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Features of buying Family Health Insurance Plans in India

by Sneha Shukla

 

Looking for family health insurance plans and don’t know where to begin or what to look for? You’ve come to the right place! In this article you will learn everything there is to know about health insurance plans in India for family, including the factors to consider when buying best family health insurance plans in India, the features that are desirable in health insurance plans for family and other important aspects.

Let’s begin by understanding more about the key factors to keep in mind when looking for best Mediclaim policy for family:

  • Family demographics: This would be a good starting point, i.e. keeping in mind each family member’s age, relationship and location. Age is important because the premium is calculated basis age of eldest insured family member. Relationships such as spouse, children, and parents are the common ones that all family health insurance plans allow for combined coverage in a family floater plan. Extended relationships such as in-laws, brothers or sisters, aunts or uncles, cousins etc. would depend upon the insurer, whether they allow such relationships or not. Location may impact premium calculation as well as amount of sum insured required because of hospitalization costs which are higher in metros compared to non-metros.
  • Family medical history: Whether each family member is in the pink of their health, or does anyone have a pre-existing disease or has undergone some medical procedure in the past? Every insurance company has certain underwriting guidelines that would determine acceptance of application, whether any pre-policy medical screening might be required and/or the amount of premium payable. For example, people with PEDs or pre-existing diseases are considered relatively risky for coverage by insurers as the probability of regular claims goes up.
  • Amount of Sum Insured: Medical inflation has made hospitalization expenditure unaffordable for many. The whole idea behind health insurance is to safeguard your family against any financial strain. Therefore, the sum insured must be sufficient to take care of treatment expenses of all the insured members where they are located.
  • Type of policy: A young, nuclear and healthy family might want a family floater plan, whereas middle-aged people would be better served by individual health insurance policies. Elder members should ideally go for senior citizen plans or critical illness insurance (if they suffer from any).
  • Annual budget: Health insurance plans have to be renewed every year in order to continue enjoying the benefits, therefore the amount should be such that it can be afforded by the family as per their income levels and financial planning.

Now, let’s move on to the plan benefits that would make for the best health insurance plans for family:

  • No-cost increase in sum insured: Look for features like no-claim bonus, restoration or reinstatement benefit etc. which augment or replenish the sum insured without having to pay any extra premium.
  • Pre- and post-hospitalization expenses coverage: While nearly all health plans take care of in-patient hospitalization due to accident or illness, it is equally important to ensure coverage for non-hospitalization treatments such as OPD, doctor consults, diagnostics, daycare procedures etc.
  • Free health checks would be a good feature to have, as it would help you save on the annual cost of conducting check-ups for the entire family.
  • Network hospitals: Always look for a wide list of network hospitals in your location (be sure to check in advance in case you plan to shift to another city)
  • Add-on covers: There are multiple add-on covers or riders that can be chosen for extra premium according to the family’s medical needs. Critical illness cover maternity benefits are some of the common ones.
  • Alternate therapies such as AYUSH treatment would be beneficial for families with members who prefer non-allopathic forms of therapies.
  • Discounts: Many insurers offer family discounts for 2 or more members, 3-year policy term discounts etc. which will help in saving some money on your overall premium.
  • Insurer Claim Settlement: Make sure that the chosen insurance company has a high claim settlement ratio and quick plus hassle-free claims management process.

 

Last but not the least, let’s learn more about the crucial policy features in family health insurance plans to keep a watch on:

  • Floating sum insured: The sum insured in a family floater plan is available across all insured members (unlike individual plans). Higher the sum insured, the better.
  • Waiting Period: Each plan mentions the waiting period for specific conditions (maternity, for example), diseases (pre-existing diseases or specified illnesses) and treatments (bariatric surgery, hernia surgery etc.). Lower the waiting period, the better.
  • Minimum and maximum age at entry: This should match the age of the youngest and oldest member who will be insured under the family floater plan.
  • Room rents: Check for limits if any in the amount or category of room you are allowed to stay in during a hospitalization event. No limit is best.
  • Sublimits: Look for maximum cap if any on the amount of expenses that is payable by the insurer for each treatment, condition or disease covered. Up to sum insured is best.
  • Co-payment: If your plan mentions co-payment, this means that a specified percentage or amount will have to be borne by you and the insurer will only pay the balance. No co-payment would be better.
  • Exclusions: Keep a watch on the list of diseases, conditions and treatments that are not covered by your plan (which means you will have to pay out-of-pocket for those).

Health insurance should not be viewed as a one-size-fits-all product. However, owing to the complexity and variety of health insurance plans in India, shortlisting and finalizing the best-fit choice for your family can be confusing. This is where SANA.Insure can help you. We offer customized suggestions for most suitable health insurance plans, by analyzing your family details, prevailing health, medical needs as well as expectations. Buying family health insurance is made easy on sana.insure – we help you understand complex policy terms and conditions in a simple and easy-to-understand manner.

You can also get in touch with us over WhatsApp chat on 8278271818 or call us on 1800 202 8118 to connect with a Health Insurance Expert at SANA.Insure.

Wish you a healthy and happy life!

 

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