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Salient features of Family Health Insurance

Health care tips

For an individual the well-being and health of oneself along with family members is of prime importance. Keeping in track with the same, Health insurance​ providers have launched many plans for the benefit of the family members along with the individual at very affordable premiums. 

Salient features:

Basic Health coverage

The most important thing to check while getting a family floater policy is to watch out for diseases which are covered in the plan and whether pregnancy or day care expenses during term of pregnancy or cataract operations are also covered or not. It is also mandatory to check whether the policy provider will cover ambulance services, in-hospitalisation expenses and other non essential expenses incurred during hospitalisation.

Age of renewing the policy

Insurance Regulatory and Development Authority, the sole body looking after the insurance sector in India has made it mandatory for health insurance providers to provide policy cover till the age of 65. But there are many health insurance providers which provide the cover for life time. It is most important to check till what age the policy cover exists for its very important to have the coverage when a person reaches a particular age where the risk of getting infected with diseases increases.

Increase in Sum insured

With the cost of living going up, so the cost of medicine and hospitalisation also has increased manifold. Keeping this in mind, many insurance providers give the facility of increasing the amount of the sum insured for individuals and family.

How to claim reimbursement

It is very important to determine whether the policy provider has a dedicated desk for claim settlement. This ensures that the policy holder doesn’t have to run pillar to post for claim refund. 

Claim reimbursement procedure is same in case of family floater as it is in case of individuals. Its important to read the documents of the policy vis a vis their claim settlement process is concerned.

Cashless and Planned Hospitalisation for family

Like individual policy holders, this facility of cashless hospitalisation is also available to the family members of the policy holder and the process is also same of filling up the preauthorization form and getting the approval of the Third Party Administrator.

In case of Planned hospitalisation for family members, the same procedure has to be follow of intimating the TPA about the nature of disease and the reason for admission to hospital.

It is very important to read the policy documents to ensure that there are no hiccups at the time of claims or at time of cashless hospitalisation and the benefits being offered to the family members along with the policy holder are same and does not vary. Most important is to understand the clauses pertaining to pre-existing diseases, cashless hospitalisation, waiting period etc.

Advantages of Family plans

It safeguards the health of the family members.
All family members can be covered in one policy.
Does not have to deal with maintaining different policies for each individual member.
Entire family can be covered by paying one premium only.
You can change or add new members in the plan.
Some insurance providers give the option of covering siblings and in-laws.
Income tax benefit under section 80D of the IT act can be availed.

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