Health Insurance Plans for Family

Family health insurance coverage policy is also popularly known as family floater health plans. They are one of the most common types of health care plans available in the Indian insurance market. The purpose of the plan is to cover each and every member of your family under a single umbrella policy.

The cover is provided in the form of the sum insured, which is divided on the basis of the number of family members or as a whole amount for the entire family. The cover is available in the form of financial aid utilized to pay off hospital bills, treat illness, doctor’s fees, cost of medical treatment, and accidental emergency injury.

Under a family floater plan, you can include yourself, your spouse, dependent children, parents, and in some cases, even parents-in-law. Each member of your family can make a claim of up to the total sum insured. In addition to the basic cover, family health insurance policies also include cover for expenses/hospitalization bills related to COVID-19.

6 Benefits of Buying Family Health Insurance Plans

Here is a list of India's top family healthcare policies for 2021, along with the maximum age at entry and sum insured. Call us on 1800 209 9930 to learn more about each plan.

Disclaimer: The information given above has been sourced from the official website of the respective insurance providers. (Last updated on 18th August 2021)

If you are a family guy, you must purchase a comprehensive health insurance plan for yourself and your family. Here are the key benefits of a family floater health care plan:

• Covers Cost of Treatment - With a family health policy, you no longer need to worry about getting your loved ones hospitalized. A family cover comes at the cost of an affordable premium, payable as an annual installment. Besides, if you do not have sufficient balance at the time of your hospitalization, you can always avail of cashless hospitalization. You will be stress-free as the financial obligation will be borne by the health insurance provider.
• Critical Illness Cover - This is a very important factor. Critical illnesses can take a complete toll on your family’s emotional, physical, mental, and financial well-being. Critical illnesses are life-threatening diseases that might leave you impaired or recovering for a prolonged period of time.
• Online Buying - Another important benefit of a family healthcare coverage policy is that it can be purchased online. You no longer need to visit the bank branch or meet with an insurance agent. With Coverfox, you can easily company, buy, and renew the best health insurance policy online at a click of a button.
• Covers COVID-19 - Due to the ongoing pandemic, existing insurers have included cover for expenses related to COVID-19, doctor’s fees, PPE kits. The Insurance Regulatory and Development Authority of India has directed all private and public general insurers to offer Corona Rakshak, and Corona Kavach Plans at a nominal premium.
• Customize Health Policy - You can add a wide range of rider options to your existing or new healthcare policy at the cost of an affordable premium.
• Tax Benefits: Premiums paid towards a health insurance coverage policy are eligible for tax deduction under Section 80D of the Income Tax Act, 1961.

You, your spouse, dependent children till the age of 25 years, senior parents, and in some cases, even parents-in-law can be covered under a family floater policy.

Eligibility Criteria for Family Health Insurance Policy is as follows:

• Entry Age for the Policyholder/Proposer under Family Health Insurance: In family health insurance, the eldest person becomes the policyholder. The entry age for a policyholder/proposer is from 18 to 65 years, while some insurance company may allow it up to the age of 70 years and above.
• Entry Age for Family Members under Family Health Insurance: For Adults: The minimum entry age is 18 years and the maximum 65 years, while some insurance company may allow it up to the age of 70 years and above. For Dependent Children: The minimum age to children under the family health insurance is from 90 days (this may vary, some insurers may allow it from 30 days and some may have different entry age) to 25 years.
• Medical Tests under Family Health Insurance Plan: Few insurers ask for medical tests to be carried out at their nominated centers. While few insurers offer family health insurance policy up to certain age, say, 45 years without any medical tests. In some instances, insurers may make medical check-up as mandatory.
• Eligibility for Renewal of Family Health Insurance Plan: Almost all the insurance companies offer lifelong renewal. You need to renew your family health insurance policy every year to keep in force and renew before it expires. After the due date of renewal the insurance company gives a grace period of 30 days. If you want to keep the policy in force, you must renew before grace period ends or else the policy terminates.

Health insurance plan for family covers in-patient hospitalization, pre-hospitalization, post-hospitalization, day care, health check-up, emergency ambulance service, etc. Let's see each in detail:

• In-patient Hospitalization: All the medical expenses due to hospitalization are covered. In case, if any of the insure family member is hospitalized for more than 24 hours, the insurance company will pay the medical expenses.
• Pre-hospitalization Expenses: Any medical expenses incurred before hospitalization are termed as pre-hospitalization expenses. For example, X-ray, MRI, blood test, urine tests, sonography results, etc. done before hospitalization are covered.
• Post-hospitalization Expenses: Any medical expenses incurred after the discharge from hospital are termed as post-hospitalization expenses. For example, medicines, or any medical tests done after the discharge to check the improvement.
• Ambulance Charges: Most of the insurance companies offering family health insurance plan covers emergency ambulance charges. The amount of the emergency ambulance charges varies from insurer to insurer.
• Hospital Cash: The insurance company provides daily cash allowance. This hospital cash can be utilized to cover the cost of the transportation or other basic requirements of the person attending the patient.
• Restore Benefit: Many health insurance companies offer restore benefit feature under family health insurance plan. This feature helps to reinstate the basic plan cover in case the coverage gets exhausted. However, restore benefit is applicable only for unrelated claims.
• Day care treatment: Day care treatments are the treatments that does not require 24 hours of hospitalization. For instance, medical expenses related to cataract which can be treated within few hours.

Here is the list of few exclusions of a family floater health insurance plan

• Any claim raised within the 30 days waiting period of the health insurance policy. issuance wouldn’t be covered unless and until it arises due to the accident.
• Any sexually transmitted diseases.
• Any treatment related to fertility issues.
• Any treatment and expenses incurred due to routine medical check-ups.
• Any treatment/surgery done for gender reassignments or for gender change.
• Artificial life maintenance, including life support machine use, where recovery or restoration of the previous state of health is not possible.
• Any treatment undergone due to surgery or a plastic surgery, aesthetic treatment, or any further consequences due to such treatments.
• Treatment of stress, mental illness or any psychological disorders, or due to the abuse of stimulants or depressants.
• Any OPD Treatment.
• Any treatment undertaken abroad.
• Any Illness or Injury directly or indirectly causing or arising because of breach of any law by the insured who has a criminal intent, war, nuclear, chemical or biological attack or weapons, acts of foreign enemies, hostilities, civil war, rebellion, revolutions, insurrections, mutiny, military or usurped power, seizure, capture, arrest, restraints and detainment of all kinds.
• Illness or Injury caused due to consumption or abuse of tobacco, intoxicating drugs and alcohol or hallucinogens.
• Any act of self-inflicted injury, suicide or attempted suicide while sane or insane.
• Any treatment related to pregnancy (including voluntary Termination), childbirth, maternity (Including caesarian section), miscarriage (unless due to an Accident), abortion or complications of any of these. However, this Exclusion will not apply to ectopic pregnancy.
• That’s the list of few common exclusions of a family health insurance plan. However, one must refer and read policy wordings for the full list of exclusions.

• KYC- Proof of Address and Proof of Identity for all family members.

• Age Proof- Birth Certificate.

• Photo- 2x Passport size photographs of each family member.

• Medical Report- Medical tests/checkups/report for certain family members above the age of 45 years.

Since the advent of internet banking, all health insurance providers have enabled the online facility of policy renewal. You simply have the visit the official website of the respective insurer and log in with your registered user ID/password. Once logged in, select the option for renewal and make the payment online via net banking/credit/debit card etc.

The claim process of Family Health Insurance can be understood as mentioned below

Cashless Claim Process:

• Go to the insurance desk of Network hospital.

• Provide ID card for identification.

• Pre-authorization form to be filled and submitted.

• TPA checks the documents and approves the cashless claim

• The insurer also assigns a field executive who makes the claim process easy for the policy holders.

Reimbursement Claim Process

• When discharged, the policy holder should pay all the hospital bills and collect all original documents.

• The reimbursement claim form needs to be submitted to the claims team of the insurer or TPA along with all the required forms, hospital and medicine bills, medical and consultation reports and bills and any other document as required in original.

• The claim will be validated by the Insurer/TPA and then cleared as per the policy terms and conditions.

Fast-paced life, junk food on the go, pollution taking deeper roots across the country, unfortunate incidents, road accidents, contagious diseases, heart attacks and diabetes in young age, and many more things may result in any kind of medical emergency.

Are you prepared?:

Rising medical inflation can wipe off your lifetime's savings. You don't want that. Since, a medical emergency comes without any prior notice to anyone irrespective of age, gender, and location, it is better to have a health insurance plan. Take care of your loved ones - spouse, parents, and children and cover their medical cost with the help of a family health insurance plan.

Family Health Insurance Premium Calculator

The incorporation of the health insurance premium calculator by most of the health insurance providers on their official portal has digitalized the process of the health insurance premium calculation. Earlier it was unavoidable to make manual errors but today due to the availability of the family floater health insurance premium calculator, life has definitely become hassle-free and easier for insurance companies as well as for the people looking for health insurance.

A family health insurance premium calculator is easy to use. In order to use the simplified health insurance premium calculator page, you can follow the below-mentioned steps:

• All you need to do is select the family members you wish to include in your family floater health insurance policy
• Enter your gender and your area pin-code
• Then the system will prompt you to enter the age of the selected family members
• Enter your mobile number and your email address (optional)
• The different competitive quotes will reflect on your screen

Is There Any Waiting Period in a Family Health Insurance?

• An Initial Waiting Period: This refers to the waiting period of 30 days but may vary from insurer to insurer and may have even 90 days of waiting period from the date of policy issuance. However, any medical expenses arising due to an accident will be covered from day one.
• Check for Specific Waiting Period: Every family floater insurance provider specifies a list of specified illnesses for which any claim shall not be admissible during the first 1 or 2 years, which is called specific waiting period. For example, arthritis, benign ear, nose, and throat disorders, cataract, hernia, kidney stone, etc.
• Pre-existing waiting period: If any of the family member insured under a family floater plan is suffering from any pre-existing diseases such as hypertension, diabetes, any heart ailments or any other ailment at the time of purchase of family health insurance plan is not covered for a specific time period. The treatment for a pre-existing disease is covered after the waiting period. The pre-existing waiting period may vary from 1 year to 4 years depending on the insurer. But, mostly the waiting period for pre-existing diseases under a family floater plan is 4 years.