. In exchange for an additional premium, you can enjoy this facility.

  7. Tax benefits:
    This is one of the most significant benefits of investing in family health insurance. Under normal circumstances, you can enjoy tax benefits up to ₹ 25000, which rises to ₹ 50000, if the policyholder is a senior citizen.

List of top 10 best health insurance plans for a family in India

PLAN NAMENAME OF THE COMPANYENTRY AGEVALUE-ADDED SERVICESAPPROXIMATE NUMBER OF NETWORK HOSPITALS
ICICI Lombard Complete Health Insurance PlanICICI Lombard From 6 years onwards. Dependent children aged between 3 months and 5 years are covered under this scheme  Pre- and post-hospitalisation costs; free health check-ups; AYUSH treatments,  nutrition and dietician costs, physiotherapy, vaccination, etc. Over 6300
Star Comprehensive Insurance PlanStar Health InsuranceAnyone aged between 3 months and 65 years,  can be included in the planMaternity coverage; additional coverage; health check-ups; several complicated medical procedures; automatic restoration; easy inclusion,  etc. Over 7900
Care Healthcare Insurance PlanCare Health InsuranceAnyone from 91 days onwardsAdvanced medical treatment procedures; in-patient hospitalisation; free health check-ups, etc. Nearly 8500
Aditya Birla Activ Health Platinum Enhanced Insurance PlanAditya Birla Health Insurance Company LimitedFrom 91 days onwardsExpenses for advanced medical treatment; health returns up to 10%; hospitalisation costs for treating mental ailment; international medical assistance; costs for wellness coaching,  etc. Over 6000
Manipal Cigna ProHealth Protect Insurance PlanManipal Cigna Health InsuranceFrom 91 days onwardsDaily cash benefits in case of hospitalisation; special cumulative bonus facility; maternity and neonatal care expenses;  fee health check-up facility, etc. More than 6500
Niva Bupa Reassure PlanNiva Bupa Health InsuranceFrom 18 years onwards Acute care boosting facility,  advanced disease management and care,  etc.  More than 14000
HDFC ERGO Optima SecureHDFC ERGO Health InsuranceFrom 18 to 65 yearsMedical kit expense coverage; fast cashless claim settlement; zero co-payment; no room rent capping, etc. More than 12000
Future Health SurakshaFuture Generali Health InsuranceFrom 90 days to 70 yearsPre- and post-hospitalisation costs; cost for in-patient treatment; no claim bonus; free health check-ups; cumulative bonuses;  premium discounts; etc. Over 5000
Family Floater MediclaimThe New India Assurance Company LimitedUp to 65 yearsDomiciliary treatment costs; ambulance charges; donor costs, AYUSH,  free health check-ups, etc. Over 2000
Happy Family Floater PolicyThe Oriental Insurance Company LimitedUp to 65 yearsIn-patient hospitalisation costs; domiciliary treatment costs; donor charges; AYUSH; free health diagnosis, etc. Nearly 5000

Why should opt for a family health insurance plan?

A family Health insurance is an all-inclusive plan that effectively covers all the members of a family. A single policy is enough to ensure complete health protection for the entire family.

You can even modify the members covered in a particular plan. If there is a marriage or childbirth in the family, you can easily make the necessary changes with the help of your insurance provider.

A family health plan ensures cashless hospitalisation across the nation. Certain insurance providers even extend their services internationally. Before choosing the plan, you must ensure the list of network hospitals included in it.

Your health insurance investment will prove to be quite budget-friendly. The premium payment amount for a family floater plan is comparatively far less than maintaining individual health plans. Moreover, you can claim tax benefits u/s 80D of the IT Act because of this investment.

Why online?

It is best to buy family health insurance online these days. You can enjoy the comfort of your home and secure your health along with all your family members. You can easily do thorough research about several companies and different plans, keeping your requirements in mind. This will clarify which plan will work best for you and then you can proceed accordingly.

Online purchase of health insurance is very fast and smooth and requires almost zero paperwork. It is convenient and hassle-free.

Things to consider before buying a family health insurance plan

Insuring the health of yourself and your beloved family members is not a matter of joke and must be taken seriously. While choosing the most suitable family health plan, you need to consider certain crucial factors:

  1. Timing
    Timing is everything here. The earlier you purchase your family health plan the better. It is best to buy when you are young and the family responsibilities are comparatively low. As your family grows, you can make the necessary modifications to suit your current needs. Early purchases will keep the premium low, allowing optimal coverage.

  2. Coverage
    The market is overloaded with various types of health insurance policies. But not every plan is equally beneficial for every family. The requirements differ in each case. This is best specified by the coverage scope of every plan. Before buying, make sure that your plan provides daycare treatment facilities, room rent capping, etc. to avoid any future misunderstandings.

  3. Premium amount
    This is one of the most crucial factors. It is dependent on the coverage scope of the chosen plan along with the additional riders added. In the case of family health policy, the age of the eldest family member included in the plan, the term of the concerned plan, etc. are also taken into consideration to determine the premium value.

  4. Insurance provider
    The goodwill of the concerned insurance provider plays a significant role. Goodwill and trustworthiness are a matter of consistent effort and deficient management. While choosing the health plan for your family, always make sure that you opt for a renowned company. Customer reviews can help you significantly in this respect.

Common inclusions in a family health insurance plan

Any standard family health insurance plan maintains certain common inclusions, irrespective of the concerned insurance company or the type of plan. Such inclusions include:

  1. Allows in-patient hospitalisation expenses if the insured individual remains hospitalised for over 24 hours.
  2. Allows pre-and post-hospitalisation expenses including consultation fees of doctors, diagnostic tests, investigations, etc. for a specific tenure before and after hospitalisation.
  3. The cost of an ambulance during any medical emergency is covered under any standard family health policy.
  4. Daycare treatment costs are covered when the insured individual(s) remains hospitalised for less than 24 hours like in the case of cataract surgery, and other similar processes.
  5. Domiciliary treatment costs are permitted to be covered when the insured individual(s) is/are treated at home for certain specific ailments listed in the chosen plan.
  6. Expenses for organ donation are a matter of significant financial burden. Most of the standard family health plans cover such expenses, without letting you compromise or worry about the financial aspect during the treatment and recovery process.
  7. Under normal circumstances, AYUSH costs are also covered. This implies alternative medical treatment processes like Ayurveda, Yoga, Unani, Siddha, and homoeopathy.
  8. Any vaccination resulting from any animal bite gets covered under the family health plan.

Common exclusions in a family health insurance plan

Certain common factors remain excluded from the purview of any standard Health insurance plan under normal circumstances. Such exclusions include:

  1. Any claim raised within 30 days of purchasing the health plan except for any accidental circumstance.
  2. Any pre-existing ailment that is not covered under the chosen plan before a specific pre-defined tenure.
  3. Any sort of STD like HIV or AIDS, etc.
  4. Any self-inflicted or suicidal injury.
  5. Any sort of cosmetic or aesthetic treatment costs.
  6. Any sort of unapproved or experimental medical treatment procedure.
  7. Any OPD treatment procedure unless it is specifically included in the chosen plan.
  8. Any other additional exclusions that are mentioned in the concerned plan.
  9. Sports injuries.
  10. Injuries are caused while doing any illegal activity.
  11. War injuries.
  12. Treatment costs for any congenital ailments, anomalies or defects.
  13. Rehab cost for any drug abuse or alcoholism.

Eligibility criteria to buy a family health insurance plan

For purchasing a health insurance plan for your family, you need to fulfil certain standard criteria. Although the exact conditions differ from one plan to another. However, the standard basic criteria remain unaltered. Such common eligibility criteria include:

  1. Family members who can be covered
    The standard inclusions of a family health insurance plan include self, spouse, and dependent children, who can be both adopted or biological. The coverage scope is largely varied premiums are to plan beyond this. Some plans include dependent parents, while some don’t. Certain plans even include parents-in-law, siblings, cousins or any other relatives.

  2. Amount of sum insured
    The average range of sum insured for a family health plan may extend from ₹ 1 lakh to ₹ 6 crores. Considering your familial requirements, you can carefully choose the amount of sum insured. The premium is decided accordingly. However, if any of the members included in the plan, suffers from any severe medical condition, the insurance plan may put a limit to the optimum sum insured.

  3. Tenure of the plan
    Every standard family health insurance policy offers single-year coverage. However, if you pay the aggregate premium, some plans even allow coverage for two or three years at one go.

  4. Age
    The proposer needs to be at least 18 years of age to buy a family health plan. Certain plans maintain the maximum entry age limit at 65 years, under most circumstances, dependent children are covered for 90/91 days. Under a standard floater plan, most of the dependent children are covered for up to 23 or 25 years, as per the terms and conditions of the particular chosen plan.

  5. Pre-existing ailments
    Before purchasing a family health plan, the insurance provider may ask all the family members included in the plan to undergo certain medical investigations to understand if they have any pre-existing medical conditions. You need to serve the waiting period before raising any claim for treatment costs of any pre-existing ailments like thyroid, diabetes, hypertension, etc.

How to file a claim for a family health insurance plan?

Every insurance company follows a standard protocol for claim settlement for a family health insurance plan. Under normal circumstances, you need to follow a few simple steps to fulfil the procedure:

  1. First, immediately inform the concerned insurance provider regarding the claim settlement issue
  2. If your plan offers a cashless treatment facility, then you must avail of treatment from any of the listed network hospitals
  3. For cashless claim settlement, you need to sign a pre-authorised form at least 3 or 4 days before a planned hospitalisation or within 24 hours in case of emergency hospitalisation.
  4. The concerned insurance provider must approve this pre-authorisation form to enjoy a cashless treatment facility.
  5. During discharge, you must fill out another form, the claim form, along with all the relevant medical documents, related to the specified claim
  6. The concerned insurance provider will verify the alleged documents before the claim settlement
  7. In the case of a reimbursement claim, you can be admitted to any non-network hospital. You have to pay the bills by yourself. After discharge, you must submit your claim to your insurance provider along with all the original bills and documents for reimbursement.

Frequently Asked Questions

Yes, generally there exists a waiting period factor for most types of family health insurance, ranging between 30 days and 90 days, before which the plan does not become active. In the case of any pre-existing ailment, the waiting period ranges between 3 and 4 years, depending on the terms of the chosen plan.

You can renew a family health plan not before 15 days of expiry. You can visit the official portal and enter certain basic details like policy details, plan expiry date, etc. Make the payment online, and you will receive a digitally signed copy of the renewed plan. You can even avail of the details of the renewed plan on the official portal of your insurance provider.

A family floater health insurance policy is like an umbrella plan that covers multiple members of a family. A single amount sum is insured and any member, included in the plan, is eligible to make a claim up to that margin.

If you feel that the sum insured is insufficient for your family health plan, you can enhance it during renewal. For a reasonable coverage enhancement, you can even opt for a top-up or a super top-up plan along with the basic plan.

Yes, you can do so. However, the claim settlement procedure is easier if the insurance provider remains the same.

Leading Health Insurance Companies

Manipal cigna health insurance
Aditya birla capital
STAR health insurance
NIVA HEALTH INSURANCE
care health insurance

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