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
Health insurance plans for a family have become a necessity due to the following reasons.
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.
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
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
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.
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.
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.
The medical insurance plans for family usually include the following.
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 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 can also be quite high but all insurance plans cover these thereby giving you
peace of mind.
The health insurance policy for family often includes preventive health check-ups so diseases are diagnosed quickly
for faster treatment and recovery.
Ambulance charges are covered by the insurance plan. In some cases, emergency air ambulance expenses are also
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.
Alternative treatments such as ayurveda, Unani, Siddha, homeopathy, yoga, and naturopathy are covered by health
Full family health insurance mostly comes with a lifetime renewability option for better protection for your entire
family at all times.
Many of the top insurance plans cover organ donor expenses which cover all medical expenses incurred from
harvesting an organ from a donor.
Medical insurance for family generally excludes the following.
Almost all insurers in India do not cover expenses that are incurred due to congenital diseases or defects.
Most plans do not cover injuries that are caused by participating in adventure sports. This includes having an
accident while participating in such sports.
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.
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.
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.
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.
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.
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.
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.
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
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.
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.
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.
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.
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.
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
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
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
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
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.
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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