Family Health Insurance

What is Family Health Insurance?

A family health insurance plan is a type of policy that provides medical coverage to the entire family. In simple terms, you buy one healthcare plan to protect your entire family. It relieves you from the burden of buying separate health covers for every family member. The best family health insurance plans will cover self, spouse, children, parents, and parents-in-law. 

 Why do you Need Family Health Insurance?

Wondering why anyone would go for family health insurance? There are countless ways where family health insurance plans prove more lucrative than individual policies. Let's explore a few reasons why you need this insurance cover:

• Affordable

Health insurance for family is more affordable as compared to individual policies. Instead of paying premiums for multiple plans, you get more feasible options with family health policies.

• Hassle-Free

Keeping track of all payable premiums can be exhausting. With a family floater plan, you can make a single payment and cover the entire family.

• Allows You to Add New Members in the Policy

Had a newborn baby? Family health insurance plans ensure that you do not have to go through the process of buying a new policy all over again. A family health plan also enables you to include parents-in-law.

Best Health Insurance Plans for Family in India on Bajaj MARKETS in 2022

Family health insurance plans at Bajaj MARKETS are highly flexible. Here are the best family health insurance plans from leading insurance companies on our platform, with their claim settlement ratio, Starting premium prices in tabular form. 

Disclaimer: Premiums rates mentioned for the above health insurance plans are not constant and subject to change over time. 

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:

• Organ Donor Benefit

Covers expenses involved in organ donor treatment.

• Reinstatement Benefit

Applicable on the same illnesses with 100% coverage of the sum insured.

• Ayurvedic/Homoeopathic Hospitalisation

Coverage for Ayurvedic/Homoeopathic hospitalisation all over India for up to ₹20,000.

• Convalescence Benefit

It provides convalescence benefit of up to ₹7,500 for 10+ days of continuous hospitalisation.

• Free Health Check-up

You can avail free health check-ups at least once in 3 years, irrespective of whether you have made any claims.

• In-Patient Hospitalisation Expenses

It covers expenses incurred due to medical treatments and diagnosis, ICU charges, fees for specialists, consultation charges, etc.

• Pre & Post Hospitalisation

Costs incurred in the pre and post hospitalisation procedures.

• Maternity & Newborn Baby Coverage

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:

• Pre-Existing Health Issues

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.

• Cosmetic Treatments

Medical procedures like dental surgeries or plastic surgeries are not covered.

• Self-Inflicted Injuries

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.

Note: Deductions for parents are over and above the maximum deduction allowed for an individual and his/her family.

Additional Deductions

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.

• Under Section 80DDB

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.

• Under Section 80DD

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

• Medical Certificate

• Family health insurance policy document

• In case of an accident, FIR or Medico Legal Certificate (MLC),