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HEALTH INSURANCE

Family Floater Health Insurance Plan

Sagar Chikane 11 December 2015

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.

Family Floater Health Insurance Plan

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.

Why Buy Family Health Insurance?

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.

Who Can be Covered in a Family Floater Plan

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.

Best 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.

Best Health Insurance Plans for Family Minimum Entry Age Maximum Age Renewability Sum insured
Care Health Plan
91 days
No Age Bar
Lifelong
NA
HDFC ERGO Optima Restore Family
91 days
65 Years
Lifelong
NA
HDFC ERGO - my: Health Suraksha
Any Age
No Age Bar
Lifelong
Rs. 3 lakh to Rs. 75 lakh
Oriental Happy Family Floater Mediclaim Plan
NA
65 Years
Lifelong
Rs. 2 lakh to Rs.20 lakh
Bajaj Allianz Health Guard Family Floater Plan
18 Years
65 Years
Lifelong
3 Lakh to 50 Lakh
Star Family Health Optima Plan
18 Years
65 Years
Lifelong
1 Lakh to 25 Lakh
SBI General Retail Health Insurance
Age of 3 Months
18 Years
Lifelong
2 Lakh
United India Family Medicare Policy
18 Years
80 Years
Lifelong
Rs. 2 lakh to Rs. 10 lakh
New India Family Floater Mediclaim Policy
18 Years
65 Years
Lifelong
Rs. 2 Lakh to 15 Lakh
National Insurance National Mediclaim Policy
18 Years
65 Years
Lifelong
Rs. 50,000 to Rs. 5 lakh

Disclaimer: The information given above has been sourced from the official website of the respective insurance providers. (Last updated on 5th January 2021)

Top Five Family Floater Plans in India for 2021

Here is a list of the best family floater policies in India along with their in-built features and annual premium amount

  • Max Bupa Health companion individual Plan
  • Royal Sundaram Health Lifeline supreme Plan
  • Aditya Birla Health Diamond Plan
  • Religare Health NCB super premium Plan
  • Star Health Family Health Optima Plan
  • ManipalCigna Health Prohealth Plus Plan
  • Apollo Munich Health Optima Restore Plan
  • HDFC ERGO Health Suraksha Gold Regain Plan
  • Universal Sompo Health Privilege Plan
  • Star Health Senior Citizen Red Carpet Plan
  • PNB Oriental Royal Mediclaim Policy

All information has been sourced from the official website of the respective insurers. (Last Updated on 5th January 2021)

The premium mentioned above is subject to change depending on the number of family members, no pre-existing diseases, no smoking/alcohol habits, and the sum insured.

In Simple Words,

A family health insurance cover should be a must-buy for your family. There is nothing better than providing excellent healthcare to your family at all times. Know more about healthcare and mediclaim policy online on Coverfox.

Check Eligibility to Buy Health Insurance Plans for Family

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 Plans For Family Inclusions

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.

Health Insurance Plans For Family Exclusions

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.

Top 6 Standalone Health Insurance Companies of India & Incurred Claim Ratio

Mentioned below is the Incurred Claim Ratio of the top 6 standalone health insurance companies of India. An Incurred Claim Ratio is the number of claims settled by an insurer from the given number of total claims in a single financial year. The higher the Incurred claim ratio, the better the company becomes with respect to settling claims. Therefore, you should always select an insurer with a high claim settlement ratio.

Documents Required to Buy Health Insurance Plans For Family

  • 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.
  • Process To Renew family health insurance Policy

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.

Family Health Insurance Claim Process

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.

Why Health Insurance Plans For Family is Necessary?

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.

Q. How to buy new family floater health insurance Plan?

Ans: The best way to buy a family health insurance plan is to log onto Coverfox, compare all the available options, select the best plan and fill in the required details, select sum insured, pay the premium. Your policy conveniently arrives in your mail box.

However, here are a few factors which you need to keep in mind when deciding on an insurance company.

Reputation: The company’s reputation plays an important role in deciding your investment. It is a good idea to go for a company with claim settlement ratio and a good brand image.

Quick Process for Claim Settlement: Consumers purchase insurance policies for their future emergencies and no doubt, you should be able to make claim on time.

Feedback from Customers: Before purchase, one must spot customer ratings and user opinions for the insurance company.

Q. How to renew family floater health insurance plan?

Ans: You can simply login to the insurer's website and fill in your family health insurance policy details, and pay the premium. Once the premium is paid, you will receive digitally copy of renewed family floater policy.

Q. Why Buy a New Family Health Plan online?

Ans:

The best thing about purchasing a family plan online is that it gives the option to compare the charges of all the plans sold in market together with analysis opportunity of their policy features and benefits. Thus, online transactions ensure complete transparency in paying the right amount.

Besides, an online Health Insurance Plan is always cheaper when compared to offline plans since the agent’s role is removed leading to the removal of commission payment. The insurer is able to save on the commission and administration charges and therefore, low premium is offered to the customers.

Also, transations done online mean complete transparency of payment of the correct amount.

Q. Does family health insurance plans cover against OPD Treatment?

Ans: Most often under a health insurance plan treatment expense is covered for Day Care Treatments or in-patient hospitalisation which means that the policyholder needs to be hospitalised beyond one day. However, Certain Insurance companies have started to offer benefits for OPD treatments also such as Apollo Munich, ICICI Lombard, Bajaj Allianz and ManipalCigna.

Q. What Are Some Popular Individual Insurance Plans for Family?

Ans: Below are few plans offered on individual sum insured basis that can be taken into account.

Religare Care No Claim Super: With attractive features like 100% Recharge Benefit, No Claim Bonus unto 150% and a complementary annual health checkup, Religare's No Claim Super plan is definitely worth considering.

Apollo Munich Optima Restore: With the maximum individual sum insured of Rs.15 lakhs, Apollo Munich Optima Restore offers benefits like coverage of domiciliary treatment, pre-post hospitalization for 60 and 180 days respectively, Organ Donor and Restore Benefit.

L&T Medisure Classic: Strongly backed by a powerful brand like L&T, the Medisure Classic plan should be on your consideration list with features totally worth paying for. With maternity & new born cover along with hospital cash, ambulance charges and cover for Ayurvedic treatment, it also offers options like room rent waiver and double sum insured for critical illness at an additional premium.

Star Medi Classic: Automatic Restoration of Sum Insured and cover for non-allopathic treatments are just few of the many benefits offered by the plan. The premium pricing is also quite cost-effective in comparison to other plans offering similar benefits.

Q. How much is a family health insurance plan?

Ans: Different insurers provide family health plans at various quotes. It is advisable to check the exact price from the official website of the insurance company.

Q. How much does family health insurance cost per month?

Ans: The average cost of health insurance per family (4 members) comes up to Rs. 6000 to Rs. 8000 per month, and for an individual, it comes up to Rs. 2000 per month.

Q. What is the average cost of health insurance for a married couple?

Ans: The average cost of health insurance for a married couple stands at around Rs. 8,000 per year.

Q. Why is health insurance plan for family so expensive?

Ans: Since it covers more than one person and every family member has different requirements in terms of health and age, family health insurance is more expensive than regular health insurance.

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