Health Insurance

How Should You Plan Your Health Insurance for Your Family?

By Admin
Mar 01, 2021
how should you plan health insurance for your family

Over the past few years, it is observed that medical costs are rising at an alarming rate. Even more terrifying is the fact that diseases are also on the rise, attacking the young and old alike. Well, maybe the nature of the diseases may differ, but younger generations are also not spared from the avaricious grasp of peculiar ailments. 

With 89.2% of the health expenses being OOP(Out of Pocket) in India, we have a long way to go before all of us understand the real importance of health insurance. Now with the Covid 19 pandemic, health insurance has become inevitable if you do not want a hefty pinch in your pocket. The average covid-19 hospitalisation expenses in India has been around INR 1-2 lakhs which increases with co-morbidities.

A single surgery with 3 to 4 days of hospitalisation is enough to wipe clean a considerable amount of savings. In order to protect against such mishaps, it is advisable to invest in planned health insurance policy schemes at an early age. 

Types of health insurance plans in India

There are innumerable mediclaim policy schemes that are currently in operation in the market. Different companies offer separate perks, benefits, and coverage options. It depends on the needs and demands of the buyer which particular policy will suffice his/her needs.

There are policies that will serve the health needs of the entire family. These are known as family health insurance policies. This kind of policy covers all the family members of a single-family under the coverage of a single premium insurance policy with a particular amount of insured sum. This sort of insurance scheme assures the coverage of 2 or more members of a single family at one go if they get hospitalised or diagnosed with any particular ailment.

Apart from this, there is a floater system. The policy buyer can get coverage for the self along with the spouse and child/children based on a floater sum basis. In this sort of policy, the policyholder is eligible for claiming the entire insured amount. Moreover, the policy buyer can also customise the plans as per the needs and requirements.

Benefits of buying family health insurance plans

One of the most convenient advantages of buying a family health insurance plan is that it suits bigger families consisting of grandparents, parents, and children. Some of the major advantages of this sort of policy include:

1. Hospitalisation expense coverage

This is the basic reason to opt for health insurance. Nearly 39 millions of Indians go below the poverty line every year because of health expenses.

A family health insurance policy lessens the requirement of buying health policy plans for every single member individually. Moreover, family health insurance does not require individual premium payment for every member separately. In the case of hospitalisation, the insured member is liable to claim cashless benefits in any network hospital, exactly like an individual health plan. This suits all the members under the insurance coverage. There is no compromise in the treatment, once the finances being taken care of by both the insurer and the insured.

2. Insuring new members

Under the family health insurance policies, additions of the new family member(s) can be done very easily. In case one of the members under a particular policy scheme dies, then the other members will continue receiving the insurance benefits as before. 

3. Affordable premium expenses

As the family mediclaim schemes do not require to pay premiums individually for every single-family member, spouse, children, parents all can be brought under the roof cover of a single policy plan. This sort of investment results in reduced premium costs.

4. Including parents in a single plan

Including both sets of parents, i.e. of self as well the parents of the spouse, is also possible under a single plan. With the payment of an additional extra premium, it is possible to include dependent parents or in-laws under a particular scheme.

However, it is always advisable to opt for a separate plan for them so that they have a specialised plan for the senior citizen, especially if they have any comorbidities or pre-existing ailments. 

5. Additional benefits

Almost all types of family health insurance policies offer certain types of additional benefits including maternity care, newborn baby cover, critical care cover, etc. However, there exists a waiting period clause. The policy buyer should carefully read all the clauses to avoid any future misunderstandings while claiming.

6. Avail discounts

Family mediclaim policies normally offer certain types of benefits and perks as incentives and discounts. 

7. Tax benefits

The health insurance premium policies are given a tax redemption option under Section 80D of the Indian Income Tax Act. A family health insurance plan is liable to receive tax benefits.

Considerable factors before buying a health insurance plan for family

1. Total health insurance coverage

The most important factor to consider before settling for any family health insurance policy is to ensure the amount of basic health coverage. Almost all health plans include hospitalisation costs, day-care charges, ambulance expenses. Moreover, the pre-existing disease factor should also be taken into consideration.

2. Flexibility

The family mediclaim policies possess the advantage to upgrade the total amount of sum insured. As the medical expenses are liable to change, therefore, the policyholder can also increase the sum insured as per the changing needs and demands. 
Health Insurance Plans also have the flexibility of increasing their coverage from time to time by adding riders, subject to underwriting approval.

3. Cashless hospitalisation

Under network hospitals, insurance companies provide cashless hospitalisation facilities. This makes the entire process of hospitalisation hassle-free and smooth. However, before settling for any particular plan, it is advisable to verify whether good and preferred hospitals are there in the list of network hospitals under the insurance company.

4. Lifelong renewability

Many health insurance companies allow policy renewal until 60-65 years of age. In recent days, this has yet further been improvised allowing lifelong renewal benefit. 

5. Smooth claim settlement

While buying a family health policy, it is advisable to understand all the clauses and proceed accordingly. This will ensure hassle-free claim settlement during the time of need.

Common Exclusions in Health Insurance Plans in India 

Almost all family health plans possess a list of certain common exclusion factors. These factors include:

  1. OPD costs along with routine health check-ups
  2. Costs of any sort of cosmetic surgery
  3. Overseas treatment, except it, is accepted in the plan
  4. War illness or injury due to any sort of illegal activities
  5. Complicated pregnancy conditions, miscarriage, abortion
  6. Pre-existing health conditions before the completion of the waiting period

Eligibility criteria in health insurance plans in India

While settling for a family health insurance plan, some vital eligibility factors need to be considered:

  1. Addition of any new family member within the policy coverage with the payment of an additional premium
  2. Expiration of the policy when the eldest member of the insured family reaches the optimal age covered of a person
  3. Increase the total amount of sum assured if new members are added
  4. As soon as a child becomes independent as per the terms of the insurance, the policy will not cover that member
  5. Not to include senior citizen parents as it will incur in increased premium payment

Summary

From the above discussion, it is clear that family health insurance coverage possesses a lot of benefits. The premium payment happens once a year for a single insured amount covering the entire family. The combined amounts of premiums paid for individual mediclaim plans will be significantly higher than that of a single-family health insurance policy. Tax benefits are also an added advantage. Therefore, for sufficient insurance coverage, it is advisable to begin and plan early to ensure a healthy future for the entire family.

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