Family Insurance Plans: Top Reasons To Buy Mediclaim Insurance For Family In India

Health Insurance

Family insurance plans could be an affordable way to cover future hospitalisation costs borne by each eligible family member. Considering the rising medical costs, it is important to have a comprehensive and adequate health insurance plan for your loved ones. Give this post a read to know the benefits of family health insurance policies, their exclusions, claim settlement and a few useful insights about some of the best family floater plans available in India.

Benefits of Buying Family Insurance Plans

Comprehensive Coverage

You might consider purchasing a family insurance plan to prevent your household savings from getting drained to foot steep hospitalisation and medical bills. A typical family medical insurance plan comes with a range of coverage benefits depending on the chosen plan’s terms and conditions. 

Here are a few major advantages of opting for a family medical insurance plan:

Lower Dependency on Group Insurance Plans

Your employer might offer you a group health insurance plan that covers your family members. However, these could be operative for as long as you work at that company. Therefore, to enjoy enhanced and customised coverage benefits for a longer time, you might want to go for family insurance plans. 

Also read: 7 Questions To Ask Before Getting A Health Insurance

Protection Against Medical Emergencies

Medical emergencies like accidents or unexpected hospitalisations can happen to anyone at any time. Thus, it’s extremely critical to have adequate family insurance plans as a protection in place to minimise the financial burden caused by such medical emergencies.

Also read: What Is A Family Health Insurance Premium Calculator? How To Use

Provide Protection to Vulnerable Members of the Family

A few members of the family, like senior citizen parents, may have pre-existing diseases owing to which they might be at higher risk of requiring medical treatment involving hospitalisation. As such, it makes sense to prioritise purchasing a health insurance plan that adequately covers each family member to protect household finances in the face of a medical emergency.

Exclusions under Family Insurance Plans

Family insurance plans could come with a number of features and benefits like cashless treatment for eligible members up to sum insured in network hospitals, complimentary annual medical checkups, no-claim bonuses at the end of a claim-free year, etc. depending on the policy terms and conditions. However, there might be certain exclusions and riders too, such as: 

1. OPD treatment expenses and costs of routine medical check-ups
2. Treatment costs from injuries due to wars, nuclear reactions, etc. ‘
3. Medical costs arising from plastic surgeries or other aesthetic treatments
4. Costs of life-support machines
5. Medical treatments taken overseas
6. Pregnancy and related complications
7. Pre-existing conditions (until the completion of the specified waiting period)
8. Costs of injuries from criminal or unethical activities

As such, you’ll be well-advised to carefully go through the terms and conditions of a family insurance plan before finalising any decision to avoid any unpleasant surprises later on.

Also read: Importance Of Cashless Hospitalisation: How Does It Work, Types and Benefits

How Does a Family Insurance Plan Work?

A family insurance plan or a family floater plan is a medical insurance plan where you can add all eligible family members, like yourself, your spouse, your dependent children up to the age of 21-25 years, and your parents, to the policy. All the enrolled family members share the policy’s sum insured or the maximum amount that can be used to settle eligible medical claims, in a policy year. 

For example, if you have a family insurance plan for five family members (yourself, spouse, child, father and mother) with a sum insured of Rs.10 lakh, any of the members can settle medical claims up to Rs.10 lakh in a year. However, if one member, say your father, uses Rs.5 lakh midway in the year in a claim, that would leave all the members with Rs.5 lakh to settle any other claim during the remaining months of the policy year. But if one member uses Rs.10 lakh in a claim in a year, this would mean all the members will not be able to make any other claim during the remaining months of the policy year as the full sum insured of Rs.10 lakh has already been exhausted.

In addition, all the members can enjoy cashless treatment using the family insurance plan in a network hospital and reimbursement of expenses for treatment received at a non-network hospital, as per the terms and conditions of the insurer. 

Also read: Managed Care Plans: What Is It & How Does It Work?

Eligibility Criteria to Buy a Family Insurance Plan 

• Age: 18-65 years for adults; 90 days-25 years for children
• Members: Spouse, dependent children and parents, parents-in-law
• Renewability: Lifetime

Best Family Floater Health Insurance Plans in India

Also Read: Critical Illness Insurance Plans Available In India: Types And Benefits

Things to Consider Before Buying Medical Insurance for Family

• You might want to consider checking the coverage scope of a plan before purchasing it.
• Some insurance companies in India offer family health renewal options till the eldest member of the family turns 60 or 65 years. However, you might want to consider a plan with a lifelong renewability option. 
• As a family insurance plan covers each family member, it might be convenient for you to choose a plan with a sum insured enhancement option. 
• A large network of cashless hospitals offers easy accessibility and affordable services. Consequently, you need to check if the network hospitals are near your residence before purchasing a policy.
• A proper understanding of the claim settlement process can help policyholders choose a plan that offers quick and hassle-free settlement options.

Also read: What Is A Cardiac Health Insurance Policy? Why Is It Important?

Steps to File a Claim for a Family Insurance Plan 

1. Inform your insurer about the medical emergency.
2. Take a pre-authorised form from the TPA (Third Party Administrator) desk and fill it up.
3. After submission, the hospital will send the same to the insurer for approval. On successful approval, the insurer will settle your payment directly with the hospital. 
4. To get reimbursement, you need to submit the claim form post bill payment. Along with this, you need to provide other documents and wait for your insurer’s approval. 
5. After successful approval, the amount will be reimbursed. 

Reasons to Buy Medical Insurance for Family from Navi 

• Comprehensive health benefits coverage
• Monthly premiums starting at Rs.241
• Cover up to Rs.1 crore
• Paperless application and claim process. 
• The app-based process allows you to insure you and your family in 5 minutes
• Cashless claims under 20 minutes**
• Cashless facility available from over 10,000 network hospitals 

* Monthly premium may vary as per the plan opted for. ** Condition Apply

Final Word

Now that you know a few important things about medical insurance for your family, you can consider purchasing the one that best meets your family’s unique medical insurance requirements. This is especially critical for families that do not have any existing insurance protection. While doing so, please read the terms and conditions of your shortlisted policies or reach out to your chosen insurer’s customer service to ensure you make informed decisions. More importantly, do not just focus on the premium cost but also the policy features and an adequate sum insured while finalising your decision. 

If you want to buy a comprehensive health insurance plan you can try Navi Health Insurance. Just download the Navi app and sign up for the policy today.

Also read: What Is Incurred Claim Ratio In Health Insurance? How To Calculate ICR?

FAQs on Medical Insurance Policy for Family

Before you go…

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Disclaimer: This article has been prepared on the basis of internal data, publicly available information and other sources believed to be reliable. The information contained in this article is for general purposes only and not a complete disclosure of every material fact. It should not be construed as investment advice to any party. The article does not warrant the completeness or accuracy of the information, and disclaims all liabilities, losses and damages arising out of the use of this information. Readers shall be fully liable/responsible for any decision taken on the basis of this article.