Family health insurance - Which is the best family health insurance plan in India?

Hello friends, in this article, Family health insurance - Which is the best family health insurance plan in India? What is the importance of family health insurance? What is not covered under family health insurance? Family health insurance or individual health insurance - which one to buy? Which one should you include in health insurance for families? Is it a good idea to cover your extended family under a family health plan? Things To Keep In Mind Before Buying Mediclaim For Family, Best Family Health Insurance Plans Of 2021. How Can You Buy Family Floater Health Insurance? How to file a family health insurance claim? Will also cover frequently asked questions for family health insurance. Let's get started. (Read in Hindi)


Table Of Contents (TOC)

Family health insurance - Which is the best family health insurance plan in India?  What is the importance of family health insurance?  What is not covered under family health insurance?  Family health insurance or individual health insurance - which one to buy? Which one should you include in health insurance for families?  Is it a good idea to cover your extended family under a family health plan?  Things To Keep In Mind Before Buying Mediclaim For Family, Best Family Health Insurance Plans Of 2021 How Can You Buy Family Floater Health Insurance?  How to file family health insurance claim?  FAQ for Family Health Insurance

Family health insurance: Provides coverage to the entire family under a single insurance policy. It is a type of health insurance, which can be customized as per the needs of your family. You are free to cover others including yourself, your spouse, your children, and your parents under this policy. You can be sure with family health insurance that you are covered for expenses related to accidental injuries or illnesses of all members (including COVID-19) as these plans cover all types of expenses.

What is the importance of family health insurance?

The importance of therapy for a family cannot be underestimated for the following reasons:

Whole family protection: Instead of taking separate health plans for all the members, you can buy a family floater plan and cover all the members under the same. It covers all at the same time and is affordable.

Affordable Value: The premium payable for health insurance for families is cheaper than the premium payable for individual health plans. For example, you have a family of 4 members, and you want to buy health insurance for all. Hence, buying an individual policy for each member will be costlier than buying a family floater plan which includes 4 covers.

Additional benefits: Companies allow individuals to make add-ons to boost the coverage of their existing family health plans. Such add-ons include Maternity and Newborn Cover, Critical Illness Cover, etc.

Tax Benefits: Family health plans can avail of tax benefits under section 80D of the Income Tax Act, 1961 by paying a premium.


What is not covered under family health insurance?

The health insurance exclusion for families varies from company to company. Generally, the following situations are not covered under such plans:

  • Plastic surgery cost.
  • Foreign treatment (unless included in the plan).
  • Any disease or injury caused by a state of war.
  • Any injury due to involvement in immoral activities or adventure sports.
  • Complications at the time of pregnancy or delivery (unless mentioned in the plan).
  • Family health insurance for alcohol or drugs
  • Family health insurance provides coverage to the entire family under a single insurance policy. It is a type of health insurance, which can be customized as per the needs of your family. You are free to cover others including yourself, your spouse, your children, and your parents under this policy. You can be sure with family health insurance that you are covered for expenses related to accidental injuries or illnesses of all members (including COVID-19) as these plans cover all types of expenses.
  • self-injury due to use


Family health insurance or individual health insurance - which one to buy?

We know that family health plans cover the entire family under a single sum insured. Whereas under an individual health plan, there is a separate policy for each individual. This means, if there are 5 members in a family, you will have to buy 5 health policies and manage them all today. It's not convenient, is it? Fortunately, you won't face this problem with family health insurance. All 5 members can be covered under a single plan.

Now let's talk about cost. The premium payable under family health plans is less than the premium payable for individual policies.

More than 95% of people in India opt for family floater cover. Because the family floater is more convenient and cheaper, you should keep one thing in mind. Those buying a family health plan have to share the sum insured. Meaning, if the husband and wife come under the sum insured of Rs 10 lakh, then anyone can use that amount. But if both need medical assistance of Rs 10 lakh at the same time, then only one of them can access that amount. Since such a situation rarely arises, it is prudent to go for a family floater plan.


Who should you cover in health insurance for families?

Most insurers offer coverage for a maximum of 2 adults and 4 children in a family floater policy. The age limit of children may vary from 18 to 21 depending on the insurer to insurer. Some plans allow extended families to be covered under a single plan. These plans allow more than 2 adults and can cover relationships like father, mother, children, self, spouse, uncle, aunt, brothers, sisters, etc. However, such plans are very few in the market and hence most of the people go for different ones. Policies to cover specific families.


Is it a good idea to cover your extended family under a family health plan?

The short answer is no. There are many reasons for this. First and foremost, the requirement of health insurance varies according to age requirements. For example, if you include your grandparents in the same policy, you will have the same sum insured for the entire family, whereas we generally recommend a higher sum insured for older people.

Secondly, in many plans, the premium cost is calculated based on the age of the eldest member, so in such a case, you may end up paying a lot. The third reason is that such plans are rarely available in the market so you will not have enough options. Fourth, there is a high chance of your Sum Assured getting exhausted if the members increase.

For example, if you only share the sum insured with your spouse and children, there is little chance that more than one member will need medical treatment at the same time, but if the plan increases The number of members increases. If there is a possibility of falling ill together, then the chances of getting the limit of the sum insured also increase.

Hence, it is better to buy a senior citizen plan for your grandparents and cover your wife, children, etc. under the family floater plan. Apart from this, there is one more thing to remember here. Most family floater plans cover dependent children up to 21 years of age. After that, you have to buy a separate health policy for them.


Things to keep in mind before buying a health insurance plan for family

Below are some of the key points that one should consider before buying a family health policy. Let's take a look at them.

  • Coverage: Before finalizing a health insurance policy for your family, check the benefits offered by the insurer. Confirm what types of expenses it covers, the sum insured offered, and whether the premium is competitive with other insurance companies in the market.
  • Requirements: In many family health plans, you can cover yourself, your spouse, your dependent children, and your parents. However, if you have a large family and you want to cover your brother or mother-in-law, some family health plans can meet this requirement. For example, Royal Sundaram Family Plus can have a maximum of 19 members. However, as mentioned earlier, we generally recommend going for a different plan for extended families. Only your immediate family should be covered in a plan
  • Claim Process: Everyone wants to get their claims settled without any hassle at the time of need. Hence, understand your company's claim settlement process thoroughly to avoid any confusion in case of a medical emergency.
  • Cashless hospitalization: Before buying health insurance for your family, make sure that you have that company's network hospitals with you so that in case of a medical emergency, you do not have to travel long distances to get treated under cashless benefits. Please note that if you get treatment from a non-network hospital, you will have to pay the cost of the treatment out of your pocket and then go for the reimbursement claim.
  • Flexibility: If you are not sure about the sum insured and want to increase it in the future, consider a family health plan that gives you that much flexibility. Contact the chosen insurer for more information.

Best Family Health Insurance Plans of 2021

When people search for family health insurance plans, one of their top priorities will be to go for good company. Defining a good company or the best company is a difficult task as the criteria of a good company can be different from person to person. Keeping this in mind, our research analysts have narrowed down a few parameters to pick the best companies to choose from in a list of 29 insurance companies offering health insurance in India. We have selected companies based on their market share, cashless network, and claims experience. We've rounded up 15 of the top 29 health insurance companies on the market. Among them, we have listed 10 companies based on market share and premium of 5 lakh and 10 lakh sum insured. Let's know about them.

name of the companyAnnual Premium (Rs. Crores)scheme namePremium/year (SI- Rs 5 lakh)Premium/year (SI- Rs 10 lakh)
star health7,716.4Comprehensive1746424686
HDFC Ergo3623.49optima restore1826122847
ICICI Lombard2495.15complete health1697320208
care insurance2151.25care plan1661321690
Bajaj Allianz2,138.53Health-Guard (Gold)1650119191
Reliance General1365.92health infinity1534719572
Max Bupa1177.56health companion1721721631
Bye835.42Medicare1922123273
Aditya Birla755.5Active Health Platinum-Enhanced1561020275
Manipalsigna567.29ProHealth Protect1345319468

Note: The schemes are numbered based on the highest market share of the companies.

  1. Star health comprehensive plan

    The Star Comprehensive policy comes with a family floater option, which helps cover a maximum of 2 adults and 3 dependent children against financial problems arising due to medical uncertainties. In this plan, individuals are not required to go for pre-medical check-ups during the purchase process.
    Entry age3 months-65 years
    Maximum Sum Assured1 crore 
  2. Hdfc optima restore family plan

    If meeting your family's medical needs is your #1 priority, Optima Restore can help you with that. This plan comes with a 2x multiplier benefit, where you get 100% SI enhancement (in the form of NCB) if you do not make any claim in a year. Also, get a complimentary health check-up and up to Rs.10,000 at the time of renewal.
    Entry age91 Days - 65 Years
    Maximum Sum Assured50 lakhs 
  3. ICICI Lombard Complete Health Plan

    By choosing the family floater option under this plan, you can get other benefits like Maternity cover, OPD cover, Donor expense cover. Apart from these, the plan also offers some golden features like no co-pay, 2 complimentary health check-up coupons in a year, and no pre-medical screening till 45 years.
    Entry age18 Years
    tax benefitsYes 
  4. Care Plan by Care Health Insurance

    With a wide range of benefits, Care Health Insurance provides protection against financial risks arising out of a medical emergency. The plan covers hospitalization, pre, and post-hospitalization, home hospitalization, day-care treatment, health check-up expenses. Not only this, but the scheme also provides coverage for modern treatments like robotic surgery, HIV/AIDS, etc.
    Entry age91 days up; no maximum entry age
    Maximum Sum AssuredRs 6 Cores 
  5. Bajaj Allianz Family Floater Health Guard Plan (Gold Variant)

    Bajaj Allianz Family Floater Health Guard covers the entire family including you, your spouse, dependent children, parents, mother-in-law, grandchildren, dependent siblings, etc. Under this plan, one can avail coverage for hospitalization, doctor's expenses. Consultation, ambulance services, and pre-and post-hospitalization expenses. Maternity expenses and medical expenses for the treatment of a newborn baby are also covered under the plan.
    Entry age3 Months - 65 years
    Maximum Sum Assured50 lakhs 
  6. Reliance Health Infinity Plan

    Health Infinity plan provides coverage to 8 members (2 adults and 6 dependent children) against heavy medical expenses. If you completely terminate your Sum Assured, this policy allows you to reinstate the policy amount subject to certain conditions.
    Entry ageAdults: 18-65 years
    Childs: 91 days - 25 year
    Maximum Sum Assured1 Core 
  7. Max Bupa Health Companion Plan

    This plan is known for its unique features, Health Saathi provides a protection rider to the policyholder, which allows an annual boost to the coverage (based on the inflation rate) and protection against non-payable items. Along with this, you can opt for Hospital Cash Benefit, where you will get a maximum of Rs.4000 per day.
    tax benefitsYes
    Maximum Sum Assured1 Core 
  8. Tata medicare plan

    With the promise of unlocking useful benefits, Medicare offers coverage for bariatric surgery, global cover, etc. to protect the financial interests of the family in times of medical emergency.
    tax benefitsYes
    Maximum Sum Assured20 lakhs 
  9. Aditya Birla Active Health Platinum-Enhanced

    It is a unique plan that provides a family with useful features like cover for advanced treatment, restoration of the sum insured, and a chronic management program. If a family member is diagnosed with COVID-19, the scheme will pay for his/her expenses.
    Minimum Entry Age91 days
    Maximum Sum Assured2 cores 
  10. Manipal Cigna ProHealth Protect Plan

    Being a family floater plan, Pro-Health Protect is an ideal option to protect your family from major medical expenses. You can get benefits like health maintenance, worldwide protection in case of emergency, etc. to cover your outpatient expenses.
    Entry age18 years - no limit
    Maximum Sum Assured50 lakhs 

How can you buy family floater health insurance?

With the advancement of technology, many insurance providers allow their potential customers to purchase family health policies through their websites. But there is a potential for online fraud, poor site navigation or high reload times.


How to file a family health insurance claim?

Every insurance company provides two ways to file a claim-
Cashless Claims and Reimbursement Claims: For cashless claims, the policyholder needs to be admitted to any network hospital, and then follow the steps given below. These are standard steps, which may vary depending on the insurance company chosen.
  • Show your health care provided by the concerned insurance company along with identity proof at the hospital insurance desk.
  • After verifying your identity, the network hospital will submit a pre-authorization request form to your insurance company.
  • The company will review the request and provide confirmation to the network hospital and share it with you via text or email.
  • After the treatment, the company will settle the claim from the hospital.
If you are admitted to a non-network hospital, you should notify the concerned insurance company as soon as possible (the time limit may vary from company to company). After the treatment, you have to pay the bills and then file a claim for reimbursement. The insurance company will review all the documents and then give a decision (approval/disapproval).


FAQ for Family Health Insurance

1. I am planning to start a family. Which type of health insurance would be better for me - individual or family floater?

Ideally, you should take a family health policy. All the members of your family can be covered under this. Also, you can ask for coverage for maternity and newborn. However, the mother should be covered under the policy for a minimum period of 1 year (depending on the insurer).

2. In family health policies, renewable energy depends on the oldest covered member of the plan. If I add a senior citizen, will it not have a major impact on the policy term?

Of course not. Thanks to IRDAI, many companies offer lifetime renewable facilities with their plans.

3. Is one eligible to buy multiple health insurance policies for one's family?

Yes, one can buy multiple health insurance policies. If the cost of your treatment exceeds the sum insured of one policy, the person can claim the balance amount from the other policy.

4. Does family health insurance provide coverage for AYUSH treatment?

Yes. Most family health plans cover AYUSH (Ayurvedic, Homeopathy, Siddha, and Unani) treatment expenses. Still, it's worth checking with your chosen provider before making a purchase decision.

5. Is there any waiting period for a family health insurance policy?

Yes. Generally, there is an initial waiting period of one month during which no claim (except accidental injury) of the policyholder will be entertained by the company.

6. What happens if I terminate the Sum Assured of my policy?

In family floater health insurance, the entire family is covered under a single sum insured. If you exhaust the entire amount, the other members will have no coverage left. However, some plans offer the benefits of refill/restore the Sum Assured like Bajaj Allianz Family Floater Health-Guard.

7. What happens to the family floater policy if the proposer dies?

In such a case, the policy can be transferred in the name of any other family member, provided he/she is above 18 years of age.

8. What is the maximum age of the child to be covered under the Family Floater Health Insurance Plan?

In family floater health insurance plans, a dependent child can be covered till the age of 21 years (depending on the insurer).

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