Health Insurance for yourself & family: Family floater plan

Individual health insurance plans cover only the policyholder. So, what can you do when you get married and build a family? Your personal health plan will not protect your family members. 

A family floater plan is a type of health insurance plan that covers the whole family under a single policy. Let’s discover more about this plan in this blog. 

Family Floater Health Insurance Plan Overview

Protect your family’s savings and get umbrella protection for the whole family with a family health insurance plan. Family health insurance is useful for all-round protection for your whole family. It comes in handy in case of any medical emergency for everyone covered by the plan. 

You can include your spouse, children, parents, and in-laws(with some insurers). Based on the policy, you will get coverage for hospitalisation, consultation, medicines, etc. 

The sum insured is shared by all the members covered under the policy. For example, suppose you purchase a family floater plan with Rs. 5,00,000 and include 5 members under the policy. In that case, you can claim medical expenses related to any one or all covered by the policy. However, the maximum claim amount per policy year is Rs. 5,00,000, regardless of the number of claims. 

Benefits of Family Floater Plan

Some of the benefits of family health insurance are:

• More affordable – Covering multiple family members under a single policy is more cost-effective than buying separate health insurance for each family member. 
• Hassle-free management – There will be only one policy and one premium to take care of. 
• Flexibility to add members – You can always add or remove family members whenever you want. Remember, the premium will vary based on family members’ age and health conditions. 
• Umbrella protection – Family floater plan provides a general medical shield for your entire family. So, if any of your loved ones get sick, you can take care of them without worrying about the financial burden. 
• Tax benefits – Get a tax deduction of Rs. 1,00,000 under Section 80D as per the old tax regime. For including senior citizens, you can also get a deduction of up to Rs. 25,000 for premiums and Rs. 5000 for preventive health checkups. 

Limitations of Family Floater Plans:

• Limited coverage for each individual compared to an individual health plan.
• Possibility of higher premiums if family size increases.
• Premium calculations depend on the health of all family members.
• Most insurers have restrictions on family size.

Individual Health Insurance Vs Family Floater Plan

Here is a quick comparison between individual health insurance and family floater plans:

Family Floater Insurance Coverage

Every insurance policy has different coverage. However, the general coverage for family health insurance is as follows:

• Hospitalisation expenses for all family members.
• Pre and post hospitalisation expenses coverage for 30 days before hospitalisation and 180 days after hospitalisation (varies based on insurer).
• Daycare procedure coverage for medical treatments requiring less than 24 hours of hospitalisation.
• Ambulance charges for transporting patients (usually has a cap).  
• Certain diseases and treatments may be declared as exclusions.
• Preventive health checkups free of charge.
• Daily cash for out-of-pocket expenses during hospitalisation (based on insurers).
• Expert consultation for critical illnesses.
• Alternative AYUSH treatments.  
• Organ donor expenses. 
• Home healthcare expenses. 
• Lifelong renewability for break-free renewals.

Points to Remember with the Family Floater Plan

Keep the following points in mind before choosing a family floater mediclaim plan:

• Premium depends on the eldest person covered by the policy. So, including your parents in your family plan may make it expensive. 
• The medical history of all family members will be considered before determining the premium. So, the premium will increase if one of your family members has a higher health risk. 
• Sub-limits on charges like surgeon fees, room rent, etc., may apply. This means that if the expenses exceed the limits, the insurer will not cover the whole amount. 
• Adding new family members may incur additional costs based on age and health conditions. 

Key Takeaways

If you are young and building a family, covering all legal family members under a single family is more affordable. However, when you have ageing parents with health conditions, consider buying a separate plan for them to keep the cost under control. Understand the coverage and premium implications before making your choice.