Health insurance plans for family

Family Health Insurance

Know the key features, benefits, coverage details, and claims process for family health insurance plans.

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2 mins
01-February-2023

A family health insurance plan is a type of medical insurance. It gives coverage for the entire family's major and minor medical expenses. Family health insurance plan enables you to access high-quality healthcare in case of a medical emergency. Having a health insurance plan for family helps in your financial planning. It safeguards your savings in case any family member is ill or requires hospitalisation. Therefore, makes it an ideal choice.

Here’s a guide to what a family health plan is, its benefits, inclusions, exclusions and more.

Know why you need a family health insurance plan

A family health insurance plan is an affordable option to help you tide over rising medical expenses. It ensures that your family has access to high-quality healthcare services without any compromise. These plans generally cover the policyholder, spouse, and children. Furthermore, several family medical insurance policies also allow the inclusion of parents as well as in-laws.
Insurers offer the sum insured on a floater basis and cover various medical expenses, including hospitalisation, pre-and post-hospitalisation, etc.
You also get a 100% reinstatement of the sum insured based on the health insurance plan chosen.

Key features of family health insurance plans

Here’s a glance at the key features of family health insurance plans offered by Bajaj Finance:

Sum assured

Rs. 1.5 lakh – Rs. 2 crore

Daycare procedures

586 daycare procedures covered

Cumulative bonus

10% - 50% on the sum assured

Tax benefit

Included

Ambulance charges (per year)

Up to Rs. 20,000

 

Benefits of family health insurance plans

Here are some key benefits of family health insurance plans.

  • Easy to manage

    Instead of having to manage multiple mediclaim policies for your family members and remember their renewal dates, you manage only one plan. You need to pay a single premium to get state-of-the-art medical treatment for every insured family member under the family health insurance plan. No need to maintain multiple documents or set up reminders for renewal payments.

  • High sum insured

    Get sum insured ranging between Rs. 1.5 lakh and Rs. 2 crore to meet the required medical expenses of your family. Make sure that you have substantial cover in case a medical emergency arises.

  • Add members

    Policy buyers can include a family member in their existing medical insurance policies for family. So, you can be sure that as your family grows, your health insurance will keep up with your needs.

  • Add-on benefits

    Many insurance providers offer add-on covers. You can add maternity or newborn child cover. Also, bariatric surgery, organ donors, or homoeopathic and ayurvedic hospitalisation covers to the policy. This way, you can enhance your coverage so that your health needs do not outgrow the plan.

  • Tax benefits

    You can save on tax as per the prevailing laws.

  • Free annual medical tests

    Based on the purchased medical insurance for family, you may have the advantage of getting a free preventive medical check-up. Get the check-up benefit for every three years for all family members, irrespective of the claim.

  • Ambulance charges

    You can get cover for ambulance charges up to Rs. 20,000 in a policy year.

  • No pre-medical examinations

    Some insurers allow policy buyers to skip the medical test based on multiple criteria and their discretion.

  • Daycare procedures

    You can utilise financial coverage for close to 586 daycare procedures like dialysis, which requires only some hours of hospitalisation.

  • Hassle-free payment

    You only pay a single premium amount and get the family health insurance plans for the whole family.

Inclusions of family health insurance plans

Having a clear idea regarding what a family health plan covers will help prospective policy buyers to make an informed choice. Here are the standard inclusions in the medical insurance plans for family:

  • Hospital registration, room rent, service charges etc.
  • Daycare treatment charges in hospitals
  • Pre- and post-hospitalisation expenses anywhere from 30 to 60 days as per the policy
  • Vaccinations and health check-ups for all family members
  • Cashless transactions in hospitals
  • Tax benefits on premiums of family health insurance plans
  • Critical illness covers and additional services in emergencies
  • In-patient treatment expenses for Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy (AYUSH)

Apart from these, policyholders can utilise additional services and expenses depending on their respective policy terms.

Exclusions of family health insurance plan

The following are a few expenses that a medical insurance policy for family may not cover:

  • Any disease that occurs during the waiting periods mentioned in the policy
  • STDs (sexually transmitted diseases) such as herpes, AIDS, etc.
  • Any disease caused due to substance abuse, including narcotics, drugs, alcohol, etc.

Apart from these, there are a few health conditions that the insurance companies will cover after a specific time. These include prolapsed, bariatric surgery, joint replacement, and extruded intervertebral disc (PIVD) or herniated. A few others include:

  • For cataracts, hernia, sinusitis, and piles, the insurer will accept claims after waiting period of 2 or more years.
  • Insurers also have waiting period for pre-existing illnesses, maternity, and newborn baby expenses.

You should however remember that these exclusions are indicative. It varies from insurer to insurer. Read the policy document for more details. So, you have the utmost clarity about waiting periods for your chosen insurer and plan.

Eligibility criteria to buy health insurance plans for family

While comparing different options, individuals must also consider the following eligibility parameters.

  • The minimum age of the policyholder's family members should be between 18 to 65 years. In case of dependent children, the age limit is between 3 months and 30 years.
  • You can opt for health insurance plans for family to cover yourself, spouse, and children. Also, for your dependent parents, and parents-in-law.

Most plans will have tenure of a year. You need to renew the family health insurance plan to keep the coverage active.

Things to consider before buying a family health insurance plan

Before buying a mediclaim policy for family, read the pointers you must consider for maximum protection.

· Sum insured 

The sum insured in a policy must be sufficient to meet the entire family's medical expenses. Therefore, reputed insurance companies offer family plans with a sum insured between Rs. 1.5 lakh and Rs. 2 crore.

· Hospital network of the insurance company

Always buy a health insurance policy for family from a company with a vast network of hospitals. You have the advantage of availing cashless treatment.

· Claim settlement ratio

Choose an insurance provider with a good claim settlement ratio. The higher the ratio, the more streamlined the processes of accepting and settling the claims.

· Waiting period

Often, insurers apply a waiting period from 2 to 5 years on certain facilities. You can check the waiting period in the policy terms and conditions. Mostly waiting period is applicable on pre-existing illnesses. Also, add-on covers like dental coverage, free annual check-ups, etc. During this period, individuals cannot file any claim.
Therefore, you must thoroughly go through the inclusions and exclusions of a family health plan. Know if the company extends any add-on covers to expand the coverage.

Why should you buy a health insurance plan for your family?

Family health insurance is crucial, especially to tackle the medical inflation. It gives coverage to the entire family against minor injuries, major illnesses, accidental injuries, and outpatient procedures.
You only pay a single premium for the family health insurance plan. The sum insured is divided among all family members enrolled in the plan. Here are some factors why you should buy a health insurance plan for family.

· One plan for all

Family health insurance policy covers your complete family. You can also add your extended family and in-laws in the policy. Therefore, it is easier to manage.

· Keeps your savings unaffected

Any medical emergency can affect your family's financial planning and dent your savings. A health insurance policy ensures that your savings remain intact. You can avail of the best healthcare services without worrying about the funds.

· Sun reinstatement benefit

Most health insurance plans for family provide 100% sum reinstatement benefit. If the sum insured gets exhausted, you can restore the amount with this benefit.

· Focus on treatment and recovery

The cashless treatment facility offered under family health insurance plans helps you focus on the treatment and recovery. You can access quality healthcare services without worrying about the availability of funds. The insurer settles the bills directly with the network hospital.

How to apply for online family health insurance plans

Step 1: Click here to open our online application form.

Step 2: Fill in the application form with your basic details or the person that you want to insure. Provide your name, gender, and mobile number. Also, date of birth, and residential PIN code.

Step 3: Now click on ‘Get Quote’ to proceed.

Step 4: From the list of policies shown, choose your preferred family health insurance plan by clicking the ‘Buy Now’ button placed under each plan. You can further modify the insured amount, policy term, and plan-type to get a list of policies tailored to your preference.

Step 5: Based on the plan you choose, you may get the option to select the policy term and premium amount.

Step 6: Enter your email ID and check if all personal details shown are correct. Click ‘Next’ to proceed.

Step 7: Enter some additional details, such as height, weight, nationality, marital status, address, and nominee details (if applicable).

Step 8: Answer a few questions about your health and lifestyle by clicking the relevant checkboxes. Click on the ‘Next’ button to proceed.

Step 9: Verify if the previously filled details are correct. Click on the ‘Proceed’ button to visit the payment page.

Step 10: Make the payment through net banking, UPI, debit, or credit card to buy the policy.

After successful payment, your policy document will be available for you to download instantly. You will receive a copy of the policy document on your registered email ID within from 5 to 7 working days.

You will also receive an SMS confirmation immediately after the payment processed successfully.

You can also access your policy details through the My Account section within 5-7 days after purchase.

Filing a claim for a family health insurance plan

Go through the step-by-step guide to raise a claim against family health insurance plans:

For cashless treatment:

Step 1: Fax or email your pre-authorisation form collected from your insurer’s website or the hospital’s insurance department.

Step 2: Submit medical records, discharge certificate, or letter, receipts of the diagnostic test, etc.

Step 3: You will receive an approval letter from the claim management department after claim authorisation.

The hospital will contact the insurance provider if they have any related queries. Upon resolving all the queries, the insurer approves the claim and settles the bill directly with the hospital. Insurer would inform the policyholder if cashless claim not approved. You can then file a reimbursement claim.

For reimbursement claim:

Step 1: Submit the claim form and other necessary documents to the address provided when you obtained the insurance plan or many insurers have now made filing online the new norm.

Step 2: Address the questions the claim management team of your insurance company has raised.

Next, once you have resolved queries and shared the relevant documents, once your claim is accepted by the insurer, you will receive reimbursement for your expenses.

Which documents do you need to raise a reimbursement claim under family health insurance?

Below is the list of documents that you need to submit when filing for reimbursement claim under family health insurance.

  • Duly filled health insurance claim form
  • Health card or policy number/document
  • Investigation/test reports like X-ray, CT scans, blood reports, etc.
  • Bills and prescriptions
  • Hospital discharge summary
  • Doctor consultation papers
  • NEFT details

Why choose family health insurance plans from Bajaj Finance

Bajaj Finance brings to you family insurance plans offered by top health insurance providers in the country. Here are some of the advantages of buying health insurance plans offered by Bajaj Finance.

Reliable brand name

Bajaj Finance is a name that inspires trust among customers. The company has provided efficient and affordable insurance policies in all sectors and consistently has been amongst the top distributors of health insurance plans in the country.

Digital process

Bajaj Finance’s online customer portal for family health insurance is quick, easy, and secure. This digital platform is informative and interactive with a customer-centric approach.

Frequently asked questions

How does a family health insurance plan work?

Family health insurance plan covers the entire family under one plan. You only pay for one plan instead of buying individual health insurance for each family members. All the family members enrolled under the plan share the fixed sum insured. Also, the benefits offered under the plan. Some family health insurance plans offer 100% sum reinstatement benefit. This benefit helps you to restore 100% of the sum insured if it gets exhausted.

Which is the best family insurance?

Family health insurance plans cover the medical expenses of the entire family. There are two types of health insurance plans in India:
1. Individual medical insurance policies cover each family member individually.
2. Family floater health insurance policy covers the entire family under a single plan and premium.
You can consider any policy that meets your requirements offering the facilities mentioned above. Also, consider the sum insured offered on the plan, number of network hospitals and claim settlement ratio of the insurer. Also, if you get lifetime renewability option.

Can I include my parents in the family floater health insurance?

Yes, you can add your parents to the family health insurance policy. There may be an increase in the premium, depending on their age and pre-existing diseases.

What is the difference between family health insurance and family floater health insurance?

Family health insurance plan is also known as family floater health insurance plan. This plan covers the entire family under one policy. You can enrol up to six members under one family health insurance plan. All members enrolled in the family share the benefits and sum insured in the plan.

Can I include my newborn baby in family floater health insurance?

Yes, you can add your newborn baby in the family health insurance policy. You can enrol the baby after three months from the date of birth. The age criteria to enrol dependent children in health insurance policy is between three months and 25 years.

What happens if one of the primary beneficiaries dies?

The coverage under family health insurance policy continues for the other members. However, the premium will not reduce. The benefits of the original policy will remain intact until the next renewal. You can make the required changes at the time of renewal.

What happens if I exhaust the sum insured of the family health insurance policy?

Most health insurance plans offer 100% sum reinstatement benefit. This benefit helps you to restore the entire sum insured of the policy if it gets exhausted. The percentage of the top-up amount differs from policy to policy.

What is the difference between individual and family health insurance?

The individual health insurance policy is for one person. Family floater health insurance policy covers all family members under one policy.

How much does a family health insurance plan cost?

Premiums for family health insurance plans differ from insurer to insurer. Premium depends on various factors like the number of members, age, and medical requirements of the policy buyer. At Bajaj Finance, you can choose from a wide range of family health insurance plans that come at affordable premiums.

How do I choose a family health insurance plan?

Select a family health insurance plan that offers comprehensive coverage to your entire family. Look for the number of network hospitals to benefit from cashless facility when needed. Many a time, you need to undergo several tests or medications before and after hospitalisation. So, ensure your health insurance plan covers pre-and post-hospitalisation expenses. Having a preventive medical check-up facility in the health insurance plan enables you to monitor your health record. So, whenever you choose a family health insurance plan, ensure that all members get substantial health coverage.
Choose from a range of health insurance plans offered on Bajaj Finance Insurance Mall.

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Disclaimer

Insurance is the subject matter of solicitation. Bajaj Finance Limited (‘BFL’) is a registered corporate agent of third party insurance products of Bajaj Allianz Life Insurance Company Limited, HDFC Life Insurance Company Limited, Future Generali Life Insurance Company Limited, Bajaj Allianz General Insurance Company Limited, SBI General Insurance Company Limited, ACKO General Insurance Limited, Niva Bupa Health Insurance Company Limited , Aditya Birla Health Insurance Company Limited and ManipalCigna Health Insurance Company Limited under the IRDAI composite CA registration number CA0101. Please note that, BFL does not underwrite the risk or act as an insurer. Your purchase of an insurance product is purely on a voluntary basis after your exercise of an independent due diligence on the suitability, viability of any insurance product. Any decision to purchase insurance product is solely at your own risk and responsibility and BFL shall not be liable for any loss or damage that any person may suffer, whether directly or indirectly. Please refer insurer's website for Policy Wordings. For more details on risk factors, terms and conditions and exclusions please read the product sales brochure carefully before concluding a sale. Tax benefits applicable if any, will be as per the prevailing tax laws. Tax laws are subject to change. Visitors are hereby informed that their information submitted on the website may be shared with insurers. BFL is also a distributor of other third-party products from Assistance Services providers such as CPP Assistance Services Pvt Ltd, etc. All product information such as premium, benefits, exclusions, sum insured, value added services, etc. are authentic and solely based on the information received from the respective insurance company or the respective value-added service provider or Assistance company.

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