Individual Health Insurance

With an impulsive surge in medical costs clubbed with annual healthcare inflation in the range of 15-25%, hospitalization on account of any grave illness can cost you not less than Rs. 3 lakh. In the absence of a proper health insurance cover, rest assured, you’ll be either digging into your hard earned savings or will be running into some serious debts.

Most first time buyers are puzzled as to opt for an individual health insurance for each family member or the family floater insurance plan. In this article, we will discover the nitty-gritties related to individual health insurance for families.

In simple terms, an individual health insurance policy means a separate policy for each of the family member with individual sum insured. To make things easier, let's consider Gupta family from Mumbai. Mr. Gupta (50) has recently bought Apollo Munich individual health insurance for himself, his wife (30), daughter (20) and son (18) for a coverage of Rs. 3 lakh each.

Although Mr. Gupta paid a whopping amount of approx. Rs. 24,500 towards the premium, there are few things he considered before investing in the plan. As Mr. Gupta has recently undergone gall bladder surgery, he wanted to ensure that his medical condition doesn’t unreasonably lead to waiting period for the rest of the family members. Also, he wanted to block a dedicated sum insured for each family member. These reasons encouraged him to decide on the individual health insurance for the family.

While we are at it, let’s delve deeper into some pros and cons for opting the individual health insurance for the family members.

Pros:

• The sum insured remains solely for the insured members. Even though the total claims raised by any member exceeds his own sum insured, he cannot dig into any additional sum insured and hence every insured has a guaranteed coverage amount at their disposal whenever required
• Even parents and in-laws can be a part of this coverage at additional premium
• Suitable for older families as they are prone to greater health risks
• If any insured member has a pre-existing condition as per policy guidelines, the rest of the members need not wait to claim until the waiting period ends
• Discounts on premiums if more than two members
• There is no maximum age for renewal

Cons:

• The individual insurance for the families works out to be costlier than the family floater
• The individual coverage is not suitable for younger families

Features of Individual Health Insurance

• Provides comprehensive cover for the individual policyholder and his/her family
• Lifelong Renewal - There is no maximum age for renewal
• Offers discounts if two or more family members are enlisted in a single policy
• Suitable for senior citizens and older families with greater health risk
• Some policies provide the feature of covering in-laws as well
• The sum insured is available on an individual as well as family floater basis

Benefits of Individual Health Insurance

• Suitable for individuals with greater health risks
• Includes pre and post hospitalization expenses
• Covers critical illness
• Includes in-patient hospitalization expenses
• Premiums paid towards a health insurance are eligible for tax deduction under Section 80D of the Income Tax Act, 1961

• Medical Expenses
• In-Patient Hospitalization
• Pre and Post Hospitalization Expenses
• Day Care Procedures
• Cashless Facility
• Lifelong Renewability
• Dependent children covered up to 25 years of age
• Domiciliary Hospitalization
• Road Ambulance/Emergency Ambulance
• Organ Donor Expenses
• Alternative Treatment - AYUSH
• Pre-existing conditions post waiting period

• War or any act of war, invasion, an act of foreign enemy, warlike operations
• Biological/Chemical/Radioactive/Nuclear fallout
• Self-inflicted injuries
• Mental conditions
• Breach of law/criminal activity
• Participation in military operations
• Participation in extreme sports
• Substance Abuse/Alcohol/Narcotics
• Treatment of Obesity
• Cosmetic Surgery
• Dental Treatment
• STDs/HIV/AIDS
• Infertility

As a first time buyer, one of the key challenge is to decide between the individual plans for the family or opt for a family floater insurance policy. As both options carry their own pros and cons, it’s best to evaluate your individual needs, age bracket, family income, medical history to arrive at an informed decision. With the availability of online portals like Coverfox.com, you can compare different plans and combinations to choose the cream of the crop.

• ICICI Lombard - Personal Protect Insurance Policy

• Bajaj Allianz Individual Personal Health Guard

• Individual Mediclaim Policy

• Star Medi Classic Individual Insurance Policy

• Proof of Age: Acceptable documents are Birth Certificate, PAN Card, Voter’s ID, Driving License, Passport, School or College Certificate, etc.

• Photo Identity Proof: Aadhaar Card, PAN Card, Driving License, Passport, Voter’s ID, etc.

• Proof of Address: Acceptable documents are Ration Card, Telephone Bill, Electricity Bill, Passport, Voter’s ID, Bank A/C Statement, etc.

• Proof of Income: Salary Slip, Employer’s Certificate, Form 16, etc.

• Medical Check-up: If asked by the insurance company

• Passport size photograph

Whether you opt for individual policies for your family or insure them under family floater plan, as mentioned prior, it’s best to assess your requirements coupled with your financial health to take a perfect decision. While an individual plan could make sense for a young family, a family floater will be the right choice for someone with older kids. In addition to this, room rent sub limits, cashless hospitalization tie ups, pre-post hospitalization cover and other benefits on offer should also form crucial part of your deciding components.