The cost of medical care is constantly spiking owing to inflation, and quality care post the diagnosis of an illness can drain a family’s savings. But there can be no compromise with the health of your loved ones. This is why purchasing a family health insurance plan is a wise decision. It covers your entire family with a single premium. Comprehensive coverage of all health problems, from injuries to surgeries, eases financial worries.
When buying a family health insurance plan in India, make sure the policy you wish to purchase has the following features:
Healthcare needs like health check-ups, doctor consultations, diagnostic tests, medicines, hospitalization charges, etc for all members of the family are covered by the family health insurance policy. One policy, instead of multiple, is easier to keep track of and lets your family members make more than one claim in a year. Everyone gets the best care without worrying about the expenses.
An individual health insurance plan only covers one person. Getting an individual plan for every member of the family can be cumbersome and not very cost-effective. A family insurance plan on the other hand lets you include yourself, your spouse, and four children (up to the age of 21). You have to pay only one premium for the whole family and get end-to-end healthcare coverage. On top of that, you get tax benefits! Moreover, such a plan also offers ambulance assistance, options for AYUSH treatments if allopathy treatment is not enough
There are certain things you need to keep in mind when buying a family health insurance plan, these include:
Inclusions: Your plan's inclusions or coverages are all the things that it will cover if you meet certain requirements. Ensure that you check what it includes: the type of treatment, the cost of hospitalization, pre-and post-hospitalization, in-patient treatment, other treatment options, day-care information, etc. The coverage scheme may differ among health plans.
Room rent limit:Room rent is essentially the cost of the hospital room. Choosing the wrong room during hospitalization, or missing the room rent limit, may cause the claim settlement amount to be less if the room rent limit is not adhered to. The claim amount would likely be a smaller amount as proportionate to the mentioned rent limit if the room opted for has a higher rent than the limit mentioned. It is better to select the room according to the policy as all medical expenses, including the doctor's fee, vary with the room chosen during hospitalization. When buying, be sure to choose the right room rental limit.
Waiting period: There is a waiting period for people with pre-existing diseases. The waiting period for filing a claim may usually be 30 days. Pre-existing diseases are subject to a waiting period before being accepted into the health plans. There are varying waiting periods under each insurance plan, so make sure you check. It may be to your advantage to choose an insurance plan with a shorter waiting period.
Exclusions:A health plan should be checked both for what is covered as well as what is not covered by the plan. This way, it is easy to determine which treatments are excluded.
Claim Settlement Ratio: When filing a claim with an insurer, you should know the claim settlement ratio to ensure the claim is approved if the claim is genuine and in accordance with the policy specifications.
Covers expenses incurred during organ donor treatment.
Coverage of 100% of the sum insured is applicable to the same illnesses.
Coverage of up to 20,000 INR for Ayurvedic/Homoeopathic hospitalizations across the nation.
Minimum and Maximum Age Limit:The members of the family must be between the age group of 18-65 years.
Age of Dependent Children:Dependent children should be between the age of 3 months to 30 years.
Health Insurance is a must for any individual or family who are looking to secure their health and financial future. Owing to medical inflation in the recent years, the cost of medical treatment and procedures often drains one’s lifetime savings and acts a burden. However, getting a health insurance means adding a fall-back cushion to safeguard savings as well as get tax benefits.
As you apply for a health insurance plan, the insurance providers do a thorough check/assessment of your health. Basis your health status, they offer a premium amount for the plan.
Your age is a major factor on which the health insurance premium will be decided. Most companies follow this mantra – the higher the age of the insured, the higher the premium to be paid. This is because older people are prone to illnesses. It is advisable to buy a health insurance plan when you are younger to enjoy more benefits and pay a lower premium.
Your occupation or the nature of your work will also determine the health risks you may be exposed to. Given our hectic lifestyles and sedentary jobs, you will be prone to stress, anxiety, etc. which will lead to other health issues. So, for example, if you have a high stress job, your premium will be higher.
Medical history plays a vital role too in deciding the premium. If you have a chronic illness, or have suffered from any past major illnesses, or if family history points to any pre-existing illnesses, your health insurance premium will go up.
If you have a co-pay feature in your health insurance plan, then your premium will be lower as a certain percentage of the medical costs will be borne by you and the rest by the insurance provider..
Habits. Yes, your habits matter a lot. For example, if you are a smoker, you are at risk of serious illnesses like cancer. If you drink regularly, you are at risk of chronic diseases. So, your premium will be higher.
Duration of your policy will also affect your premium. If have a longer duration for your policy, you will pay less premium.
Your BMI or Body Mass Index also affects your premium. If your BMI is high, then you are at a higher risk of chronic or lifestyle illnesses. This means you will pay a higher premium.
Location If you stay in locations where food, water, air quality is an issue, it will lead to serious health issues and therefore, your premium will be higher.
Your plan type affects your premium amount.
Platinum Plan:Per claim-free year, a bonus of 50% is added to the total bonus.
Multiple sum insured options:You can select from 3 plan options, along with options for covering sums ranging from 1.5 lakhs to 1 crore
Immediate family cover:This policy covers you, your spouse, and your children
Ayurvedic and homoeopathic treatment:With the Gold & Platinum Plan, policyholders are covered for inpatient hospitalization expenses (up to Rs 20,000) in a recognized Ayurvedic/Homoeopathic hospital with the admission period not less than 24 hours.
Convalescence benefit:A continuous hospitalization claim for more than 10 days is eligible for a benefit pay out of Rs 7500 per year, provided the hospitalization claim is admissible.
Sum insured reinstatement: The amount insured, along with any cumulative bonus (if any), will be reinstated if it has been exhausted by the end of your policy year.
Road ambulance cover:Ambulance expenses incurred during the policy period will be covered up to Rs. 20,000.
Daily cash benefit: As an accommodation expense benefit, one parent or legal guardian may claim Rs 500 per day for up to 10 days during a policy year, to stay with a minor insured under the policy.
Day-care procedures cover:Under this policy, listed day-care procedures and surgeries are covered for medical expenses incurred during treatment.
Bariatric surgery cover:Medical advice is required for bariatric surgery coverage, subject to certain terms and conditions.
Pre and post hospitalization:The policy covers medical expenses 60 days prior to and 90 days following hospitalization.
Maternity/new born baby cover: The policy covers maternity expenses as well as medical expenses incurred for treating a newborn. However, certain terms and conditions apply.
Tax planning is one of the most effective ways to save on health insurance. When you purchase either an individual health insurance policy or a family health insurance policy, you will be able to take advantage of several tax benefits.
An overview of the same is provided below:.
You can avail all your health insurance benefits PAN India. Explore our vast network partners.
You can avail all your health insurance benefits PAN India. Explore our vast network partners.
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Family health insurance covers the entire family. The family plan covers every member of your family for a single premium, in contrast to the individual plan. Thus, no separate premiums are required for any of the individuals, regardless of their age.
Typically, children are much more susceptible to illness than adults. And since kids tend to get sick more frequently, it is important to make sure they have a safe and affordable health insurance plan. That way, you can handle hospitalization and medical expenses for their treatment without a hassle and focus on just being there for the little one.
Bajaj Finserv Health offers the best cashless health insurance in India.
The concept of a family floater refers to a health insurance plan that covers the entire family. Because of a floater, all members of the family receive benefits from the same pool.
Yes, you can add your parents in the family health insurance, however, there may be an increase in the premium amount, depending upon their age and pre-existing diseases.
In a family health insurance plan, for a single premium amount, separate policies are given to each members of the family based on their age and requirement. On the other hand, in a family floater plan, all the members are covered under one umbrella policy with the same benefits.
The premiums will be determined by the age and amount of insurance of each individual. However, most insurers will give you a 10 percent discount if you are insured with more than one family member at the same time. The sum insured by other members remains intact if a claim is made by one member.
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