Medical expenses incurred towards the treatment of any ailment, surgery, hospitalization, etc. are covered under a health insurance plan. The cost borne may be reimbursed up to the eligible sum insured via the insurer by providing supportive documents or by using the cashless facility offered at the listed network hospital. Family medical insurance plan is a type of health insurance plan (also referred to as family floater plan), which covers all the family members against medical expenses arising out of diseases and illnesses or accident. Health insurance plans for family covers your entire family at lowest possible premium. The premium depends on the sum insured, number of members included, age of the oldest family member.

Feature of a health insurance plans for family

• Increase in the sum insured: A family floater medical insurance plan comes with a no claim bonus feature, this feature increases the sum insured if there is no claim for the duration of the policy period.
• Cashless claim settlement option: You can avail cashless facility at listed network hospitals.
• Policy term: Health insurance plan for family also offers options in coverage term. You can choose 1, 2 or 3 years as a coverage term.

Benefits of Health Insurance Plans for Family

• Save money: You can cover your whole family under a family floater insurance plan. You will save ample money as opposed to buying a single medical health insurance plan for every member.
• Tax benefit: You can avail tax benefit on all the premiums towards a medical health insurance plan as per Section 80D of the Income Tax Act, 1961.
• Restore exhausted coverage: Many family floater medical insurance plans offer special benefits referred to as restore benefit, which facilitates to reinstate full insurance for unrelated medical expenses as soon as the sum insured is exhausted during the policy period.
• Medical umbrella for the whole family: You can cover the whole family underneath one umbrella plan (under a single health plan).
• Easily add a new member: You can add kids or any other family member easily in the same family floater plan.

Check Eligibility to Buy Health Insurance Plans for Family

Eligibility Criteria for Family Health Insurance Policy is as follows:

• Entry Age for the Policyholder/Proposer under Family Health Insurance
• In family health insurance, the eldest person becomes the policyholder. The entry age for a policyholder/proposer is from 18 to 65 years, while some insurance company may allow it up to the age of 70 years and above.
• Entry Age for Family Members under Family Health Insurance
• For Adults: The minimum entry age is 18 years and the maximum 65 years, while some insurance company may allow it up to the age of 70 years and above. For Dependent Children: The minimum age to children under the family health insurance is from 90 days (this may vary, some insurers may allow it from 30 days and some may have different entry age) to 25 years.
• Medical Tests under Family Health Insurance Plan
• Few insurers ask for medical tests to be carried out at their nominated centers. While few insurers offer family health insurance policy up to certain age, say, 45 years without any medical tests. In some instances, insurers may make medical check-up as mandatory.
• Eligibility for Renewal of Family Health Insurance Plan
• Almost all the insurance companies offer lifelong renewal. You need to renew your family health insurance policy every year to keep in force and renew before it expires. After the due date of renewal the insurance company gives a grace period of 30 days. If you want to keep the policy in force, you must renew before grace period ends or else the policy terminates.

What is Covered In Health Insurance Plans For Family

Health insurance plan for family covers in-patient hospitalization, pre-hospitalization, post-hospitalization, day care, health check-up, emergency ambulance service, etc. Let’s see each in detail:

• In-patient Hospitalization: All the medical expenses due to hospitalization are covered. In case, if any of the insure family member is hospitalized for more than 24 hours, the insurance company will pay the medical expenses.
• Pre-hospitalization Expenses: Any medical expenses incurred before hospitalization are termed as pre-hospitalization expenses. For example, X-ray, MRI, blood test, urine tests, sonography results, etc. done before hospitalization are covered.
• Post-hospitalization Expenses: Any medical expenses incurred after the discharge from hospital are termed as post-hospitalization expenses. For example, medicines, or any medical tests done after the discharge to check the improvement.
• Ambulance Charges: Most of the insurance companies offering family health insurance plan covers emergency ambulance charges. The amount of the emergency ambulance charges varies from insurer to insurer.
• Hospital Cash: The insurance company provides daily cash allowance. This hospital cash can be utilized to cover the cost of the transportation or other basic requirements of the person attending the patient.
• Restore Benefit: Many health insurance companies offer restore benefit feature under family health insurance plan. This feature helps to reinstate the basic plan cover in case the coverage gets exhausted. However, restore benefit is applicable only for unrelated claims.
• Day care treatment: Day care treatments are the treatments that does not require 24 hours of hospitalization. For instance, medical expenses related to cataract which can be treated within few hours.

What is Not Covered in Health Insurance Plans for Family?

Here is the list of few exclusions of a family floater health insurance plan

• Any claim raised within the 30 days waiting period of the health insurance policy. issuance wouldn’t be covered unless and until it arises due to the accident.
• Any sexually transmitted diseases.
• Any treatment related to fertility issues.
• Any treatment and expenses incurred due to routine medical check-ups.
• Any treatment/surgery done for gender reassignments or for gender change.
• Artificial life maintenance, including life support machine use, where recovery or restoration of the previous state of health is not possible.
• Any treatment undergone due to surgery or a plastic surgery, aesthetic treatment, or any further consequences due to such treatments. – Treatment of stress, mental illness or any psychological disorders, or due to the abuse of stimulants or depressants.
• Any OPD Treatment.
• Any treatment undertaken abroad.
• Any Illness or Injury directly or indirectly causing or arising because of breach of any law by the insured who has a criminal intent, war, nuclear, chemical or biological attack or weapons, acts of foreign enemies, hostilities, civil war, rebellion, revolutions, insurrections, mutiny, military or usurped power, seizure, capture, arrest, restraints and detainment of all kinds.
• Illness or Injury caused due to consumption or abuse of tobacco, intoxicating drugs and alcohol or hallucinogens.
• Any act of self-inflicted injury, suicide or attempted suicide while sane or insane.
• Any treatment related to pregnancy (including voluntary Termination), childbirth, maternity (Including caesarian section), miscarriage (unless due to an Accident), abortion or complications of any of these. However, this Exclusion will not apply to ectopic pregnancy.
• That’s the list of few common exclusions of a family health insurance plan. However, one must refer and read policy wordings for the full list of exclusions.