Think of an umbrella that shields both you and your family members, especially when you are sick or require medical assistance. That is the beauty of a family health insurance plan. It’s not merely about paying a bill to hospitals and doctors; it’s about providing comfort for you and your loved ones.
So, let’s understand family health insurance and its various aspects in detail.
What is Family Health Insurance?
A family health insurance policy is a type of health insurance scheme where several members of the same family are covered by one policy.
Unlike having specific insurance plans for each family member, a family health insurance policy targets the policyholder, the spouse, and the children who depend on that policyholder. This type of plan makes managing health insurance easy and is usually considered cheaper.
Read about: Tips To Find The Best Family Health Insurance Policy
Key Features of Family Health Insurance Plans
Family health insurance plans come with several key features that make them an attractive option:
Comprehensive Coverage
These plans usually encompass various medical fees, such as hospitalization, visits to physicians and specialists, prescription drug costs, and preventive care.
Cost-Effective
Traditionally, it is more cost-effective for individuals associated with a family to purchase a family-friendly plan rather than each person getting his or her plan.
Shared Benefits
Co-payments can be spread among family members to help them reach the thresholds for deductibles and out-of-pocket expenditures.
Flexibility
Most of the plans provide the flexibility of including new members in the family, such as a newborn.
Individual vs Family Health Insurance
When deciding between individual and family health insurance, consider the following differences:
Coverage
An individual plan entitles a person, and a family plan entitles more than one person under the same policy.
Cost
While group plans can cost more per capita than individual plans, they can be cheaper for the family.
Deductibles and Out-of-Pocket Maximums
Family policies usually allow one deductible and an out-of-pocket maximum for related family members, which is advantageous when many require medical attention.
Benefits of Family Health Insurance
Family health insurance plans offer numerous benefits. These are:
Financial Protection
They are employed to offer protection to insured persons against huge medical expenses.
Comprehensive Coverage
It entails that all the family members receive all the necessary medical services through these plans.
Convenience
It is also easier to contribute to a single-family policy than to get involved with many policies for each person.
Tax Benefits
Claiming rebates on premiums paid towards the family’s health insurance is possible.
Read about: 10 Common Exclusions in a Health Insurance Policy
Who Should Buy a Family Health Insurance?
Family health insurance plans are ideal for:
Young Families
Young families would like to maximize the utility of health insurance by covering all household members.
Middle-Aged Families
Families with teenagers or young adults will benefit, especially if the parent’s insurance doesn’t extend coverage to older children.
Extended Families
This plan particularly benefits families with elderly parents or disabled members who need additional health coverage.
Key Factors to Evaluate Before Purchasing a Family Health Insurance Plan
Here are a few key factors to consider when choosing a specific Family Health Insurance Plan:
Plan Coverage
Ensure it includes daycare, in-hospitalization, ambulance charges, and all pre and post-hospitalization costs. Select the one that can address your family’s health requirements and is within your ability to pay.
Increasing the Limit of Insurance
Opt for a plan that allows you to increase the sum insured upon renewal. Look for options that offer compound bonuses on top of the basic bonus, and consider raising your coverage limit if you haven’t made any claims.
Cashless Hospitalisation
Make sure the plan allows for cashless payments and provides the extent of hospitalization in the network hospitals. Also, make sure that the good hospitals within your region are in the health insurance company’s network.
Maximum Renewal Age
When selecting a plan, avoid one that can only be renewed up to the age of 60/65 years. Always prefer those that can be renewed for a lifetime.
Eligibility Criteria & Documents Required for Getting a Family Health Insurance
To purchase a family health insurance plan, you typically need to meet the following criteria:
1. Age:
- Adults: The age range for adults is typically between 18 and 65. However, some insurers may extend the age limit.
- Children: Usually covered from 90 days to 25 years, but this can vary based on the insurer.
2. Number of Family Members
Family floater plans generally cover 2 adults and up to 2-4 children. Some policies allow coverage for additional members at an extra premium.
3. Pre-existing Medical Conditions
Insurers may have a waiting period (usually 2-4 years) for pre-existing diseases before they are covered.
4. Medical History
A health check-up may be required for older family members or if there’s a significant health history.
5. Coverage Amount
Minimum and maximum sum insured limits vary by insurer and plan.
Documents Required for Health Insurance Plan for Family in India
Listed below are the documents you must arrange when applying for a family health insurance plan:
- Identity Proof: Aadhar Card, Passport, Voter ID, PAN Card
- Address Proof: Utility bills (electricity, water, etc.), Rent agreement, Aadhar Card, Passport
- Age Proof: Birth certificate, School/college leaving certificate, Passport, Aadhar Card
- Income Proof: Salary slips (if employed), Income tax returns (ITR), Bank statements
- Medical Reports: Medical check-up reports if required by the insurer.
- Passport-size Photographs: Generally required for each family member to be insured.
- Proposal Form: Duly filled and signed proposal form provided by the insurance company.
Read about: Is Health Insurance Exclusively Accessible Only Through Online Platforms?
Where to Buy – Online/Offline
You can purchase family health insurance plans through various channels:
Online
Undoubtedly, the convenience of purchasing health insurance online cannot be rivaled. You do not waste time filling in numerous forms or attending physical offices to seek the help of an advisor in comparing different plans.
Instant quotes from various insurance companies enable you to get the best insurance plan for your needs. Safe modes of payment, such as debit/credit cards, internet banking, wallet options, etc., make the transactions safe.
Your policy can be bought online and received in your email in a few minutes, reducing waiting time. You can also explore policy documents and after-sale services through a web portal or mobile application and submit the health insurance claim online.
Offline
Another option for obtaining insurance is through insurance agents, brokers, or directly from the offices of insurance companies. As a Claims Assessor, it’s crucial to understand how this method can offer additional guidance based on the specific nature of your queries.
Working with an agent or broker allows you to receive personalized advice tailored to your unique needs. You may also gain access to exclusive offers that are not available online. Additionally, engaging with a knowledgeable agent can help ensure you fully comprehend your policy, making it easier to make informed decisions about your coverage.
Conclusion
Regulating family health insurance plans is necessary to protect the family’s health and finances. The features, benefits, and options described in this paper will help you decide based on your family’s needs.
Regardless of the method you decide to use, ensure that you choose a policy that covers all areas of importance to you so that you get the best service.
