We know that not everyone understands medical and financial terminologies. You, too, will have your fair share of doubts regarding family health insurance, especially if you are single and yet to start a family. So, how about we solve some common doubts when buying health insurance for family with the help of illustrations.
Illustration 1: You have a lovely family with a spouse and one child
Along with his wife and one child, Ramesh seeks to purchase health insurance. He is thinking of purchasing individual health plans for each family member–wherein he will have to pay premiums for three people differently.
Instead, he can simply secure himself and the remaining two family members under a single policy–family health insurance. It not only becomes easier to manage the plan, as it is a single policy but also becomes an affordable option for Ramesh.
Illustration 2: You have significant financial responsibility
Sometimes, health insurance for family can be an excellent financial investment, especially for those in their early 20s. It helps you seek family health insurance plans to avail tax benefits and provide extra medical coverage to their parents.
For instance, Ketki, who is 22-years-old, recently started working at a multinational company. Now, she can seek family health insurance for herself and her parents. This way, she can avail tax deductions under Section 80D of the Income Tax Act, 1961. Also, when she decides to start a family later in life, she can add her spouse and children to the plan by simply paying extra premiums thereon.
Illustration 3: You have young children and old parents to take care of
As your parents grow older, their health issues are likely to rise. Similarly, infants and toddlers are bound to fall sick more often. Therefore, if you are someone who just had a baby and also has old parents to look after, your hospital visits might be frequent. In this case, you cannot always rely on your savings to overcome the medical expenses.
Inclusions of Family Health Insurance
Choosing an appropriate family health insurance plan is an overwhelming task. You must double-check factors like ‘what is covered’ and ‘what is not covered’. Medical insurance for family must include multiple factors like pre-hospitalisation expenses, maternity coverage, ayurvedic treatments, and more. Here are a few things that your family health insurance plan should cover:
Covers expenses involved in organ donor treatment.
Applicable on the same illnesses with 100% coverage of the sum insured.
Coverage for Ayurvedic/Homoeopathic hospitalisation all over India for up to ₹20,000.
It provides convalescence benefit of up to ₹7,500 for 10+ days of continuous hospitalisation.
You can avail free health check-ups at least once in 3 years, irrespective of whether you have made any claims.
It covers expenses incurred due to medical treatments and diagnosis, ICU charges, fees for specialists, consultation charges, etc.
Costs incurred in the pre and post hospitalisation procedures.
The plan offers coverage of up to ₹25,000 for normal delivery and ₹35,000 for caesarean section.
Exclusions of Family Health Insurance
Every good policy has certain limitations. Here’s what is not covered under family health insurance plans:
This is any medical issue or complication (pre-existing disease) that existed before seeking coverage or for which the doctor recommended care or treatment. That’s because healthcare plans are formulated to tackle unforeseen emergencies and not something that already prevails. Even if a policy covers pre-existing health conditions, you will have to go through a waiting period, which is different for different policies.
Medical procedures like dental surgeries or plastic surgeries are not covered.
Family health insurance plans do not cover injuries caused as a result of self-harm.
Family Health Insurance Plans Tax Benefits
Health insurance is one of the most effective tax-saving instruments. Family health insurance plans and individual covers allow tax deductions under Section 80D. Here’s a quick walkthrough of the same.
Maximum Deduction Under 80D
Self + Family (All below 60 years)
Self and Family + Parents (All below 60 years)
₹25,000 + ₹25,000 = ₹50,000
Self and Family (all below 60 years) + Senior Citizen Parents
₹25,000 + ₹50,000 = ₹75,000
For Self and Family (with eldest member over 60 years) + Senior Citizen Parents
₹50,000 + ₹50,000 = ₹1,00,000
Note: Deductions for parents are over and above the maximum deduction allowed for an individual and his/her family.
Here are a few additional deductions you can enjoy with medical insurance plans for family:
For Preventive Health Check-Ups
You can claim an annual deduction of up to ₹5,000 for expenses incurred on regular health check-ups. It includes check-up expenses of the entire family, including self, spouse, children, and parents.
You can claim additional tax deduction on expenses incurred by self, family, or parents towards treating specific illnesses such as chronic renal failure, dementia, ataxia, chorea, etc. The deduction can be availed up to ₹40,000 (for individuals below 60 years of age). Senior and super senior citizens can avail tax deductions up to ₹1 lakh.
You can enjoy tax benefits of up to ₹75,000 for the nursing, training, medical treatment, preservation, and rehabilitation of a dependent with a disability. The amount is ₹1.25 lakh in cases of extreme disability.
Buy/Renew Family Health Insurance Plans Online
Most insurance companies have now moved online. While you can still buy insurance policies by visiting the insurer’s office, the online process is more streamlined and quick. Here’s how you can purchase or renew the best family health insurance plans in India online:
Steps to Buy Family Health Insurance Online
Step 1: Scroll up to the top of this page and click on ‘Buy Now’
Step 2: Provide the necessary details about the family members you wish to insure and your personal information.
Step 3: Pick from the list of available health insurance plans for families. You can also select add-on covers to enhance your coverage.
Step 4: Finally, upload the required documents and make instant health insurance premium payment online.
Step 5: And voila! Your insurer will send the policy document via email shortly.
Steps for Family Health Insurance Renewal Online
Step 1: Scroll up and click on the ‘Renew Now’ button.
Step 2: Enter details about your existing health insurance for family and other necessary information. Now, check the renewal quote.
Step 3: Upload the necessary documents and make your renewal premium payment.
Step 4: Your renewed plan will be sent to your registered email shortly.
How to Calculate Health Insurance Premiums Online in India in 2022?
Before deciding on a health insurance plan, it is imperative to get an estimate of the premium you will have to pay. When it comes to a health plan, nobody wants to go for a lower coverage, especially with health insurance plans for family. After all, it covers not only you, but also those close to you. Multiple factors like age, number of family members, area of residence, etc., influence the cost of your health insurance plan. Hence, there is no way that you can calculate your family health insurance premium manually.
Here’s good news:
Calculating family health insurance premiums is now easy! Firstly, visit our Health Insurance Calculator page. Then, enter relevant information such as your age, gender, weight, amount of coverage needed, and other important details. The premium calculator uses this data to estimate the premium amount you will have to pay for a family health insurance policy.
Family Health Insurance Claim Process
Now that you have a family health insurance plan, how should you raise a claim during medical emergencies? There are two types of claim settlement processes–cashless and reimbursement claims. Here’s a complete guide on how to file health insurance claims.
How to File Cashless Claims
Step 1: Inform your insurer about the situation and visit a partner hospital.
Step 2: Submit family health insurance plan details and take the pre-authorisation form.
Step 3: The insurer then verifies the form, and the hospital is notified about the policy details.
Step 4: Once discharged, the hospital will share documents like bills and discharge papers with the insurer.
Step 5: The claim will then be directly settled with the hospital after reducing the co-payment (if any).
How to Get a Claim Reimbursement
Step 1: Share all original medical documents, hospital bills, and insurance claim forms with the insurer.
Step 2: The insurer evaluates the details and may ask for any additional information if required.
Step 3: Your claim decision is made post verification.
Step 4: You will receive the claim amount based on the policy terms and conditions.
Documents Required for Filing an Insurance Claim
Here’s a list of documents you need to submit for raising an insurance claim:
Duly filled claim form
Original copy of hospital discharge summary or card
Prescription and cash invoices from pharmacies and the hospital
An investigation report by the doctor
Family health insurance policy document
In case of an accident, FIR or Medico Legal Certificate (MLC),