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Difference between Corporate Medical Insurance and Family-floater Insurance

Team AckoAug 27, 2021

Corporate Medical Insurance provides coverage to the employees (and their dependent members). On the other hand, a Family floater plan provides coverage to a family. In both cases, the sum insured is equally divided among insured group members and so are the benefits. However, there are a few differences between Corporate medical insurance and Family-floater plans. This article sheds light on the key differences between these two widely popular health plans.

Corporate medical insurance vs. Family-floater health insurance

What is meant by Family-floater and Corporate health insurance plans?

Family-floater and Corporate insurance are some of the common types of health plans that most people prefer. Let’s understand their meaning in detail.

What is a Family-floater plan?

A Family-floater health insurance policy offers flexible coverage to you and your family members. These plans are cheaper than buying Individual Policies for each member as the risk and the sum insured are divided among the insured members. Family-floater plans are the best way to ensure basic health insurance coverage. The cost of this type of policy depends upon the following four things.

  • Number of insured members

  • Extent of coverage

  • Sum Insured

  • Age of the members

You can insure yourself, your spouse, two children, parents or in-laws under a Family-floater plan. This generally depends upon the terms and conditions of the insurance company.

What is a Corporate plan?

The meaning of a Corporate plan is you get health insurance coverage from your employer. It comes under a Group Health Insurance Policy. Your employer will bear the cost of the policy, and you may have to pay for any additional coverage that you opt for.

Corporate medical insurance vs. Family-floater health insurance

Take a look at the following table to understand the differences between Corporate and Family-floater health insurance plans.

Parameter Corporate medical plan Family-floater plan
Meaning A corporate health insurance plan covers the employees (and even their dependents) of a certain organisation. A family-floater plan insures people are related to each other. For example immediate family members or in-laws.
Who is covered? Employees of a company (each policy covers the employee and their dependents). Immediate family members are covered. Some Family-floater plans can also include in-laws.
Premium The cost of this policy is borne by the employer for the basic plan. The employee may have to pitch in for additional coverages. The full cost of the policy is paid by one family member.
Tax implications The employee can only claim tax if he/she has paid for corporate health insurance from their pocket. The insured person who paid the premium can avail of a tax benefit under Section 80D of the IT Act.
Eligibility An employee will be eligible until associated with the organisation. Any person above the age of 18 years can buy a Family-floater health insurance plan.
Exit criteria Retirement, termination, or leaving the job are the exit criteria for opting out of a Corporate health insurance policy. Reaching the exit age (as per the terms of the policy), failing to renew the policy, or death are the exit criteria for opting out of a Family-floater health insurance plan.
Claim settlement Through a Third-party Administrator (TPA) appointed by the insurer. Either via the TPA or by directly contacting the insurance company.
Pros 1. The employers pay for the base policy 2. Your claims are processed on a priority 1. One health insurance plan is easier to manage than multiple policies. 2. Separate health insurance cover for parents is not required, as they are a member of a Family-floater plan.
Cons 1. You don’t have a say in the type of coverage you get. 2. The plan will not be active when you leave the job or get retired. 1. The sum insured is used by multiple members and can easily get exhausted if more members get sick. 2. Siblings of the person who is a main member of the plan may not be covered if he/she is married.

Benefits of ACKO group health insurance policy

ACKO's Corporate plan offers extensive health insurance coverages, no-stress claims, and wellness benefits. We are a digital-first insurance company that offers comprehensive group medical coverage and ensures a hassle-free experience for both employees and the employer. Here are a few benefits of ACKO's Corporate plan.

  • Raise a claim without any physical documentation.

  • Visit any medical facility from ACKO's wide network (6,500+ hospitals, 35,000+ doctors, 4,500+ labs) across the country to avail of cashless claims.

  • Use services like teleconsultations, emotional assistance, Outpatient Department (OPD) treatment, and more through the ACKO app.

If allowed by your employer, you and your family will get health insurance coverage from ACKO and access to the above benefits plus more. You don’t have to pay a premium for the base plan. Simply pay for additional coverage that might seem necessary to you. 

Takeaway

A medical emergency is highly unpredictable, and you must create a financial backup to fight it better. This will help you focus on recovery rather than worrying about finances and the quality of treatment.

One must create a strong health insurance portfolio with different types of mediclaim plans. Thus, consider opting in for both Corporate as well as Family-floater coverage as this will increase your financial safety net against medical contingencies as Corporate plans cannot offer coverage when you quit the company. Additionally, buying a Family-floater plan is logical from a financial standpoint as your employer will bear the cost of a basic Corporate policy.

Frequently asked questions

Here are a few common questions related to Corporate and Family-floater health insurance plans. Feel free to contact us through email if there are more queries. Send your question to [email protected] and we will get back as soon as possible.

What is meant by the word ‘floater’ in Family-floater health insurance?

The word floater refers to the flexible benefit that is shared by the insured members of the plan. The sum insured and coverages are not fixed for a particular family member, and thus it is a floater health plan.

I have an Individual Health insurance policy. Can I convert it to a Corporate plan?

Usually, this is not possible as there might be different health insurance companies involved, and a Corporate plan is paid for by the employer. Also, it is not advised to be solely covered under one health insurance plan if you are looking for comprehensive coverage.

Can my claim against the Corporate policy get rejected?

Yes, there are multiple reasons why your Corporate claim can get rejected. Here are a few reasons.

  • You did not disclose the correct information.

  • You made a claim against an event not covered under your health plan.

  • The claim process was not correctly followed.

Thus, be sure to disclose all the correct information about your health history. Reading the terms and conditions of the policy will help you understand the plan better. With this, following the claim process correctly will enable you to get the claim amount faster.

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