What is Family Health Insurance?

Family health insurance plans are a great way to ensure that all members of your family have access to quality healthcare services without having to pay separate premiums for each individual. These plans typically offer a higher sum insured, wider coverage, and a range of benefits and features that can help you save money on medical expenses.

The best family health insurance plan covers the entire family, including your spouse, children, parents, and parents-in-law, and can offer a cost-effective solution to a family’s insurance needs.

Advantages of a Family Health Insurance Plan

There are many benefits of opting for a family health insurance plan. Here are some:

  1. It is more affordable

    The possibility of suffering from a severe ailment is increasing by the day. Pollution levels are soaring, most food items are adulterated, and stress is inevitable even in the lives of children. Purchasing adequate health insurance for your dependents is no longer a choice but a necessity. Family health insurance plans make it more affordable to cover your loved ones. Instead of paying premiums for multiple policies, you pay a single amount for one plan and secure everyone under it.

  2. It is hassle-free

    Remembering to pay for different policies can be exhausting and confusing. Every policy may follow a different schedule. You may pay monthly installments for some and yearly for others. Managing them all along with work and other commitments can be hard. A family plan bridges this gap and simplifies payments, making the process entirely stress-free.

  3. It facilitates tax savings

    You can claim tax benefits on the premium paid for family health insurance plans under Section 80D* of the Income Tax Act of 1961. You can claim up to ₹ 25,000 for yourself and additional an ₹ 30,000 for your parents, which makes a total of ₹ 55,000 in a given financial year.

  4. It makes it easy to secure new members of your family

    If you have just had a baby, you can add the new member of your family to the existing family plan. You do not have to buy a new policy as and when you have children. Family health insurance plans also provide the option of adding parents-in-law, so your parents and your spouse’s parents are all secured under one policy.

  5. Discounts and additional covers

    You can enjoy benefits like a maternity cover or family discounts depending on the number of members and their ages. These add-ons make family packs a more viable option than individual plans.

Features of Family Health Insurance Plans

Family health insurance plans are thoughtfully curated to suit every family’s need. Here are some features of the policy:

  1. Cashless hospitalization

    Family plans allow cashless hospitalization for all members. This eases a challenging and chaotic situation and offers excellent liquidity.

  2. Maternity cover

    Family plans offer maternity riders for expecting mothers. Parents can also cover fertility treatments under the policy. Additionally, the policy covers delivery expenses, c-sections, termination, etc.

  3. Accident cover

    A family health insurance plan provides an accident cover in case of an accident. It also offers a waiver of premium in case of permanent disability.

  4. Critical illness cover

    In case of a critical ailment, you receive a pay out on the first diagnosis of the listed medical condition. You also do not need to produce hospital bills to receive this pay out.

The Need for a Family Health Insurance Plan

The healthcare sector has seen a drastic rise in costs. Inflation and added material needs make it nearly impossible to cover the costs of doctor visits, hospitalization, and medicines in today’s world. The current times have also made it clear that a health emergency can strike anytime and affect people of all ages. This is why having a health insurance plan is crucial. It protects your ageing parents, young children, and gives you and your spouse the right financial cushion in urgent and unprecedented times. You can use a family health insurance premium calculator to pick a suitable amount that covers your entire family and rest assured that your loved ones will be financially safe and secure in case of a health emergency.

Exclusions and Inclusions in a Family Health Insurance Plan

Just like any other plan, family health insurance plans also come with some stipulations. Here are some things to note.

  1. Exclusions
    • Only children older than 91 days can be included in such plans.
    • Once your children cross the age of 18, they are no longer included in the family plan.
    • There is a waiting period in these plans. Pre existing medical conditions are not covered during this period.
  2. Inclusions
    • Family health plans include psychiatric benefits and cover the cost of such treatments.
    • Annual medical checkups are offered to all your family members covered in the policy.
    • The plan provides a maternity benefit for expecting mothers. This includes termination, delivery, emergency c-sections, infertility treatments, etc.

What is covered in a Family Health Insurance Plan?

Here are some things covered under family health insurance in India:

  • In-patient hospitalisation expenses
  • Day care procedures
  • Maternity and newborn child expenses
  • Ambulance charges
  • Pre-existing conditions (after a waiting period)
  • Alternative treatments (such as Ayurveda, Yoga, and Naturopathy)
  • Dental and vision care (in some plans)
  • Organ donor expenses
  • Domiciliary treatment
  • Mental illnesses
  • Daily cash allowance
  • Cashless facilities at network hospitals

What is not covered in a Family Health Insurance Plan?

Here are some things that are not covered under family health insurance in India:

  • Aesthetic treatment or plastic surgeries
  • Non-medical expenses
  • Life-support machines
  • Injuries incurred during war and riots
  • Injuries or illnesses resulting from illegal activities
  • Pre-existing medical conditions
  • Injuries or illnesses resulting from participation in extreme sports or hazardous activitives

To sum it up

If you conduct a comparison of health insurance plans in India, you will find how a family plan is incredibly cost effective and easy to manage. It takes away your worries, provides the best of benefits to each and every family member, and gives you peace of mind to carry on life with zeal and no stress. Investing in a family health insurance plan is the need of the hour, so make sure you buy a suitable plan soon.

COMP/DOC/Apr/2023/184/2800

Family Health Insurance Plan FAQs

You must provide the following documents when reporting a claim under family health insurance:

  • Claimant's statement or claim intimation form
  • Certificate from the attending doctor
  • Copies of medical records, including admission notes, discharge summary and test reports
  • Original policy certificate
  • Canceled cheque
A family health plan can be used to cover multiple members of your family. You can add your spouse, children, parents and parents-in-law to your existing family health insurance policy.
A family health insurance policy can be ideal for safeguarding the financial interests of the entire family. You can evaluate factors, such as the family's medical needs, budget and age groups, when looking for the best insurance plan. It is also important to consider coverage options, the network of hospitals, premiums and benefits offered by the insurance plan.
The cost of family health insurance can vary depending on tenure, sum assured, the total number of people covered under the plan and more. You can use the health insurance calculator to get a clear idea.
A family health insurance plan may be a more affordable choice for families. It can be a better option to cover all members of the family. On the other hand, an individual health plan can be suitable for single individuals.
Children who are at least 91 days old can be covered under such plans. However, once your children reach the age of 18, they are no longer eligible to be included in the family plan.
COMP/DOC/Aug/2023/288/3874

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* Tax benefits under the policy are subject to conditions under Section 80C, 80D, 10(10D) and other provisions of the Income Tax Act, 1961.Tax laws are subject to amendments made thereto from time to time. Please consult your tax advisor for details, before acting on above.

COMP/DOC/Oct/2020/1210/4583

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