Under the current circumstances, it can be said beyond a shadow of a doubt that investing in healthcare insurance plans is a thing of utmost necessity. With that decided, next comes what type to choose—an individual health plan or a family floater policy. Both of these types of plans are “indemnity plans”. This means that reimbursement of the hospitalisation costs occurs up to the limit of the insured amount under the scheme of the particular policy. In case of a mediclaim plan, the insured sum determines the limit of the claim amount that the insurer will settle either through instant payment or reimbursement as per the clause of the plan.
Individual Health Plan
This has to be bought under the name of a single individual and the plan will provide coverage of the medical expenses of the buyer. Every individual of a single-family might possess and maintain individual health policy. The premium will depend on the age of the individual and the amount insured.
Family Floater Health Plan
Here, more than one member can be covered under the benefits of one single plan. For example, a couple along with their children can take shelter under the coverage of a single policy with the payment of a single premium. The premiums of most of such policies depend on the age of the eldest member involved under the plan.
Under a family floater health insurance policy, any one or all the members involved are eligible to claim and avail the total insured amount. This is unlike the individual plan where none else other than the holder is eligible for claiming. One of the most striking bases of the planning of floater policy is that all the members involved in a particular floater plan falling sick in one single year are practically negligible.
This sort of floater plan can be bought by a proposer along with spouse, children (up to 25 years), unmarried offspring, divorced/widowed daughters, dependent parents.
If INR 5 lakh is invested by a person between 30 and 35 years for an individual plan, the premium value is supposed to be around INR 12,500, after a deduction of 10% as a discount. But, if the same amount is invested in a family floater policy, the premium value is supposed to be around INR 10,400, the difference being nearly 20%.
Age Bar of Children
Under a family floater policy, the age of the children is a vital factor. The adult age of the children ranges from 18-25, as per the terms and conditions of the plan concerned. Beyond this set limit, the children get automatically moved out to a separate individual plan but that will not affect the availability of the coverage benefits of the policy. The grown-up child might opt for a separate individual policy but all the continuity benefits of the previous floater plan will remain unchanged.
Floater policies allow the best coverage at reasonable expenditure. It is better to choose a floater policy that opting for separate individual plans. The maintenance also becomes easier.
The sudden skyrocketing of the healthcare expenses have led to an increased demand for health insurance policies. The family floater option suits best to fulfil the healthcare needs of the entire family under the shelter of a single plan.
Salient Features of a Family Floater Health Insurance Plan
- Cashless transaction in case of hospitalisation
- No bar for maximum age limit
- Maternity care benefits
- Eligibility for tax benefits
Apart from these common features, certain plans also provide additional benefits
- Cost coverage for diagnostic investigations, consultancy charges, ambulance costs, etc.
- Payment of both pre-hospitalisation and post-hospitalisation charges
- Complimentary health check-up at the end of a claim-free year
- No necessity for any medical investigation up to 60 years
- Special coverage for pre-existing ailments
- Provision for personal accidental injuries
- No third party administrator involvement
- Covers daycare costs, organ transplantation charges, covering OPD expenses
- Cumulative bonus for a certain span of claim-free period
- Instant restoration of the insured amount in case it gets exhausted during the policy term
Although there are plenty of cashless health insurance plans currently available in the market, careful consideration is essential as to which one to choose. The plans with reasonable premium rates with necessary facilities are the best to opt for. With online insurance compatibility portals, calculating premiums and comparing the pros and cons of different types of policies is not difficult.