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Everything You Can Include in Your Family Health Insurance Plan

Owing to exponentially rising healthcare costs in India, having a health insurance policy has become a necessity. One of the primary benefits of health insurance is that it acts as a safety net during medical emergencies. Several kinds of health insurance policies are available in the market individual health insurance, family health insurance and more. You must choose the one that suits your needs the best and offers wide coverage at the time of emergency.

What family health insurance is?

As the name suggests, family health insurance or family floater health insurance offers financial protection to individuals and their family members during a medical crisis. Such health insurance policies are becoming increasingly popular because they help families to sail through medical emergencies without worrying about healthcare expenses.

Benefits of family health insurance

Family floater health insurance extends coverage for doctor consultations, ambulance charges, pre-hospitalisation and post-hospitalisation expenses and other medical costs arising because of illnesses or accidents. Some insurance policies also let the entire family get free medical check-ups under the same plan. Having a single health insurance policy eliminates the hassle of tracking and maintaining several policies. A family health insurance policy is also more affordable because you only pay a single premium amount.

Another advantage of family health insurance is that if a family member is sick, they have access to the entire cover for treatment. Moreover, if the eldest family member passes away, the other family members can continue using the policy coverage as usual. Family floater health insurance offers more comprehensive coverage than individual health insurance policies. Beneficiaries of family health insurance policies can also avail of tax benefits under Section 80D of the Income Tax Act, 1961.

Who all can be covered by a family health insurance policy?

Typically, when you purchase a family health insurance policy, your spouse and child or children are added automatically. In exceptional cases, the coverage can also include your siblings and in-laws. Many family health insurance plans have maximum age limits. While you have the option to add your dependent parents, it is advisable not to do so because:

  • If your parents are over 40 years of age, know that insurance premiums for individuals aged 40+ are higher.
  • Older people are more prone to having pre-existing diseases which increases the premium. Moreover, if a beneficiary with a pre-existing illness gets hospitalised, it impacts the no claim bonus.
  • If your parents get frequently hospitalised, it reduces the other family members' sum assured.

Opting for an individual health insurance plan designed to meet the needs of individuals aged 40+ may be better suited for your parents. If your parents are 60+ years old, consider getting a senior citizen health insurance policy. Such insurance policies provide excellent benefits for senior citizens. Know about Health Gain Policy here​

Things to consider when selecting a family health insurance cover

Selecting a family health insurance cover requires some planning to make the most of the benefits offered. Here are some critical aspects to consider:

  • Polic​y coverage
    The health insurance policy you pick must offer you coverage for pre-hospitalisation and post-hospitalisation expenses, critical illnesses, maternity expenses, daily hospital cash and the like. The policy should cater to the needs of all the family members. Moreover, the coverage amount must suffice all the members. When selecting the coverage amount, consider the healthcare costs in your city of residence and medical inflation. A higher sum insured means a higher premium make sure you can afford it. The insurance premium also depends on the age of the eldest family member.

  • Waiting​ period clause
    Health insurance policies typically cover pre-existing illnesses, maternity expenses and specific treatments for varicose veins, hernia and the like after a usual waiting period of two to four years. The waiting period, which affects when you can file a claim, varies from insurer to insurer. Most health insurance policies usually cover maternity expenses two to four years from purchasing the policy. Before you buy a policy, check after how long it will provide coverage for pre-existing illnesses. Pick the insurance policy with the shortest waiting period.​​

  • Coverage for pre-hospitalisation and post-hospitalisation expenses
    Pre-hospitalisation costs arise before a patient gets hospitalised due to a diagnosed disease. It includes doctor visits, tests, medicines etc. Post-hospitalisation expenses occur after the treatment such as follow-up doctor appointments and medicines. Most insurance policies cover the costs that arise 45-90 days before hospitalisation and 45-90 days from the date of discharge. Choose an insurance policy that covers both types of expenses.​

  • Lifetime renewability
    When selecting policies, consider those with lifetime renewability. The reason for this is simple you mostly require health insurance during the later years of life. If you choose a policy that remains valid till a specific age limit, you will have to purchase another insurance plan after your current policy expires. Health insurance costs more as you grow older. Having an insurance policy with lifetime renewability helps you avoid the hassle of buying another policy.

  • Network hospitals
    Always check the insurance provider's network of hospitals and choose the ones situated in your locality. These hospitals have a tie-up with the insurer, know how to settle bills with the insurer and offer cashless hospitalisation. Additionally, check the hospitals' speciality and reputation. Choose an insurer with a higher number of hospitals in its network.​

  • Claim settlement
    Search for policies with insurers offering a simple, straightforward and quick settlement procedure because this ensures you get the reimbursement as soon as possible. Also, look at insurers' settlement ratio the number of claims settled out of the total filed. A higher settlement ratio means a more reliable insurer. You want an insurance provider who processes your claims instead of rejecting them.​

Aside from these, consider aspects such as coverage for maternity benefits and free medical check-ups. Looking into these factors can help you get a family health insurance policy that fulfils the needs of all the family members and is worth the money.Considering how ​ family health insurance ​​​can be better than individual health insurance policies for each member, you must do your best to secure the best insurance plan possible.

Also Read: ​​Steps to Create a Daily Routine to Stay Healthy​​