Health Insurance Plans For Family

Health Insurance Plans For Family

When you want comprehensive coverage for your entire family, it makes sense to purchase family health insurance. You can add your spouse, your dependent children, your parents, and your in-laws to the health insurance plan. As medical costs are rising by the day and medical inflation is reaching new heights, choosing the right medical insurance for a family is essential to stay afloat when medical emergencies or illnesses hit any member of the family.

Need for health insurance plans for family

Health insurance plans for a family have become a necessity due to the following reasons.

Increasing medical expenses

Medical expenses are rising all over the world and India is no exception. As these costs are rising with no signs of slowing down, it is best to get a health insurance plan that covers your entire family rather than waiting for the costs to come down. You never know when a medical emergency can affect one or more people in your family. It is better to stay safe rather than sorry with an insurance plan that provides apt coverage.

Rise in lifestyle diseases

India is experiencing an alarming trend of rising lifestyle diseases which is affecting people of all ages. As more and more people have high-stress levels or work at a desk for the entire day, lifestyle diseases are only increasing. Lifestyle diseases can affect your pockets heavily. So buying an insurance plan helps you in covering a range of hospital expenses. Without a medical policy for the family, it is difficult to manage all expenses without going broke.

Affordable premium

Health insurance plans are available from a range of insurance providers and can suit different budgets. You can first purchase a plan that offers basic coverage for you and your family before moving to a more comprehensive coverage plan with wider coverage. Family health insurance plans are often affordable while covering your entire family which gives value. It also is more convenient as you do not have to buy an individual policy for every member.

Peace of mind

The best health insurance policy for a family provides you with peace of mind because you know you are covered for any type of medical emergency. If you had to pay all the expenses out of pocket, you will empty your savings in no time. By paying premiums regularly, you ensure you and your family are secure from whatever happens in the future in terms of medical requirements. This is essential more than ever before.

Insufficient cover from the employer

Even though your employer may provide a health insurance plan, it is probably basic which means it excludes a lot of essential inclusions. Moreover, the cover is not applicable after you resign from your job and you have no say in the coverage as your employer decides that. To include all that you and your family need, a health insurance plan for your entire family is required.

Tax benefit

Cashless health insurance plans for family and those that enable reimbursement claim both give you tax benefits so you can save on your income tax. This is specified in Section 80D of the Income Tax Act, 1961. You can get tax deductions of up to Rs. 25,000 on the premium you pay if you are 60 years old or younger. You can get deductions of up to Rs. 50,000 on the premium you pay for your parent’s health insurance policy.

What is covered in a family health insurance plan?

The medical insurance plans for family usually include the following.

Daycare procedures

Daycare procedures and treatments are always included in insurance plans for you and your family. Such treatments require less than 24 hours of hospital stay.

Hospitalization expenses

Hospitalization expenses can go through the roof but as most health insurance plans cover these, you and your family are safe in case of a medical issue arising.

Pre and post-hospitalization expenses

Pre and post-hospitalization expenses can also be quite high but all insurance plans cover these thereby giving you peace of mind.

Preventive health check-ups

The health insurance policy for family often includes preventive health check-ups so diseases are diagnosed quickly for faster treatment and recovery.

Ambulance charges

Ambulance charges are covered by the insurance plan. In some cases, emergency air ambulance expenses are also included.

Domiciliary care

When care can be given in your home, those expenses are often covered by the insurer provided such care has been advised by a doctor from one of the network hospitals.

AYUSH treatments

Alternative treatments such as ayurveda, Unani, Siddha, homeopathy, yoga, and naturopathy are covered by health insurance plans.

Lifetime renewability

Full family health insurance mostly comes with a lifetime renewability option for better protection for your entire family at all times.

Organ donor expenses

Many of the top insurance plans cover organ donor expenses which cover all medical expenses incurred from harvesting an organ from a donor.

What are the exclusions in a family health insurance plan?

Medical insurance for family generally excludes the following.

Congenital diseases

Almost all insurers in India do not cover expenses that are incurred due to congenital diseases or defects.

Injuries related to adventure sports

Most plans do not cover injuries that are caused by participating in adventure sports. This includes having an accident while participating in such sports.

Illegal activities

Most family health plans will not provide cover for the expenses incurred due to performing any illegal activity that ends up harming your health in some way or another.

Alcohol or drug abuse

Health insurance plans always exclude all expenses incurred due to alcoholism and drug abuse. They also exclude cover for any addiction-related problem that the person may be suffering from.


Wars wreak havoc on people’s lives but insurance providers do not provide cover in such cases and they are one of the most common exclusions.

Hospitals not in the network

Even the best mediclaim for family does not cover any expenses incurred when you or any of your family members get treated at a hospital that is not part of the insurer’s network hospitals list.

Is there any eligibility criteria to buy a family health insurance plan?

When purchasing a mediclaim policy for family, make sure you check the eligibility criteria because there is always one. It can differ from one insurance provider to the other but mostly the eligibility is the age limit of the family members of the policyholder. Generally, there is an age limit as the family members need to be between 18 to 65 years and the dependent children’s age limit is from 3 months to 30 years.

What things to keep in my mind while buying health insurance plans for a family?

When going through the best health insurance plans for family, keep the following points in mind so you select the best health insurance for family.

Sum insured

The primary factor is to look at the sum insured. The plan must have a sufficient sum insured amount to cover anyone in your family to get immediate treatment without any shortage. When determining the correct sum insured amount, you can factor in the ages of the insured people, any pre-existing diseases they may have, and if anyone is suffering from a critical illness.

Inclusions and exclusions

It is vital to look at the inclusions and exclusions because you need to know what is covered and what is not. Generally, health insurance policies do not cover dental expenses. If such expenses are common in your household, you may want to choose a plan that includes such expenses. Knowing the inclusions and exclusions gives you a realistic understanding of what you can claim.

Waiting period

A waiting period is common in every type of health insurance policy; even in the best medical insurance for family. Although it may vary from insurer to insurer, the one with the least waiting period is recommended because it means you can quickly file a claim as the need for doing so arises. The waiting period may be longer for plans which cover pre-existing diseases.


A health insurance plan for your family may seem good enough but you should see if you can add any riders to enhance its coverage. Riders enable you to get better protection than the base plan as they include cover for aspects excluded in the base health plan. Almost every person who purchases a health insurance plan adds a rider to improve coverage and ensure better protection.


It is possible to get discounts on your health insurance policies. If you had an individual health insurance policy earlier and now you want to get a family health plan, you may be eligible for a discount on the premium. Also, if you have a no-claim bonus from the previous year, your insurance provider can give you a discount when you purchase the family plan.

Network hospitals

When selecting from a list of health insurance plans for family, make sure you consider the network hospitals. Are the network hospitals close to where you live? How many network hospitals are there in total? Network hospitals are places where you or your family members will get treatment when required and so knowing which ones are listed is key to deciding which plan to purchase.

Compare policies

It is easy to get swayed by a certain policy but it is best to compare many plans before deciding on the perfect one for you and your family. You should compare the inclusions, exclusions, sum insured, pre-existing diseases covered, premiums, and so on. You want to think of every member of your family and ensure the plan offers something ideal for everyone.

How to file a claim for a family health insurance plan?

When you purchase the best mediclaim policy for family, it is necessary to understand how to file a claim. There are essentially two methods of doing so; cashless claim and reimbursement claim.

Cashless claim

The cashless claim is where the insurance provider directly pays the hospital the amount due for your treatment and there is no need for you to pay either party any amount. The process for a cashless claim for a family floater health insurance plan is as follows.

  • Step 1: Get in touch with the insurance provider

    Contact the insurance provider to intimate them about getting treatment at one of their network hospitals. You also need to send a cashless claim form duly filled and signed to the insurer at least 2 days before the treatment is scheduled to begin.

  • Step 2: Wait for the confirmation

    Your insurance provider will contact the network hospital and get the details of your treatment for verification purposes. Your cashless claim form will also be used for verification of the details you entered. Once the confirmation is complete, the insurance provider will confirm via email or letter.

  • Step 3: Submit documents to the hospital

    The last step is to submit the required documents to the hospital before you get the treatment. This can be done on the day of your treatment too. The required documents are usually the confirmation letter or email from your insurance provider and any other documents they ask for.

Reimbursement claim

The reimbursement claim is where you pay the hospital out of your pocket and then raise a claim with the insurance provider who reimburses the amount you paid. This is how such a claim needs to be filed for health insurance family cover.

  • Step 1: Get treatment and settle bills

    You can go to the network hospital and get the treatment that is covered by your insurance provider. You need to then settle all the bills by paying out of pocket. You must store all the medical bills of your treatment as they need to be submitted later to the insurance provider.

  • Step 2: File a claim and submit documents

    Contact your insurance provider and file a claim with them. Most insurance providers enable you to submit a claim online or by calling them. You must also attach all the documents and bills associated with your treatment and hospital.

  • Step 3: Wait for reimbursement

    The insurance provider will verify to ensure the correctness of the claim you submitted. Once the verification is complete, they will reimburse your money back to you as stipulated in the health insurance policy. You

Emergency claim

Sometimes there is no time to file a claim in advance due to a medical emergency. In this case, this is how to proceed with filing a claim for mediclaim for family policy.

  • Step 1: Contact the nearest network hospital

    Get in touch with the nearest network hospital where the treatment you require is provided and let them know that emergency treatment is required at the earliest.

  • Step 2: Contact the insurance provider

    Then contact your insurance provider and inform them that you are going for emergency treatment. You will be required to share your policy number and hospital details.

  • Step 3: Claim processing

    The insurance provider will begin to process your claim soon so that you receive the emergency treatment timely.


What is the waiting period for family health insurance policies?

The waiting period for family insurance plans varies from insurer to insurer. It can be anywhere between 30 days or more beginning from the policy start date.

How can I add my family members to the existing family health policy?

It depends on your insurance provider. Some insurers allow you to simply give them a call and request the addition of family members. Other insurers may ask you to visit their branch, fill out a request letter and submit supporting documents to add family members.

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