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All You Need to Know about Family Health Insurance

Team AckoJul 22, 2021

Your family is important to you and you do everything to make sure that they lead a comfortable life. But health-related ailments and illnesses can strike any family member. And when it happens, you have to shell out a lot of money for treatments. Given the fact that medical costs have become very expensive, you need a health insurance cover for your family members as well. This is where a family health insurance plan comes into the picture. The plan covers your family members and settles a claim for their medical expenses.

All You Need to Know about Family Health Insurance

Health insurance plans for family are different from health plans for a single individual. So, here is a complete guide to family health insurance plans for your understanding –

What is a Family Health Plan?

A family health plan is a mediclaim policy for family which covers the family members in a single plan. The plan has a single sum insured and a single premium. All the covered members can use the sum insured jointly as well as individually.

Who are covered under the plan?

Health insurance plans for family are also called family floater plans. These plans cover you, your spouse and dependent children (both biological and adopted). Some plans also allow your dependent parents to be covered under the plan. Moreover, there are some policies which even allow other relatives to be covered if they are financially dependent on you.

How is the premium calculated?

You can choose any level of sum insured as per your requirement subject to the maximum limit allowed under the mediclaim policy for family. The premium would then be calculated on the chosen sum insured and the age of the eldest member of the family who is covered under the plan. Moreover, the premium also depends on the number of members covered and their respective ages.

How does the plan work?

A single policy is issued where the sum insured is applicable on a floater basis. This means that if any family member falls ill and there is a claim, the entire sum insured can be used by the member. However, if there is more than one claim, the used sum insured would not be allowed to be claimed. For instance, a family floater plan covering four members has a sum insured of INR 5 lakhs. One member falls ill and the claim is made for INR 2 lakhs. In the same policy year, if another member falls ill, claim would be restricted to INR 3 lakhs only.

What does the plan cover?

The coverage under health insurance plans for family depends on the plan you select. Different plans allow different coverage benefits. Some common ones include inpatient hospitalization, pre- and post-hospitalization, ambulance cover, day care treatments, organ donor cover, etc. Ideally, you should choose a plan with the maximum coverage features for a comprehensive scope of cover.

Also, check: Health Insurance for Parents

Are there any exclusions?

Yes, family floater health plans also have exclusions just like other health insurance plans. Common exclusions include self-inflicted injuries, participation in hazardous activities, cosmetic treatments, mental treatments, etc.

It becomes extremely critical for you to understand the inclusions and exclusions of your policy before purchasing. In case of a claim, the first thing that an insurance company checks is whether the damaging event is a part of the policy’s inclusion. If you have any doubts pertaining to what is covered and what is not covered by your policy, get them cleared before buying the policy.

Now that you know everything about family health plans, make sure to buy a plan and cover all your family members. The plans allow umbrella coverage for all your family members and are also affordable.

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