Family Floater Health Insurance
With a steep increase in the number of lifestyle diseases, there has also been a steady rise in the cost of healthcare services. A health insurance plan for yourself and your family members can surely act as a saviour.
The insurance market today is flooded with health insurance policies and with so many varied options selecting the best one can be an overwhelming experience. There are certain basics that you must know about health insurance, and when you know them, choosing the right plan for your family will be easy.
The first thing that you need to decide when contemplating buying medical insurance is whether you need a Family Floater or an Individual health insurance plan.
Family Floater Health Insurance
Both family floater and individual health plans are indemnity plans, which means that the expenses incurred during hospitalisation are reimbursed, up to the sum insured. However, in a family floater plan, you can avail the entire sum insured for one or all the insured members. Unlike an individual plan, the sum insured in a family floater plan is not restricted to a single member.
For example, if you buy an individual plan of INR 2 lakhs insurance for each member of your family of four, each of you has a cover of INR 2 lakhs. But in a family floater plan of INR 10 lakhs, each member can avail the benefits up to INR 10 as compared to INR 2 lakhs earlier, provided no other family member claims in the same year.
On the payment of a single annual premium, you can get a sum insured that would cover your entire family for a year. Not just this, the sum insured can be used in case there are multiple hospitalisations in the family. The premium is determined by keeping the age of the eldest member as the basis.
Features of a Family Health Insurance Plan
- Umbrella coverage
The most important feature of a Family Health Insurance Plan is an umbrella coverage wherein the entire coverage or sum insured can be utilised by any of the insured family members.
|Family Floater Sum Insured||INR 10 lakhs|
|Each member can claim up to||INR 10 lakhs|
|A total claim under the Family Floater Health Insurance Plan, across all members||INR 10 lakhs|
A single policy for all
A single policy for all family members implies you do not need to deal with multiple policies for multiple family members.
Easy premium payment
Being a single family floater health insurance plan, the premium needs to be paid at one go and there is no hassle of policy servicing and maintenance for individual members
Addition and deletion of members
The primary member of a family floater health insurance plan can add/delete family members at any point of time with the additional premium at the time of renewal without any hassle.
Many insurers allow covering in-laws and even siblings in the same family floater health insurance plan, which makes it easier to handle, especially for a young family.
Benefits of Family Floater Health Insurance
Compared to an individual health plan a family floater plan comes with almost 15-20% lower premiums.
- Sharing is Caring: (sharing coverage)
Being an umbrella coverage, family floater health insurance plans have a cover that can be shared by all the family members.
- Tax Benefits
With a family floater plan you can enjoy a tax deduction on the premium that you pay towards the insurance, under Section 80D of the Income Tax Act. You can claim up to INR 25,000 for self, spouse and two children, and for senior citizens up to INR 50,000.
Such kind of health insurance plans offer you a lot of flexible alternatives. You can add more members to the policy, increase the amount of sum insured, etc. There would be no requirements for buying a separate health plan every time you want to add a member or remove one or increase the coverage.
- Cashless Hospitalisation
Available at network hospitals the facility of cashless hospitalisation is a privilege for all policyholders. It makes the process of hospitalisation simple and hassle-free.
- Easy processing
From purchasing a family floater health insurance plan to making a claim, you can do it all online. The procedures are self-explanatory and easy to follow.
- Discounts and Deals
Many health insurance companies offer attractive discounts on floater health insurance plans.
What is Covered in a Family Floater Health Insurance Plan?
These are the generic coverage benefits. However, each plan has its own coverage benefits and may vary from case to case.
1. In-patient hospitalisation expenses
Some illnesses need a minimum of 24-hour hospitalisation and the family floater will cover you and your loved ones from all treatment-related expenditure. It covers all in-patient expenses like hospital room rent, doctor’s fees, medicines, cost of surgery, ICU charges, etc.
For example, if you have a Family Floater Health Insurance Plan of INR 10 lakhs, it would cover all your and your family member’s in-patient expenses upto INR 10 lakhs including hospital room rent, ICU charges, doctor’s fees, medicines, cost of surgery, etc.
2. Pre and Post Hospitalisation
The expenses due to hospitalisation are not limited to the hospital alone. Many tests and investigations, medications, consultations, etc. are required before and after your hospitalisation. The pre and post hospitalisation expenses related to the treatment would be covered within the specified dates.
For example, a Family Floater Health Insurance Plan offers 60 days of pre-hospitalisation and 90 days of post-hospitalisation expenses. So, if you are hospitalised, then all related expenses 60 days prior to hospitalisation and 90 days after hospitalisation would be covered in the claim.
3. Day Care Treatment
Some treatments like cataract surgery or angioplasty do not require 24-hour hospitalisation. Such treatments would be covered under the Family Floater Health Insurance Plan as a daycare treatment upto the total sum insured amount.
For example, if you have a Family Floater Health Insurance Plan of INR 10 lakhs, then you can claim for daycare treatment upto INR 10 lakhs.
4. Daily Hospital Cash
This is an additional feature which might be present in some plans. In this feature, your family floater plan can bring you a cash benefit up to a certain limit for each day that you are under hospitalisation. The amount received is fixed and so are the number of days.
5. Annual Check-Ups
Most health insurance companies offer annual check-ups to the entire insured family, usually after a claim-free year as a no-claim benefit.
6. Add-Ons and Other Benefits
The list of add-ons and other benefits is quite long, however, the facilities may be different for different companies. Most of then offer:
- Organ donation
- AYUSH (Ayurvedic, Unani, Siddha and Homoeopathy) treatment
- Bariatric Surgery for weight loss
- Maternity benefits: Some plans have maternity benefits with new-born coverage like vaccination cost, etc.
- Domiciliary treatment
- Ambulance expenses to and from the hospital
- Worldwide emergency coverage is available in some Family Floater Health Insurance Plans
7. Additional Benefits:
Some family floater plans also come with additional benefits like
- Restoration Benefit, where the sum insured would be restored as soon as it is exhausted
- Health maintenance or wellness benefits
- Expert option on any critical illness
What is Not Covered in a Family Floater Health Insurance Plan?
Despite having a large scope, there are certain exclusions in a Family Floater Health Insurance, which may vary from plan to plan:
- Pre-Existing Illnesses
Unless the waiting period is over, you will not be able to make a claim for pre-existing diseases. Most companies have a waiting period of 4 years, however, there are a few companies that offer plans with a 2-3 year waiting period as well.
- Pre and Post Natal Expenses
Unless there is hospitalisation, before and after childbirth, the expenses may not be covered unless mentioned in the policy bond.
- Unprescribed Hospitalisation or non-traditional treatment
Unless the hospitalisation is recommended by a medical practitioner, it would not be covered in the family floater health insurance plan.
- Breach of Law
A hospitalisation that arises because of being involved in an illegal act with criminal intent will not be covered under the plan.
- Sexually Transmitted Illnesses
Treatment of sexually transmitted diseases like HIV AIDS, Syphilis, Genital Herpes etc. are not covered.
Each policy has its own list of exclusions which must be read before opting for the plan, so that claim is not denied at a later point of time.
How to Compare Family Floater Health Insurance Online?
A health plan is nothing like an investment that you are making today to keep yourself and your family safe from a financial crisis in case there is a medical emergency at home. Therefore, you must spend some quality time in finding the pros and cons of different family floater health insurance plans, and then pick the one that best suits your requirements. Comparing the different plans would allow you to get :
- An affordable premium
- A plan that is suitable to your needs
- Additional benefits
- There would be no hidden information
- You will be able to make an informed decision
To help you in selecting the best health insurance plan, given below are a list of parameters that you should keep in mind before making the final decision:
1. Coverage options of the Family Floater Health Insurance Plan
The most important factor in choosing a Family Floater Health Insurance Plan is to weigh the plan with respect to the other plans available in the industry in terms of the coverage features and benefits. The plans need to be compared in terms of:
- Sum insured of coverage of the plan
- Sub Limits on Room rent, ICU charges, doctor’s fees
- Co-pay limits, deductibles and other restrictions
- No claim bonus
- Restoration Benefits, etc.
2. The Health Insurance Company
Buying a family floater health insurance plan from a well-established and IRDA registered company is the first important step. Check online reviews and find out about the company’s Incurred Claim Ratio.
3. Network hospitals
One of the biggest benefits of a good insurance plan is a huge chain of network hospitals where you can get a cashless hospitalisation. Check how many such hospitals are there in the vicinity of your residence.
Entry to a health insurance plan can be till the age of 65 years, however, as per the guidelines of IRDA, insurance companies have to offer lifelong renewability. You must check the renewability clause carefully as having a health insurance plan in old age is all the more important.
The kind of coverage that you select will have a direct effect on the amount of premium that is payable. Evaluate the benefits that are being provided and then finalise the premium that suits your budget as well.
6. Waiting Period
Some people who are not well-versed with how health insurance works, often have the misconception that the policy comes into effect the day you buy it. But it is not like that. Every health insurance policy comes with a waiting period and any illness during this period is not covered. Most companies have a waiting period of 3-4 years, while some have 2 years only. Try and select one with a shorter waiting period.
7. Income Tax Benefits
The premium that you pay towards your health insurance plan is exempted under Section 80D of the Income Tax Act. But it is better to check from the company if they will provide you with an exemption certificate.
8. Complimentary Health Check-Ups
Do not forget this from your “list of parameters to be checked” as it is very beneficial. Along with a claim-free year, many insurers offer free annual health check-ups for the whole family.
9. Availability of Add-ons
Do look out for the different add-ons that are being offered by the shortlisted insurance companies. Select the one that has options that suit your future requirements.
For example: if you have just got married or are planning to start a family soon, it will be prudent to add a Maternity and New-born Baby Cover to your plan.
Most common add-on benefits of a Family Floater Health Insurance Plan could be:
- Hospital Cash Benefit
- Maternity and new-born coverage
- No claim bonus protection
Family Floater Health Insurance Premium Calculator
A premium calculator is an online application that helps you in calculating the premium amount that will be payable for a particular insurance plan. Just follow given instructions and in no time, you will find out the payable premium for the family floater health insurance plan of your choice.
On your phone/computer/laptop search for an Online Family Floater Health Insurance Calculator. A long list will appear on your screen, you can pick the one you wish to use.
When you open that page, there would be certain spaces to fill in all the floater plan related details. Fill them in carefully and correctly.
Submit your name, phone number, email address and gender.
You will be prompted to enter the number, names and age of the members you wish to include in your family floater health insurance plan.
Then you would have to fill in all the other details like the sum insured you require, your health condition details, the add-ons you want etc.
Once you fill in all the details, check them once and then click on “Submit”, “Continue” or “Get Quotes”
On your screen will now be displayed an approximate value of the premium that you would have to pay to buy that family floater health insurance policy.
Family Floater Health Insurance Claim Process
The demand that you make in accordance with the contract of the policy for a payment release of the benefits for the person who has been insured is called a claim. If you follow all the guidelines given by the health insurance company carefully, making a claim will not be a problem.
A Family Floater Health Insurance Claim can either be done on a cashless or a reimbursement basis.
Cashless Family Floater Health Insurance Claim: When you or anyone in your family (under the same family floater health insurance plan) is hospitalised in a network hospital for medical treatment, and the entire claim is processed by your hospital, then it is called Cashless Hospitalisation. In this case, you do not need to pay the money and the same is settled by your insurer with the hospital.
Reimbursement Family Floater Health Insurance Claim: On the other hand, if you get admitted to a non-network hospital, you would be required to pay the entire money upfront and then claim the same back from the insurance company. This process is called Reimbursement.
Documents to process a Family Floater Health Insurance Claim:
The following documents are required at the time of making a Claim:
- Policyholder’s name and name of the insured family member for whom the claim is being made
- Policy number
- Kind of illness/injury
- Details of the Hospital and Medical Practitioner/Doctor
- In case of a planned hospitalisation the proposed admission date
The company may ask for any other documents too such as:
- Valid Photo Identification document of the insured member who has been hospitalised
- Claim Form-filled and signed
- Bills and receipts of the Treatment
- Pathological and Diagnostic Test Reports
- Doctor’s letter that advises hospitalisation
- Doctor’s prescription of tests, medicines and consultations
- Ambulance Bill, if used
- A Medico-Legal Certificate or copy of FIR in case of an accidental injury
Best Family Floater Health Plans in India
To help you in selecting the best family health insurance, here is a list of the top 5 Floater Health Plans in India (2020):
|Name of the Company & the Plan||Highlights|
|National Insurance Company Limited - National Parivar Mediclaim policy|
|Care Health Insurance Company - Care Policy|
|ManipalCigna Health Insurance Company Limited - ManipalCigna ProHealth Plan|
|Star Health Insurance Company - Star Health Family Optima|
|Apollo Munich Health Insurance Company - Apollo Munich Optima Restore|
Family Floater Health Insurance Tax Benefits
Health insurance is a significant cost-saver when it comes to medical issues. The government gives tax concessions to promote health insurance and therefore, the premium paid towards a health insurance policy is tax-deductible under Section 80D of the Income Tax Act.
But remember, only when you pay your premiums through cash, can you avail the tax benefits.
Tax Deductions Under Section 80D
|Scenario||Policyholder, spouse, 2 children, under 10||Parents||Total Deduction|
|All family members under 60 years (Not parents)||Up to INR 25,000||NA||INR 25,000|
|All family members under 60 years (including Parents)||Up to INR 25,000||Up to INR 25,000||INR 50,000|
|Self/spouse < 60 years and Parents above 60||Up to INR 25,000||Up to INR 50,000||Up to INR 75,000|
|Policyholder and Parents both over 60||Up to INR 50,000||Up to INR 50,000||INR 1 lakh|
When you buy health insurance, the contract will contain a list of network hospitals. A healthcare centre/ a hospital/a medical clinic that has an agreement with a health insurance company for giving cashless treatment to the policyholders is called a network hospital. In a network hospital, you would not have to run around to raise money for the treatment. Your health insurance company will settle the bills directly and thus make your shoulders burden-free. Without compromising on quality healthcare you can avail the best facilities.