With medical expenses staying on an ever-increasing trajectory, it is no surprise that one of the biggest worries facing a bread-winner today is the prospect of a loved one’s hospitalization. A persistent nightmare that can keep anyone awake is the thought of a medical treatment being available but out of their reach due to the prohibitive expenses involved.
Health insurance providers are waking up to the fact that India is still a country where a large population lives under the aegis of a joint family, and a simple individual insurance cover will not work for everyone.
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Q1. What are the alternatives for family health cover?
There are three alternatives that can be explored by individuals looking for health insurance plans for family:
1. Individual cover: One can purchase an individual plan tailored to the needs of each family member. While the advantages of this kind of coverage are obvious, the costs of premiums for each policy can quickly add up to unmanageable amounts.
2. Floater policies (with immediate dependents): A family health cover with a single premium and a significant sum insured to cover a family. However, most such policies include coverage for two adults and two children, thus excluding the elders in the family.
3. Family policies with cover for extended family: This new arrival in the insurance market has coverage for parents, in-laws and other people in your family like siblings and cousins.
Insurers like Bajaj Allianz Life, Max Bupa and Oriental, among other players, have introduced multiple family plans to take advantage of this gaping void in the market.
Q2. What are the advantages of health insurance plans for family?
1. Manageability: With one policy covering the entire family, you are freed from the burden of having to keep track of various individual plans. A single premium is all that is needed to protect your entire family from any health emergencies.
2. Easy to add new members: Every time there is a new addition to your family or a new responsibility in the form of an elder family member, you can simply modify your policy to add them in. The sum-insured can be correspondingly increased depending on the age of the member and their health status.
3. Cover for Parents and In-laws: Not only your parents, but even your in-laws can be covered under the same policy. Thus, you can ensure the continued protection of both sides of your family.
4. Tax Benefits: Whether you buy health insurance online or offline, as long as you do not make cash payments, you can take advantage of a tax deduction of Rs. 55,000 (25,000 for you, plus 30,000 for the elders in your family) under section 80D.
5. Policy tenure: Many plans in the market cover your family for two to three years, thus locking in your premiums and avoiding the year on year increase.
6. No-claim advantage: For policies where there is no claim made during the policy tenure, there is usually a bonus provided in the form of an increase in sum insured for the following period.
Q3. What are some crucial points I need to be aware of?
- It is always better to purchase a new family plan with senior members included, rather than to add them into an existing family plan. Adding into an existing plan will make your premiums shoot through the roof.
- Family plans expire as soon as the eldest member included in the plan reaches the maximum covered age.
- Once dependent children reach the age limit (generally 25) specified in the policy document, their coverage automatically lapses and they must invest in individual plans for themselves.
- It is important to increase the sum insured every time you add a new member into the plan, depending on their age and health status.
- Always discuss pre-existing health conditions and any waiting period until they are covered under your plan. Similarly, maternity may also not be covered until without a waiting period.
- Understand the policy document in detail and pay special attention to exclusions and their norms related to cashless hospitalization, in-network hospitals, co-payment factors and claim processing.
Q4. But will a single sum-insured be enough for my whole family?
The biggest challenge that family insurance providers face is very basic in nature – What is the sum insured gets exhausted during the year itself? This is particularly relevant when there are senior citizens included in the plan with serious health ailments.
Many insurers have come up with creative solutions to tackle this issue:
1. Restore coverage benefit: This is a special clause only available with family health cover plans. Providers allow you to replenish coverage that was exhausted during the coverage period under special conditions:
- When subsequent claims are made by different family members
- When subsequent claims are made by the same family member, but are totally unrelated
- When the claims are accident related
2. Combination of Individual and Floater limits: Certain providers take the route of providing a combination of individual and floater limits so that you can cater to specific members of the family (who require the insurance cover more).
3. Same cover for all family members: New entrants in the market also allow the same sum-insured to be available to each member covered under the plan. So if you have 3 family members with a sum-insured of 4 lakhs, you are essentially getting coverage worth 12 lakhs!
There are umpteen advantages to purchasing health insurance plans for family – You ensure that your family is protected in the event of any medical emergency, while at the same time managing costs so they do not go through the roof. Start researching the various avenues through which you can buyonline health insurance and get your families health goals done!