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Family Health

family health insurance plan is a policy that insures the health of your entire family. You can include your spouse, children, dependent siblings, parents and parents-in-law in these plans. You need to pay a single premium and the sum assured is shared across all members. The coverage is generally extended to up to six members of the family. 

Types of health insurance plans for your family

You can buy 2 types of health insurance plans for family:

  1. Individual family health insurance policies that cover each family member separately.
  2. Family floater health insurance policy where the entire family is covered under a single policy.

If you buy individual plans for each member of your family, the total premium would be quite high. However, if you buy a family health insurance plan, then the premium will generally be much lower and the entire family will be covered under one plan, making it a simpler process. 

Health insurance coverage calculator

When buying insurance the major factors you look for are the features of the plan, the benefits the plan offers and the premium it demands. Earlier when policies were bought offline people solely depended on their insurers and agents regarding the premiums, they were charged. They hardly knew the breakup of the amount they were charged. However, today the policyholders can check the amount they will be paying to their insurers even before buying the policy.

With a health insurance premium calculator, you can enter your personal details and it will showcase the amount to be paid. Not only this insurance premium calculators even tell you the features your health insurance plan offers and the benefits it provides. Therefore, an insurance premium calculator is a very useful tool that will help you in selecting the best policy for yourself.

Health insurance for parents

You can either include your parents in the family health insurance plan or buy a separate plan for them. However, do note that the maximum entry age for most plans is 65. If they are senior citizens, then customised policies for senior citizens are also available. 

It’s important to remember that the premium value increases with the age of the eldest insured family member. So, depending on their age, it might be more cost-effective to buy a separate health insurance for parents rather than include them in the family floater policy.

Companies offering best family health insurance plans in India

Here’s a list of some of the best Family health insurance plans & policies offered by various companies –

Company 

Family Health Insurance Plan 

Coverage and Features

Range of sum assured (in INR)

Maximum entry age 

Waiting period 

HDFC ERGO General Insurance Company Limited 

my: Health Suraksha Insurance- Silver Smart Plan

Gold&

Silver

No Room rent, cashless home healthcare, sum assured rebound, yearly free health check-ups, hospitalization, AYUSH, day-care, lifetime renewability, free renewal, mental healthcare

3, 4, 5 Lakh

65 years

30 days for any claim,

2 years for certain ailments,

36 monthsfor pre-existing

TATA AIG General Insurance Company Limited

Medicare

Domiciliary, In-patient treatment, pre and post-hospitalisation, daycare, ambulance charges, donor expenses, AYUSH, health check-ups, hospital cash benefit/p>

2 – 10 Lakh

65 years

30 days for any claim,

2 years for certain ailments,

48 months for pre-existing

Bajal Allianz General Insurance Company Limited

Health Guard insurance plan

Hospitalisation, day care, ambulance charges, donor expenses, AYUSH, health check-ups, hospital cash benefit, convalescence benefit, restore coverage, bariatric, 

3 – 50 Lakh

18 to 65 years

30 days for any claim,

2/3/6 years for certain ailments,

3 years for pre-existing

Universal Sompo General Insurance Company Limited

Complete Health Care

Domiciliary, hospitalisation, day care, ambulance charges, donor expenses, health check-ups, room rent, ICU Charges

Basic- 1 – 5 Lakh

Essential- 6 to 70 Lakhs

Privilege- 75 lakhs to 3 Crores

65 years

30 days for any claim,

2/3 years for certain ailments,

6 years for pregnancy and related issues

3 years for pre-existing

National Insurance Company Limited 

National Parivar Mediclaim Policy

Domicilliary hospitalisation, in-patient, day care, donor expenses, ambulance, AYUSH, hospital cash benefit, infertility

1 – 10 Lakh

65 years 

30 days for any claim,

1/2/4 years for certain ailments

4 years for pre-existing

Star Health & Allied Insurance Company Limited 

Family Health Optima

Domicilliary, hospitalisation, day care, ambulance charges, donor expenses, AYUSH, health check-ups, hospital cash benefit, infertility 

1 – 25 Lakh

65 years 

30 days for any claim,

2/4 years for certain ailments

3 years for infertility

The Oriental Insurance Company Limited

Happy Family Floater Policy

Domicilliary, hospitalisation, day care, ambulance charges, donor expenses, AYUSH, health check-ups, hospital cash benefit, infertility, restore coverage, life hardship survival

1 – 20 Lakh

65 years 

30 days for any claim,

1/2/4 years for certain ailments

The New India Assurance Company Limited

Family Floater Mediclaim 

Domicilliary, hospitalisation, day care, ambulance charges, donor expenses, AYUSH, health check-ups, hospital cash benefit, restore coverage

2L-5L

65 years 

30 days for any claim,

2/4 years for certain ailments

HDFC Ergo Health Insurance Company Limited

Optima Restore

Domicilliary, hospitalisation, day care, ambulance charges, donor expenses, AYUSH, health check-ups, hospital cash benefit, restore coverage, stay active discount

3 -50 Lakh

65 years

30 days for any claim,

2 years for certain ailments

3 years for pre-existing diseases

Niva Bupa Health Insurance Company Limited

Health Companion family floater

Domiciliary, hospitalisation, pre and post hospitalisation, day care, ambulance charges, donor expenses, AYUSH, health check-ups, hospital cash benefit

5 – 12.5 Lakh

None

30 days for any claim,

2 years for certain ailments

4 years for pre-existin diseases

Benefits of family health insurance

Here are the benefits which you can avail if you invest in the best health insurance plans for family in India–

Covers all family members: You can buy a single policy for the entire family, making sure that everyone gets the best treatment possible. Parents and parents-in-law can also be included. A new member can be added to the existing family floater health plan with ease. This helps you avoid paying multiple premiums for multiple policies. 

Cashless hospitalisation for family: Cashless hospitalisation is extended to all family members covered under the family health insurance plans. 

Save money: The premium for a family floater policy generally works out to be lesser than the total premium on separate policies for individual members. 

Claim tax benefit: The premium paid for family health insurance plans is eligible for tax exemptions under Section 80D of the Income Tax Act.

Restore coverage: These days, most companies offer a special benefit called restore benefit. This is particularly useful for family health insurance plans. Under this, if the entire sum insured is exhausted by one family member, the entire sum insured is again reinstated so other family members still stay covered. Restore coverage can be availed by the same family member too, but only for unrelated claims.

Enhancement of sum insured: A flexible family health insurance plan allows you to increase sum insured during renewal.

Higher coverage for each member: This is easier to understand with an example. 

Let’s assume you have 4 members in your family. You can do one of the following 2 things.

  1. Buy individual policies with sum insured of Rs 1 lakh for each. In this case, the maximum coverage amount for each person is Rs 1 lakh. So if one member is hospitalised and the expenses are 1.5 lakh, you will have to pay the difference of Rs 50,000 yourself. 
  2. Buy a health insurance plan for family with sum insured of Rs 4 lakh. In this case, the maximum coverage amount for the entire family is Rs 4 lakh. So, if one member is hospitalised and the expenses are 1.5 lakh, the entire cost will be borne by the insurance company, provided the amount has not been exhausted by other members in the policy year.

Soeven the cheapest health insurance for family offers higher coverage to each member, at a lower overall premium.

Common Inclusions under best family health insurance plans

Category

Description

In-patient Hospitalisation

Medical expenses if the insured is hospitalized for more than 24 hours.

Pre and post-hospitalization

Prescribed tests, medications, treatment etc for a certain defined period before and after hospitalisation

Emergency ambulance charges

Expenses for ambulance needed for an emergency situation

Day-care 

Medical expenses if the insured is hospitalized for less than 24 hours.

Domiciliary treatment

Medical expenses for certain ailments when the insured is being treated at home

Organ donor expenses

In case an organ donation is required, then expenses incurred by the organ donor

AYUSH

Medical expenses if the insured undergoes Ayurveda, Yoga, Unani, Siddha or Homeopathy treatment

Vaccinations

Vaccinations that result from an animal bite

Common Exclusions under best family health insurance plans

Category

Any claim raised within 30 days of purchase of policy, unless caused due to an accident

Pre-existing illnesses are not covered before a pre-defined duration

Sexually transmitted diseases

Treatment for problems aesthetic or cosmetic in nature

self-inflicted injury

illness caused due to drug or alcohol abuse

Experimental or unapproved treatment

Any OPD treatment unless specified in the policy

Any other exclusions specified in the policy document

What is the importance of family health insurance?

Medical emergencies can happen anytime, anywhere. Moreover, the growing number of lifestyle diseases and the rising cost of healthcare has made it necessary to have health insurance plans for all members of your family. Though most organizations these days have health insurance facility for their employees, quite often the coverage is inadequate. Therefore, you need to buy a personal health insurance policy that is customized based on your family’s requirements. 

Difference between family health insurance and individual health insurance

A mediclaim policy for family is quite different from an individual health insurance plan. The differences between these plans are as follows –

Family floater health insurance plan

Individual health insurance plan

Covers all family members under a single policy

Covers only one individual under a single policy

The sum insured can be used jointly and independently by all insured members of the family under a mediclaim policy for family

Under individual health plans, the sum insured is used only by the insured individual

The collective premium for all family members works out to be cheaper

If you buy individual health plan for each family member, the aggregate premium payable would be higher than mediclaim policy for family

The premium is calculated based on the age of the eldest insured member

The premium is calculated based on the age of the insured member

Thus, both family floater and individual health insurance plans are different from one another. You should, therefore, understand these differences and then choose the most suitable policy for your family.

Eligibility criteria for family health insurance

To buy mediclaim for family, you need to fulfil some specified eligibility criteria laid down by the insurance plan. While the exact eligibility parameters depend on the policy that you buy, some of the most common parameters are as follows –

  • Members who can be covered

    All policies of mediclaim for family cover the policyholder, spouse and dependent children, both biological and adopted. Coverage for dependent parents, however, varies across plans of mediclaim for family. Some plans allow dependent parents to be covered under the policy while some don’t. In fact, some health insurance plans for family even extend coverage to siblings, grandparents, parents-in-law and other relatives that you might have.

  • The sum insured

    Sum insured under plans of mediclaim for family range from INR 1 lakh to up to INR 6 crores. You can choose any sum insured depending on your coverage needs and the premiums are calculated accordingly. However, if any member of the family suffers from a severe medical condition, the insurance company might impose a limit on the maximum sum insured which you can avail under mediclaim for family.

  • Policy tenure

    All health insurance plans for family have coverage duration of one year. Some plans also allow coverage for two or three years at once if you pay the aggregate premium upfront.

  • Age limits

    Plans of mediclaim for family are available for adult proposers who are aged 18 years and above. Dependent children can be covered from 91 days onwards. The maximum entry age for adults is usually restricted to 65 years under most plans while some plans don’t have any such restrictions. Dependent children are covered under the floater policy for up to 23 or 25 years of age, depending on the policy terms and conditions, after which they should be covered under an individual plan.

Claim process for family health insurance

For making a claim under a mediclaim policy for family, the following steps should be followed –

  • The insurance company should be informed immediately of the claim
  • In case of cashless treatments, you should get admitted in a networked hospital
  • A pre-authorization form should be filled and submitted to the insurance company to get an approval for cashless claims. This form should be submitted 3-4 days before planned hospitalisation or within 24 hours of an emergency hospitalisation
  • Once the insurance company approves the cashless claim based on the pre-authorization form, you can avail cashless treatments
  • Upon discharge from the hospital, fill up and submit a claim form and all medical documents pertaining to the claim
  • The insurance company would verify the documents and settle the claim
  • In case of a reimbursement claim wherein you were hospitalised in a non-networked hospital, get treated at the hospital and pay for the medical expenses that you incur. After being discharged, file a claim with the insurance company and submit all your original medical documents with bills. The insurance company would verify the documents and reimburse you for the expenses that you incurred.

Things to consider before buying a family health insurance plan

Family, health and fitness are the most important things that we need to take care of in our lives. Health should be the priority of all individuals and one of the most important things that can help us in taking care of our lives is a health insurance plan. Health insurance plans come in a number of packages but if you are concerned about safeguarding the lives of your family then going for family health insurance would be the best idea. 

Family health insurance plans come with a number of benefits but there are some things you need to consider before buying a plan for yourself:

  1. Try to buy your health insurance at the earliest:

    People often think that health insurance is not needed when you are younger. While you may make the least claims while you are young, buying health insurance at this age will be beneficial with a lot of things. A younger age will benefit you in reducing your insurance premiums.

  2. Look at the insurance coverage you are getting:

    To make sure your family is in the best of their health every time you will have to consider a plan that serves the needs of all. To do this in the first place you will have to estimate the amount of health insurance coverage your family would need.

    Next, you would need to check the number of daycare procedures your company is offering. This may include cataract treatment, skincare treatments, etc. Moreover, look at the room rent limits and other details before finalizing the plan.

  3. Have a look at the premium:

    Simply put your health insurance premium would be calculated majorly on the amount of sum assured and add-ons included in your plan. Moreover, when it is a family floater plan the premium you are liable to pay will take into consideration a number of factors like the age of the eldest family member, the policy term, add-ons, etc.

  4. The Insurance Company
    When it comes to health insurance, what you buy is as important as from whom you buy. So, the insurance company that you choose has to be such that suits your insurance needs. Make sure you compare different companies on the basis of their ratings, reviews, Incurred Claim Ratio and Claim Settlement Ratio.

How to buy family health insurance plans from Turtlemint?

In today’s busy world we want all things to be done with one click and in the shortest time possible. Turtlemint is one such website that serves to be a one-shot solution for all your insurance-related queries. At Turtlemint you can search for the most suitable family floater plan, compare it with others, calculate the premiums, finalize the plans and purchase it, and all this can be done very easily at the website. 

  • Step 1

    To buy a family health insurance at Turtlemint you will have to log in to the official website and read about the type of insurance you are looking for. 

  • Step 2

    Next up you can compare plans from the best insurance providers to decide which one will cater to your needs in a better way. Comparing insurance plans at Turtlemint is effective as the comparison is based on a number of factors. 

  • Step 3

    Once you have your preferred plan in hand you can use the website’s free premium calculator and estimate your premiums. If you have any queries regarding the purchase of your family health insurance you can contact the experts at Turtlemint to help you with the same. 

  • Step 4

    Once you choose the plan, you’ll be asked to fill in a few basic more personal and health details. Once you submit your data, a company executive will get in touch with you soon.