Family Health Insurance

Family Health Insurance


An emergency can occur anytime and nobody can bet on one’s health. Hence, the best decision is to procure family health insurance in order to face unexpected medical emergencies. When one thinks to join a plan, many questions arise like the type of coverage, the repayment options, various schemes, and doubts related to reimbursements. 

Reasons Why Family Health Insurance is important

There are various reasons to opt for a family health insurance policy. Below mentioned are a few of the reasons for the same:

  1. One of the foremost reasons for purchasing family health insurance is that it guards against unnecessary medical expenses. Usually, people do not save enough for health emergencies and in such critical situations, people end up using their long-term savings. It is a bad step as it has an adverse effect on long-term savings. Availing a family health insurance policy helps in major health treatment costs thus, saving you more.

2. The changes in the lifestyle, adoption of outside eating habits, and lack of exercise have led to serious-risk diseases such as high blood pressure, cardiac problems, diabetes, etc. A family health insurance              policy comes to rescue from any such health issues.

3. The medical treatment charges are rising day by day for certain diseases like cancer. A hefty amount is needed to treat such critical illnesses. Getting health insurance for family ensures that this                                 treatment can be taken cashless via network hospitals.

4. A family floater option is provided under one health insurance plan to ensure treatment for family members under the concerned plan.

Features of Family Health Insurance

Following are the features of a family health insurance plan:

  • It covers the entire family members.
  • The majority of insurers provide rebates on high sums assured on health insurance plans for the family.
  • It provides the facility of cashless claim settlement when the person is treated in a network hospital of the insurance company.
  • It comes with no claim bonus. If the person does not raise a claim throughout the policy period then the health insurance companies can increase the sum assured each year.
  • The policy term offered by health insurance companies ranges between 1 year, 2 year or 3 years.

Benefits of Family Health Insurance

A health insurance plan for family comes with a lot of benefits.

Below mentioned are some of the benefits of family health insurance policy:

  • It includes all members of the family; yourself, spouse, dependent children, dependent parents & dependent parents-in-law under the same plan. Some plans also offer the facility to cover your extended family under the health plan. Basically, it is a one-stop health insurance plan for families. 
  • When compared with individual plans, the premium paid for a family health insurance plan is cheaper thus, enabling affordable coverage and saving your time & money.
  • If any member of the family falls ill then the sum insured can be used completely under the family floater plan.
  • Some of the insurers offer maternity coverage for any maternity related expenses under the family health plan to those planning to start a family in the future. 
  • One can opt for a comprehensive cover as it comprises coverage features.
  • A family floater plan enables you to add new members depending on the new terms and conditions of the policy. All you have to do is inform your insurer, pay an additional premium & the child would be included under the plan without any worries.
  • A family floater plan provides certain tax benefits. When you purchase a concerted plan, you can avail a tax deduction for up to Rs 25,000. If you are a senior citizen then the amount increases to Rs 50,000. A deduction of Rs 25,000 can be availed if the plan is separately bought for parents. If your parents are senior citizens then the same amount can go up to Rs 50,000.

Eligibility Criteria

A family health insurance plan which is affordable and encompasses all the family members should be chosen. Various types of eligibility criteria are needed to be entitled to family medical insurance. It is advised to choose a plan that is extensive and includes a majority of the criteria that you are searching for. If your family has better health insurance coverage then you will get preventive medical care which will lead to early treatment & diagnosis of any type of illness before they get serious.

Exclusions of Family Health Insurance Plan

There are certain medical expenses which are not added in family health insurance plans like OPD treatments & routine medical check-ups, expenses incurred on any aesthetic treatment or plastic surgeries, expenses incurred on life-support machines, treatment taken overseas unless covered under the plan, illness/injury occurring due to unethical activities, war conditions, nuclear reaction or similar conditions, pregnancy or childbirth-related complications; abortion or miscarriage, and persisting medical condition not included until the waiting period is completed. 

The Claim process for a Family Health Insurance Plan

A health insurance claim can be processed in 2 ways:

For Cashless request for Pre-authorization

Following steps need to be followed for a cashless request for pre-authorization

  • Either email or fax the pre-authorization form, whichever way you like and easily available at the TPA or insurance desk of the hospital. The pre-authorization form can also be downloaded from the insurance company’s website. 
  • Submit necessary documents like medical reports, bills, discharge letters, etc.
  • The claim management team will further send the approval letter post the approval of the claim request.
  • The insurer will contact the hospital for any query pertaining to the claim.
  • If in any case, the form is not approved then the concerned person needs to apply for a reimbursement claim.

Reimbursement Claim process

Following steps need to be followed for the reimbursement claim process:

  • As mentioned at the time of policy procurement, you need to submit the claim form with various other essential documents.
  • Also, you need to answer the queries raised by the claim management team of the concerned insurer.
  • Post submitting the form, you will either get a letter of approval or rejection.

Thus, Family Health Insurance is very important and it saves money because in one Plan the entire family is protected. Any family member diagnosed with a disease or hospitalised can avail the policy plan.