The family health insurance policy is a kind of health insurance plan that provides coverage for the entire family under a single insurance plan against a fixed sum insured. This type of health insurance policy can be tailored and customized according to the convenience of the family. Apart from covering the insured
person, the policy can cover his/her spouse, dependent children, parents, among others. In a nutshell, it gives you overall comprehensive health coverage against different diseases and thus offers financial protection to you and your family..
Under a family health insurance policy, the policyholder can insure his/her entire family under single health insurance and for that, the single sum insured is required whereas the standard or individual health insurance plan provides coverage for only one person.
This denotes that if you are a family of 5 members, then you have to buy separate 5 insurances for each and bear the expenses. That is hazardous and might put a burden on your pocket. But under family health insurance, you don't need to carry this burden as all the 5 members can be covered under a single-family health insurance plan.
You might be thinking that the premiums paid for family insurance are higher than the individual health insurance. But unfortunately, you are wrong. The premium paid for family health insurance is lesser than the premium paid for individual health insurance. Let us understand this with the help of an example..
A family health insurance policy not only covers the insured person but also provides coverage for the entire family, even for the grandparents, parents, and dependent children. It comes with several other benefits. Let us have a look at the key advantages of this plan below.
◦ Comprehensive Protection to The Entire Family - Under one family health insurance plan, you can cover your entire family and you need not buy separate insurance policies for the family members. It is not only hassle-free but also convenient and pocket-friendly.
◦ Affordability - The premiums that you have to pay for the family floater health insurance that is way cheaper than the premiums paid for the individual health plans. For better understanding, suppose, you are a family of 4 members, by buying one single-family health insurance plan, you can cover all the four members while buying an individual health plan for each member, and paying 4 premiums separately would be costlier and hazardous.
◦ Additional Benefits - Different insurance companies come up with varied add-ons to extend the benefits of the policy to make protection for you and your family stronger. Such extensions are critical illness cover, maternity cover, newborn and child's marriage cover, and so on.
◦ Tax Benefits - Under this policy one can avail of the tax benefits under Section 80D of the Income Tax Act, 1961.
Protection Against Covid-19 - Almost all the insurance companies are now offering coverage for the coronavirus under the family health insurance plans..
There are lots of family health policies in the market offered by different insurers with some varied benefits. For this reason, it becomes difficult and confusing for the policy-seekers to select the proper and convenient. But this is not such a heavy task if you consider a few factors before going for any plan and the mentions are as follows.
◦ Coverage and Benefits - At first always look for the benefits offered by different insurers. Look for what type of coverage it provides, the amount of the sum insured, the premium rate, etc, and then compare it with the other plans. Only then go for the most convenient one for you.
◦ Understand Your Requirements - Most of the family health insurance plans provide coverage for you, your spouse, dependent children, and your parents. But if you have an extended family and you wish to cover your brother, brother-in-law, or a few members of your family, then you have to go for those plans that allow you to cover maximum family members. But it would be advisable to purchase a separate policy for the extended family members and insure only your immediate family.
◦ Claim Process - We purchase insurance policies so that at the time of any emergency we can avail of a hassle-free claim process. So it is vital to understand your company's claim procedure. Go through it thoroughly so that you don't face any hazards at the time of a medical emergency.
◦ Network Hospitals - To avail of the cashless treatments, one needs to get admitted at one of the network hospitals of the company. So look for the company's network hospitals and make sure that you have at least one network hospital within your vicinity so that at the time of the medical emergency you can get admitted smoothly and quickly. It has to be remembered that if you get admitted to any non-network hospital, then you have to pay the medical bills out of your pocket only, and then you can apply for the reimbursement claim. .
Most of the insurers allow 2 adults and 4 dependent children to be covered under a single-family health insurance policy. However, the age of the child might vary from one insurer to another.
A handful of insurance companies are there in the market, which provides coverage for the extended family under a single health plan. Such plans allow more than 2 adults to be covered and can provide coverage to the relations like, self, father, mother, spouse, brothers, sisters, uncles, aunts, children and etc. but this type of plan is very rare in the market and hence, for extended members of the family one has to go for separate policies.
It is not a good idea to include your extended family members under a single family floater health plan.
There are lots of reasons for it. The most important one is that every individual has separate medical requirements according to age. For example, if you include your grandparents under the same policy, you will land up having the same sum assured for the entire family while in general, the older people need a higher sum assured as they are more prone to the risks of health hazards..
The exclusions under a family health insurance policy may vary from one insurer to another. The general inclusions are as follows.
◦ Expenses arising out of any kind of plastic surgery.
◦ Treatments that are taken outside on foreign lands (unless specified in the Policy Wordings).
◦ Any treatments or injuries occurred due to wars, war-like situations, strikes, riots, or any public unrest.
◦ Intention or self-inflicted injuries.
◦ Injuries occurred due to some unethical activities or adventurous sports.
◦ Expenses due to complications during childbirth unless it is mentioned in the policy.
◦ Expenses arising out of consumption of alcohol or any other drugs or intoxicating substances outside registered doctor's prescription.
◦ Expenses incurred on life-support machines.
Any pre-existing health condition is not covered until the completion of the waiting period..
If you already have a family health insurance policy and you want to add a new family member to it, it would be better to talk to your insurer about it. But if you are a policy-seeker and want to buy a new family health insurance plan, you have various options to do it.
You can buy it online by visiting their official websites as it is a simple and the most convenient one as you can compare different policies and then can select the right one for you. It would be advisable not to look for the cheapest one as you should not compromise with the coverage.
Otherwise, you can purchase it offline by paying a visit to the selected insurer's nearest office and their experts will help you throughout the process to buy this policy seamlessly..
Every health insurance company is open to two types of claim settlement processes namely - Cashless claims and Reimbursement Claims. However, the processes can differ from one insurer to another but the general and standard procedures are as follows..
If you get admitted to a non-network hospital, you need to file the reimbursement claim according to the following steps.
◦ Inform the insurer as early as possible if a medical emergency occurs.
◦ Submit the signed and duly filled claim form with other required documents as it was mentioned at the time of purchasing the policy.
◦ You need to address the queries raised by the claim management team of your insurer.
Either your claim will be rejected or approved and you will be notified accordingly by the company..
