Family Health Insurance

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

2 mins
01 Feb 2023

Making sure your family is well looked after is always high priority. This includes ensuring they have access to high-quality health care in case of a medical emergency. While planning your savings for the family, it is thus essential to plan a Family Health Insurance plan that will safeguard your savings in case a family member is ill and requires hospitalisation. Protecting your family from financial distress due to unforeseen health conditions is crucial. In this regard, health insurance plans for family are an ideal choice.
Here’s a guide to what a family health plan is, its benefits, inclusions, exclusions and more.

Family health insurance: Let’s know it better

A family health insurance plan is an affordable option to help you tide over rising medical expenses and still make sure that your family has access to high-quality health care 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.
Furthermore, if the amount is exhausted, policyholders may also get a 100% reinstatement of the sum insured based on the plan they choose to buy.

Key features of our family health insurance plans

Here’s a glance at the key features and benefits 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

  • Easy to manage

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

  • High sum insured

    You can secure a sum insured, ranging between Rs. 1.5 lakh and Rs. 2 crore to meet the required medical expenses of your family and make sure that you have substantial cover in case a medical emergency does arise.

  • 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 facilitate add-on covers such as maternity and newborn child, bariatric surgery, organ donors, and homoeopathic and ayurvedic hospitalisation against a single policy. This way, you can enhance your coverage so that your health needs don’t outgrow the plan.

  • Tax benefits

    You can save on tax as per the prevailing laws.

  • Free annual medical tests

    Based on the plan you purchase for the family, you may have the advantage of getting a free preventive medical check-up 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>

  • Day-care procedures

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

Leading family health insurance plans

Here are some of our leading family health insurance plans offered by Bajaj Finance:

Family Health Insurance Plans


Sum Insured

Number of Network Hospitals

Aditya Birla Group Activ Health

It provides extensive financial coverage against various health conditions.

Up to Rs. 10 lakh


Aditya Birla Activ Assure Diamond

It pays for diseases like blood pressure issues, hypertension, diabetes, asthma, cholesterol etc.

Up to Rs. 2 crore


Aditya Birla Super Top-up

This is ideal for those looking for add-on health protection for their family.

Up to Rs. 50 lakh


Bajaj Allianz Heath Guard

This comprehensive family health policy covers major health conditions, critical surgeries, and accidental injuries.

Up to Rs. 50 lakh


Bajaj Allianz Global Personal Guard

It provides complete financial protection for death, partial or permanent disability or accidental injuries.

Up to Rs. 2 crore


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 a family health insurance plan:

  • 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 cover and additional services in emergencies

  • In-patient treatment expenses for AYUSH (Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy)

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

Exclusions of family health insurance plans

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 like prolapsed, bariatric surgery, joint replacement, and extruded intervertebral disc (PIVD) or herniated that the insurance companies will cover after a specific time. A few others include:

  • For cataracts, hernia, sinusitis and piles the insurer will accept claims after a stipulated longer waiting period of 2 or more years.

  • Similarly, insurers can fix a waiting period for raising a claim for multiple health reasons like pre-existing illnesses, maternity and newborn baby expenses, etc.

You should however remember that these exclusions are indicative and may vary from insurer to insurer. Don’t forget to read the policy document for details so you have the utmost clarity about waiting periods for your chosen insurer and plan.

Eligibility criteria to buy a family health insurance plan

While comparing different options, individuals must also consider the following eligibility parameters to ensure a seamless experience.

  • 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 for yourself, your spouse, dependent parents, children, and parents-in-law.

Most plans will have a tenure of a year and need to be renewed to keep the coverage active. However, when you have a single-family health insurance plan, you have the convenience of renewing one policy only instead of having to keep track of multiple policies for renewal.

Things to consider before buying a family health insurance plan

Before securing your family financially with medical insurance, read along 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 starting from Rs. 1.5 lakh to 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 to utilise the advantage of cashless treatment.

  • Claim settlement ratio
    Choose an insurance provider with a good claim settlement ratio. The higher the ratio, the more streamlined the processes that the insurer must accept and settle claims. This will ensure that your claims are dealt with timely and with fewer hassles.

  • Waiting period
    Often, insurers apply a waiting period from 2 to 5 years, depending on the policy terms and conditions. During this period, individuals cannot file a claim for any pre-existing illness, and add-on covers like dental coverage, free annual check-ups, etc. Apart from these, you must thoroughly go through the inclusions and exclusions of a family health plan and whether the company extends any add-on covers to expand the coverage.

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 basic details such as name, gender, mobile number, date of birth, and residential PIN code for you or the person you want to insure.

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 and 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. A copy of the policy document will also be mailed to your registered email ID within 5-7 working days.

You will also receive an SMS confirmation immediately after the payment process is completed.

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 all your necessary documents, including 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 once the claim is authorised.

The hospital may contact the insurance provider if they have any related queries. Once all queries are resolved and the claim is approved then the insurer directly pays the hospital before the discharge. However, in case the claim is not approved for cashless treatment for any reason, the policyholder will be intimated, and you must 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.

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.

Given the yearly medical inflation, health insurance plans for family have become crucial to avoid hefty expenses. Moreover, as it covers the entire family under one premium, it is easy to manage and helps keep savings intact.


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