- Right Cover Amount: If you are thinking about covering your entire family, consider choosing a sum insured that is large enough to take care of the whole family's health needs. Here take into account the age of the eldest family member.
Suppose you include your parents into your health insurance plan; when they face a medical emergency, their treatment expenses will eat away a large portion of the sum insured and leave a tiny amount for use among the remaining family members for the remaining policy year.
So, go for a sum insured that ranges around Rs. 5 to 10 lakhs; this way, all family members are adequately covered.
Check Policy Inclusions: After zeroing on the sum insured, check what the family health plan offers. It should, most importantly, include:
a. Cover for a large number of family members, i.e., Self, Spouse, Children, and Parents or Parents-in-law (compulsorily)
b. Cover for a wide range of medical conditions\
c. Daycare Procedures (higher the better)
d. Pre and Post-Hospitalization (pre-hospitalization expenses should be covered for a minimum period of 30 days and post- hospitalization expenses should be covered for a minimum period of 60 days)
Cashless Treatment Facility
e. In-patient Hospitalization Expenses
f. Domiciliary Treatment Expenses
h. AYUSH Benefit
i. Ambulance Benefit
j. Critical Illness Cover
k. Maternity Benefits
l. Daily Hospital Cash Benefit
m. Free Annual Health Check for the entire family
n. Worldwide Cover
- Flexibility To Add New Members: Your family floater health insurance plan must have the flexibility of including new members into the cover without undergoing any lengthy and tedious procedures.
Like when you bought the health insurance plan, you were just 4 people, i.e., Self, Spouse, and Parents. A few years later, you become a proud parent.
Now including your baby into your family, the health insurance plan must be easy, or say, one of your elder parents passes away, removing them from the family floater plan must be easy.
This way, you can continue enjoying the accrued benefits. If the current policy gets terminated and you would have to buy a new one, it results in a significant loss.
Waiting Period: Check the waiting period applicable to your plan. All plans have a waiting period, ranging from 24 months and goes up to 48 months; only after completing this waiting period, pre-existing diseases are covered. Lower the waiting period better is the plan for you. This way, all pre-existing medical conditions will get covered within no time at all.
Co-Payment: This is the most important term that you should be well versed with. Co-Payment means the general insurance company will pay the claim amount only after you have paid a particular percentage of the claim.
Say a health insurance plan has a 10% co-payment clause, and you make a claim of Rs. 1 lakh. Now in this scenario, you will first have to pay Rs. 10,000, and the insurance company will pay the remaining amount of Rs. 90,000.
Hence, it would be best if you went for a plan that does not have a co-payment clause. However, remember that family health insurance plans without a co-payment clause are slightly costlier than a health insurance plan with a co-payment clause.
- Sub Limits: This is another clause that is as important as the co-payment clause. Sub-limits essentially means that the insurance company caps certain treatment expenses.
Like, you have to undergo a cataract surgery procedure to undergo. The insurance company has put a cap of Rs. 50,000 per eye. So, if the hospital bill is Rs. 65,000, you will have to pay Rs. 15,000, and the insurance company will pay Rs. 50,000.
Like with the co-payment clause, you should select a family health insurance plan that does not have sub-limits. This way, you get to use the entire sum assured without any worries.
Lifetime Renewability: Lifetime renewability is a significant factor that must not be missed out. A family floater health insurance plan with lifetime renewability is a boon for you and all your family members. The need for a health insurance plan becomes most evident in the later years of life. If a health plan does not allow you to continue utilizing its benefits when needed, it is no use investing in.
Room Rent: What will you prefer when hospitalized, a single private room, a semi-private room, or a shared room. It is best to have a health insurance plan that gives you a single private room. This way, you will have complete peace while undergoing treatment at a hospital without worrying about a huge hospitalization bill.
Network Hospitals: You can avail of cashless hospitalization facility only at network hospitals. So, ensure that you choose a health insurance plan with many hospitals under its network, especially within your locality. This way, your family members can easily access cashless treatments at the hospital even during late hours.
In case of an emergency, a network hospital will start treatment immediately, waiting for you first to deposit some money. All you have to do is present the health card at the time of admission. You can complete the remaining formalities within the next 2 days.
