Health Insurance Plans For Family

A family health insurance plan, also known as a family floater plan, is a single health insurance plan designed for families. Such a plan covers all immediate members of a given family. Investing in health insurance for family is incredibly important as it allows you to get financial coverage if you or your family members are diagnosed of an illness. In such situations, your insurer covers your medical expenses up to the policy’s sum insured amount, which, in turn, saves you from using your accumulated savings to pay for medical treatment.

When you buy a Health Insurance Plans for family you have to pay a single annual premium, which is determined based on the age of the eldest member covered under the policy. Also, the sum insured amount applicable to such plans is distributed among all the covered members. So, if more than one member of a family needs medical coverage during a policy year, you can file claims and seek treatment, up to the sum insured amount applicable to the policy.

If you wish to enhance the sum insured on your family health policy, you can purchase top and super top-up plans with higher sums insured. The only criteria to utilize the top-up cover is to ensure that you have exhausted the base sum insured applicable to your family health coverage plan. Top-up and super top-up covers are typically available for an extremely low premium and may include 5x or 10x the sum insured amount of the base policy.

Medical insurance for family members typically covers all the individuals under an immediate family unit. For instance, if you are married and have children, you can get a family medical insurance plan covering you, your spouse and your dependent children up to the age as defined in policy terms and conditions. Similarly, if you are an unmarried or married adult with dependent parents but no children, you can purchase a plan that covers you, your parents, and your spouse. Some health insurance providers in India also allow you to add your in-laws to your family health insurance plans.

Medical insurance for family plans generally include all the basic covers afforded by insurers under a regular health insurance plan. A typical family health plan covers you for the costs of hospitalization, pre and post-hospitalization expenses, doctor consultations and surgeon’s fees, costs of medical reports and similar tests, the cost associated with renting a hospital room (up to a pre-determined sub-limit), the cost associated with your ICU stay (if applicable), the costs of using an ambulance in case of a medical emergency, the cost of daycare treatments, domiciliary expenses, hospital daily cash allowance, Covid-19 treatment, AYUSH treatments, and so on.

Yes, your health insurance provider is not liable to cover your costs under certain circumstances that are not deemed medically induced or necessary such as cosmetic enhancement procedures like rhinoplasty, liposuction, facelift, etc. Similarly, your insurer can refuse to cover treatment costs in case your hospitalization is caused due to self-inflicted harms (e.g., a suicide attempt) or certain, non-medical reasons or events leading to hospitalization, such as your participation in harmful practices like drug abuse, adventure sports activities, riots, and other acts of civil strife. How can I select the ideal family health coverage plan that suits my family’s insurance requirements? You must consider factors such as the scope of coverage and exclusions, the sum insured applicable to your policy and the premium you are paying against it, the network of hospitals with which the insurer has tied up, the limits and sub-limits applicable to your plan, and the waiting period attached to your insurance policy. It also helps to research about the insurer and check their claim settlement ratio, the time taken to settle claims and their customer reviews. Assessing these vital details can help you find the best health insurance for family members.

Yes, you can. Insurance companies in India allow you to add your infant child to your health insurance plan. However, you can add your baby to your existing policy only after the baby turns 91 days old, and not immediately. If you want coverage for your newborn baby in the first few months since their birth, you can always buy a maternity insurance policy or a maternity rider with your family floater or standalone/individual health insurance policy. Such a plan covers both, mother and child for up to 90 days after the baby’s birth.

While comparing different family health insurance plans, the first and most vital factor to consider is the insurance provider. Ensure you choose an insurer with a good market reputation – one with a high claim settlement ratio. You must also consider the scope of coverage and assess the inclusions and exclusions of the policy. Another vital factor to take into consideration is the sum insured applicable to your chosen policy, because it represents the maximum financial coverage you can get. Also look out for benefits or covers like sum insured restoration, no claims bonus, and so on.

You can pay your premiums for your family health insurance policy as a lumpsum once a year, or in monthly, quarterly, or half-yearly EMIs. If you choose the EMI premium payment method, you must opt for the online payment process using your debit card, credit card, net banking, or by setting up standing instructions. Insurers accept the same modes of payment for online lumpsum payments. Additionally, you can pay make offline lumpsum premiums payments via cheques and demand drafts.

Yes, all health insurance plans, including family medical insurance plans include a waiting period. Typically, you need to wait for 30 to 90 days to file your first claim for any general illnesses. However, if you add riders like maternity rider or critical illness rider, you must wait for up to 2-3 years to file a related claim. Additionally, if your health plan cover a person with a pre-existing illness, and if that person needs insurance coverage, they must ride out a 2-3 years waiting period before filing a claim.

Yes, under IRDAI regulations you are permitted to switch your existing family medical insurance policy to a different insurance provider through a process called portability. Essentially, you can port your policy only when it is due for renewal and start the porting process in the 45 days window before your policy is up for renewal. Additionally, your new insurer must agree to take you on, and you have to comply with the portability process as required by both insurers.

If you miss paying your health insurance premium, your insurer suspends your coverage benefits temporarily. If you file a claim during such a time, the insurer is not liable to accept, process, or approve your claim request. Insurers typically give you a 15-days grace period if you’ve opted for EMI premium payments and 30 days grace period if you choose the lumpsum mode of premium payment, wherein you can revive your policy. If, however, you do not pay the premiums before the grace period ends, the insurer has the right to terminate your insurance coverage.

Coverage for routine and preventive health checkups under a family health insurance plan may vary based on the product chosen.

Whether or not you need to undergo medical tests before purchasing health insurance for family depends on the ages and medical conditions of the individuals for whom you are buying insurance. For instance, if your family has four members with the oldest member being under 40 years of age, insurers may not insist on medical check-ups. However, if you or any of the covered members under your plan has any pre-existing illnesses, the insurer may ask you/them to undergo a medical test. Likewise, if you buy insurance in your 40s or if you intend to add your parents and/or in-laws to your family health insurance plan, then all of you may need to undergo medical tests.

Both Family and individual health insurance plans have their own merits. While the former covers all members under one plan, the sum insured is distributed among everyone. If you opt for the latter, the sum insured can be utilized only by the named policyholder, which proves helpful if the policyholder is diagnosed of financially draining illness. Additionally, if your compare the premiums of family health plans with buying an individual health insurance policy for each family member, you may find the former to be a more affordable option.

The number of people you can add to your family health insurance plan differs from one insurer to another. The standard rule is that you must add at least more than one person in the family health plan. Some insurers allow you to add only your immediate family members, i.e., your spouse and dependent children to a family policy, whereas others may permit you to add your married or unmarried siblings and parents to your policy. A few insurance providers in India also allow you to add your entire immediate family of spouse and children, your parents, and your parents-in-law to a family health insurance plan.