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Medical expenses incurred towards the treatment of any ailment, surgery, hospitalization, etc. are covered under a health insurance plan. The cost borne may be reimbursed up to the eligible sum insured via the insurer by providing supportive documents or by using the cashless facility offered at the listed network hospital. Family medical insurance plan is a type of health insurance plan (also referred to as family floater plan), which covers all the family members against medical expenses arising out of diseases and illnesses or accident. Health insurance plans for family covers your entire family at lowest possible premium. The premium depends on the sum insured, number of members included, age of the oldest family member.
Covers family member: You can cover your family members which includes your spouse, children, parents, in fact, many family floater plans also allow the in-laws to be included in the plan.
Rebate on higher sum insured: Many insurers are also offering rebates on their health insurance plans on opting for a higher sum insured.
Increase in the sum insured: A family floater medical insurance plan comes with a no claim bonus feature, this feature increases the sum insured if there is no claim for the duration of the policy period.
Cashless claim settlement option: You can avail cashless facility at listed network hospitals.
Policy term: Health insurance plan for family also offers options in coverage term. You can choose 1, 2 or 3 years as a coverage term.
Save money: You can cover your whole family under a family floater insurance plan. You will save ample money as opposed to buying a single medical health insurance plan for every member.
Tax benefit: You can avail tax benefit on all the premiums towards a medical health insurance plan as per Section 80D of the Income Tax Act, 1961.
Restore exhausted coverage: Many family floater medical insurance plans offer special benefits referred to as restore benefit, which facilitates to reinstate full insurance for unrelated medical expenses as soon as the sum insured is exhausted during the policy period.
Medical umbrella for the whole family: You can cover the whole family underneath one umbrella plan (under a single health plan).
Easily add a new member: You can add kids or any other family member easily in the same family floater plan.
List of Best Health Insurance Plans for Family in India in 2018 - 2019
Religare Care is a comprehensive family health insurance plan that safeguards the members of a family against financial risks arising from a medical emergency.
|Minimum Entry Age||91 days|
|Maximum Age||No Age Bar|
|Waiting Period||30 days for any illness except injury|
|Waiting period for pre-existing illnesses||Four years of continuous coverage|
Source: Official website of Religare Health Insurance
Optima Restore Family Health Insurance plan offers a unique restore benefit that automatically reinstates the basic coverage amount in case the policyholder exhausts it in a policy year.
|Minimum age||91 days|
|Maximum age||65 years|
|Policy period||1 or 2 years|
|Who is eligible?||An individual and/or his family members, namely spouse, dependent children and dependent parent/parents-in-law can avail this cover on an individual or floater basis.|
Source: Official website of HDFC ERGO
my:health Suraksha is a comprehensive health insurance plan by HDFC ERGO General Insurance that is designed to safeguard the policyholder against the rising medical expenses.
|Sum insured options||Rs. 3 lakhs to Rs. 75 lakhs|
|Entry age||Any age|
|Premium payment||Option to pay yearly premium in 3, 6 and 12 equal instalments|
Source: Official website of HDFC ERGO
Happy Family Floater Policy by Oriental Insurance is available in three plan options, namely Silver, Gold and Diamond. The family floater policy includes maternity expenses cover and new-born baby cover, among other benefits.
|Sum insured||Rs. 2 lakhs to Rs.20 lakhs|
|Maximum Entry Age||65 years for all members, however, this can be extended to 70 years, subject to conditions.|
|Policy Period||1 year|
Source: Official website of Oriental Insurance
This policy is designed to suit all of an individual and his or her family’s healthcare needs. It covers the medical treatment expenses incurred during hospitalization due to a serious illness or accident.
|Policy Period||1, 2 or 3 years|
Source: Official website of Bajaj Allianz
This is a super saver plan that covers the whole family under single sum insured.
|Policy Period||1 year|
|Sum Insured||Rs.1,00,000, Rs. 2,00,000, Rs. 3,00,000, Rs. 4,00,000, Rs. 5,00,000, Rs. 10,00,000, Rs.15,00,000, Rs. 20,00,000 and Rs. 25,00,000|
Source: Official website of Star Health
This policy offers wide coverage and insures the entire family. There is no need for a medical check-up up to the age of 45 years.
|Minimum Entry Age|
|Maximum Entry Age||65 years|
|Policy Period||1 year|
|Sum Insured||Minimum sum insured for family floater policy is Rs. 2,00,000|
Source: Official website of SBI General
The policy insures all the members of the family under a single sum insured. Here, family would comprise of self, spouse and dependent children.
|Sum Insured||Rs. 2 lakhs to Rs. 10 lakhs|
Source: Official website of United India Insurance
This policy is designed to give the members of a family protection against unforeseen hospitalization expenses.
|Sum Insured||Rs. 2, 3, 5, 8, 10, 12 and 15 lakhs|
|Policy Period||1 year|
Source: Official website of The New India Assurance
The policy covers the hospitalization expenses incurred for treating illness/disease or injury contracted/sustained by the insured persons during the policy term. It also covers 140+ day care procedures/ surgeries.
|Sum Insured||Rs. 50,000 to Rs. 5 lakhs|
Source: Official website of National Insurance
Eligibility Criteria for Family Health Insurance Policy is as follows:
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.
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.
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.
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.
All About Mediclaim Policy for family
The rising cost of modern medicine and healthcare treatment has made a mediclaim policy for your entire family a necessity. In case of emergency hospitalization, a mediclaim policy will help you by covering your family’s health care expenses.
A mediclaim policy for family is an insurance (health) plan under which the policyholder and his/her family gets health cover of a certain amount available for the entire family. In case of a medical emergency or accident, the policyholder will receive medical care and the expenses will be deducted/reimbursed from the amount insured, as per the health plan. A mediclaim policy can be taken on an individual or a family floater basis.
Note: Purchasing a mediclaim policy on an individual basis means buying a separate insurance for each member with a defined medical cover. In case of a family floater plan, the mediclaim policy can be utilised by any of the family members.
The benefits of a mediclaim policy are as follows:
The inclusions of a mediclaim policy for family are:
Hospital expenses – Expenses incurred due to hospitalization like medicines, oxygen, blood, OT charges, medical tests and diagnosis, chemotherapy, radiotherapy, organ transplantation, etc. Hospital accommodation expenses – Expenditures towards hospital room, ICUs are either addressed through cashless hospitalisation feature or are reimbursed by the company. Day-care hospitalization – Expenditures towards tech-driven medical treatments that do not involve 24-hour hospitalization. Pre and post-hospitalization expenses – Expenses incurred for up to 30-60 days before and till 60-120 days after hospitalization. It may also include medical assistance for emergency services like ambulance, etc. Charges for medical experts – The fees for medical professionals involved during hospitalization like doctor, surgeon, nurse, etc. are also provided by mediclaim policies.
Note: These are common inclusions of a mediclaim policy for family. The inclusions also vary from one policy to another.
The exclusions of a mediclaim policy are:
The eligibility criteria is as follows:
The documents required to purchase a mediclaim plan are:
The details have to be provided for each and every family member.
Top Health Insurance Plans for Family
|Yes, Rs.10,000||No deductible|
|In patient hospitalization||Up to Sum Insured||Up to Sum Insured|
|Pre-hospitalization||30 days||30 days||Post-hospitalization||60 days||60 days|
|Day Care Treatments||Yes||Yes|
|Room Rent||1% of SI per day||Single Private Room|
|ICU charges||2% of SI per day||No Limit|
|Ambulance Cover||Rs.1,500/ hospitalization||Rs.2,000/ hospitalization||Daily Allowance||Rs.500/ day up to 5 days||NA|
|Domicilliary hospitalization||Up to 10% of SI||Up to 10% of SI|
|Up to 10% of SI||Yes, all members||Yes, all members|
|Recharge of SI||Yes||Yes|
|No Claim Bonus||Yes||Yes|
|Organ Donor Cover||Rs.50,000||Rs.100,000|
|Alternative Treatments||Up to 15,000||Up to 20,000|
|Min Age||91 days|
|Renewal||Lifelong Renewability. The Policy can be renewed under the then prevailing Health Insurance Product or its nearest substitute approved by IRDA.||Renewal premium||Premium payable on renewal and on subsequent continuation of cover arc subject to change with prior approval from IRDA.|
|Co-payment||No Co-payment in policy, if age of the eldest member insured with the company at the time of first policy is below 61 years. 20% Co-payment will be applicable in policy, if age of the eldest member insured with the company at the time of first policy is 61 years or above 61 years i.e. you will have to pay 20% of the claim amount under the policy, if any. The company will pay the rest.|
|Waiting period||30 days for any illness except injury|
|Waiting period for pre-existing illnesses||Four years of continuous coverage|
|Change in sum insured||You can enhance your sum insured under the policy only upon renewal|
|Grace period||30 days from the date of expiry to renew the policy|
|BASIC SUM INSURED PER INSURED PERSON PER POLICY YEAR (RS. IN LAKHS)||3.00 - 5.00 - 10.00 - 15.00 - 15.00 20.00,25.00,50.00|
|Pre-hospitalisation||Covered, up to 60 days|
|Post hospitalisation||Covered up to 180 days||Day Care procedures||All Day Care Treatment Covered|
|Daily cash for Choosing shared accommodation||Rs.800 per day, Maximum Rs.4,800 (Rs.1000 per day, Maximum Rs.4,800)|
|Emergency Ambulance||Up to Rs. 2000 per hospitalisation||E-opinion in respect of critical illnesses||Covered||Emergency Air Ambulance Cover||Not Covered (Covered up to Rs.2.5 Lacs per hospitalization and maximum up to sum insured in an year)|
|Restore Benefit||Equal to 100% of basic sum insured|
|Multiplier Benefit||Bonus of 50% of the Basic Sum Insured for every claim free year, maximum up to 100%. In case of claim, bonus will be reduced by 50% of the basic sum insured. However, this reduction will not reduce the Sum Insured below the basic Sum Insured of the policy.|
|Health Checkup||Not covered (Up to Rs. 2,500, 5,000, 8,000, 10,000)|
|Critical Advantage Rider||Offered (where base Sum Insured is Rs.10 lacs & above)|
|Age||91 days to 65 years|
|Eligibility||● 18-65 years of age|
● 65+ for renewals
● Child from 16th day of birth can be covered as part of the family
|Pre-Hospitalization expenses||Up to 60 days|
|Post-hospitalisation expenses||Up to 90 days||Lump-sum for Treatment in Preferred Network Hospital||In the event of a medical contingency requiring hospitalization, if the insured seeks advice from the Company, Up to 1% of Basic Sum Insured, subject to maximum of Rs.5000/- per policy is payable as lump sum.|
|Automatic Restoration of Sum Insured||3 times at 100% each time, during the policy period.|
|Bonus||Following a claim free year bonus of 25% of the expiring basic sum insured in the second year and additional 10% for subsequent years (max.100%) would be allowed.|
|NCB||Increase in Sum Insured @20% of Base Sum Insured subject to the maximum of 100% of Base Sum Insured for each claim free year with no penalization in case of a claim|
|Health Check-up||Avail Heath Checkup for yourself and your family once in two years (for variant 1) or annually (for variant 2 & 3), so that you live a healthier and happier life.||Policy Term||Default policy term for all plans is one year. You can choose a 2 year term as well and thereby avail a discount of 12.5% on the second year’s premium.|
|Refill Benefit||Under this benefit, you are entitled for an additional sum insured equal to the base sum insured for a subsequent claim in the same year, provided it is for an unrelated illness.|
|AYUSH||Avail In-patient treatment under AYUSH (Ayurveda, Unani, Siddha, and Homeopathy) up to the base sum insured.|
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
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.
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:
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.
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
The claim process of Family Health Insurance can be understood as mentioned below.
Reimbursement Claim Process
Top Family Health Insurance Companies in India? What is Incurred Claims 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.
|MANIPAL CIGNA||46.29||MAX BUPA||50.19|
Unfortunate incidents that require timely medical treatment can bring you and your family financially down. The burden of the rising medical expenses takes a toll not only financially but also emotionally. In such a scenario, having a family health insurance plan to support you financially at the time of medical emergencies can be a saviour.
Family health insurance policies are customizable. There are two ways you can cover your family members:
You can opt for individual policies for each family member or opt for a family floater health insurance, wherein you and your family together are covered in a single policy on a shared basis. A family floater health insurance protects your entire family – spouse, parents, and children in a single plan. Itis also commonly called as family floater plan.
Let’s see the difference between the two.
Cover each family member individually having different coverage (sum insured)
The benefit of family floater is that your whole family is covered and sum assured is shared across all the family members. Plus, family health insurance plans also offer to restore benefit, which helps to restore the sum insured to its full coverage value once it gets exhausted.
Here's an example how these health insurance policies work:
God forbid, if something happens to any of the family members, say you yourself get hospitalized and the medical expense sums up to Rs.2.5 lakh.
Suppose, you bought individual health insurance policy for each of the family members. You are covered with a sum insured of Rs.1 lakh. Under such a case, the maximum amount that the health insurance company would pay is Rs.1 lakh, while the rest of the amount you need to pay from your pocket.
Despite having a health policy, you will be paying Rs.1.5 lakh from your pocket.
Suppose, you bought a family floater health insurance policy having the sum insured of Rs.5 lakh. Under such a case, the health insurance company will pay the full incurred medical expenditure. That means you won't have to pay any extra money from your pocket. Moreover, the rest of the coverage of Rs.2.5 lakh can be utilized by the other insured family members, if the need arises during the policy period.
Thus, the insurance advisor suggests to opt for a family floater insurance plan to cover the whole family instead of having different individual policies.
Frequently Asked Questions
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. What is the best health insurance plan for a middle-class family?
Ans: The best health insurance plans for a middle class family are
Q. Why Buy a New Family Health Plan online?
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.