Health Insurance Plans for Family

Read on to know the key features, benefits and claim process for family health insurance plans providing coverage of up to Rs. 50 lakh*.
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2 mins
30-July-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.

What is family health insurance?

A family health insurance plan is a cost-effective solution to manage increasing medical costs, providing access to top-notch healthcare services for your entire family. Typically covering the policyholder, spouse, and children, these plans may also extend coverage to parents and in-laws. Such comprehensive health insurance plans for family ensure peace of mind and financial security during health emergencies.

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.

Family Health Insurance Plans in India 2024

Family health insurance plans in India are a crucial aspect of every household's financial planning. They ensure that medical expenses, expected or unexpected, do not cause a financial burden to the family. With the rise in medical costs, opting for a medical policy for family plan has become a necessity. A health insurance for family is designed to cater to the medical needs of the entire family under a single cover. Various insurance companies offer a wide range of family medical insurance plans, including some of the best family health insurance plans with different benefits and coverage options, ensuring comprehensive protection and peace of mind.

Let us look at the some of the best family health insurance plans in India that provide comprehensive coverage, various benefits, and financial stability to the policyholder and their family.

Family health insurance plans

Sum insured

Key benefits

Aditya Birla Group Activ Health Plan

Up to Rs. 10 lakh

Coverage even with asthma, blood pressure, cholesterol, and diabetes

Coverage of both pre - and post-hospitalisation for 30 and 60 days respectively

Coverage of 527 daycare procedures

Bajaj Allianz Health Guard Insurance Plan

Up to Rs. 50 lakh

Coverage of modern treatment methods

Covers bariatric surgery, maternity benefits

Covers organ donor expenses

ManipalCigna Pro-Health Group

Up to Rs. 10 lakh

Available with both co-pay and without co-pay

Covers domiciliary and daycare treatments

Covers in-patient hospitalisation for AYUSH treatment

Niva Bupa Health Plus Plan

Up to Rs. 10 lakh

Covers pre- and post-hospitalisation expenses for 30 and 60 days respectively

Covers domiciliary and daycare treatments

Covers organ transplant expenses

Aditya Birla Activ Assure Diamond

Up to Rs. 50 lakh

Get back up to 30% of your premium as HealthReturnsTM

Get 150% reinstatement on the sum insured

Get health coach for nutritional and wellness counselling

 

Key features of health insurance plans for family

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

Features

Specifications

Premium starts

Rs. 17.5/per day*

Cashless claim settlement

Across 8,000+ network hospitals

Family coverage

Self, spouse, son, daughter, father, and mother

Expenses coverage

Up to Rs. 50 lakh

Ambulance charges (per year)

Up to Rs. 20,000

Tax benefit

Included

Cashless claim process

Within 30 minutes

Daycare procedures

586 daycare procedures covered

Cumulative bonus

10% - 50% on the sum assured

 

Individual Health Insurance vs Family Health Insurance

Here are the key differences between individual health insurance and family health insurance plans:

Parameters

Individual health insurance

Family health insurance

Plan details

One person or individual is insured under this policy

Offers coverage for multiple family members under one plan

Coverage

The sum insured covers the medical expenses of only the individual

The sum insured is shared among the family members covered under the plan

Benefits

Offers extensive coverage for the individual

A more affordable option to cover multiple family members

Disadvantages

Can be expensive to buy

Offers limited coverage for family members since the coverage is shared amongst the family members

Family Health Insurance plans benefits

Here are some key benefits of family medical 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 family health policy will keep up with your needs.
  • Add-on benefits
    Many insurance providers offer add-on covers. You can add maternity insurance or new-born 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.
  • Stress-free hospitalisation cover
    In the event of hospitalisation, insured family members can receive cashless treatment at a network hospital of the insurer, similar to individual health plans. This ensures that all your family members can access medical care without compromising on their treatment.
  • Tax benefits
    You can save on tax with deductions under Section 80D of the Income Tax Act.
  • Free annual medical tests
    Based on the purchased health insurance plans for family, you may have the advantage of getting a free preventive medical check-up. These plans often provide the check-up benefit every three years for all family members, irrespective of any claims made.
  • 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, while purchasing health insurance for family.
  • 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 family health coverage plans include will help prospective policy buyers make an informed choice. Here are the standard inclusions in the medical insurance plans for family:

Hospitalisation expenses:

A family health insurance plan covers the hospitalisation expenses, including room rent, ICU charges, and doctor's fees, which can easily mount up and create a financial burden.

Daycare procedures:

Some insurance providers also cover day care procedures that don't require hospitalisation for 24 hours or more. These procedures include chemotherapy, dialysis, and cataract operations.

Pre-and post-hospitalisation expenses:

Family health insurance plans also offer critical illness coverage, which includes the costs associated with the treatment of severe conditions such as cancer, kidney failure, and heart ailments. These plans, under the umbrella of medical insurance for family, ensure that your family is financially protected against significant medical expenses during critical health situations.fv

Maternity cover:

Many family health insurance plans offer maternity coverage, which covers the delivery costs of a child. Some plans also cover newborn baby care for a specific period.

Pre-existing diseases coverage:

Certain family health insurance plans offer coverage for pre-existing diseases. However, coverage for these diseases may come with a waiting period, usually between one to four years, depending on the policy.

Critical illness coverage:

Family health insurance plans also offer critical illness coverage, covering medical expenses incurred during the treatment of critical illnesses such as cancer, kidney failure, and heart ailments.

Alternative treatments:

Some family health insurance plans include coverage for alternative treatments such as Ayurvedic, Homeopathic, and Unani treatments.

Ambulance charges:

Family health insurance plans may also cover ambulance charges, which can help take the financial strain off of you during an emergency.

No claim bonus:

Some policies offer a no-claim bonus, where policyholders get a discount on the premium amount if they don't claim for a certain period.

Health check-ups:

Some insurance providers offer health check-ups for free as part of a family health insurance policy, allowing you to stay on top of your health and detect any health conditions early on.

Also read: Check your Body Mass Index (BMI). Explore BMI Calculator

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 family health insurance policy.
  • STDs (sexually transmitted diseases) such as herpes, AIDS, etc.
  • Any disease caused due to substance abuse, including narcotics, drugs, alcohol, etc.
  • Most family health insurance plans do not cover outpatient department (OPD) expenses, such as doctor consultations, diagnostic tests, or minor procedures that don't require hospitalisation, leaving these costs to be paid out-of-pocket.
  • Cosmetic or plastic surgeries, unless medically necessary due to an accident or illness, are typically excluded from family health insurance plans, meaning expenses for elective procedures are not covered.
  • Treatments received outside the country are generally not covered under family health insurance plans. If a family member needs medical care abroad, these expenses will likely not be reimbursed by the insurance.

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 two or more years.
  • Insurers also have waiting period for pre-existing illnesses, maternity, and newborn baby expenses in a health insurance policy for family.

You should, however, remember that these exclusions are indicative and can vary from insurer to insurer. It's important to read the policy document for more details to understand the specific terms and conditions of family health insurance plans. This ensures you have utmost clarity about waiting periods and coverage details 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 in health insurance. 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. Opting for the best mediclaim policy for family ensures comprehensive coverage for the entire family, protecting against minor injuries, major illnesses, accidental injuries, and outpatient procedures. This type of policy provides peace of mind by safeguarding your loved ones from the financial impact of unexpected medical expenses.

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.

. More convenient

A family health insurance plan simplifies managing healthcare for all members under a single policy. With shared coverage, there's no need to track multiple plans, making healthcare management easier and more streamlined.

. Financial security

A family health insurance plan provides financial protection against unexpected medical expenses. It covers hospitalisation, treatments, and emergencies, ensuring that your family is protected without straining your finances.

· 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.

. Tax exemption

Purchasing a family health insurance plan offers tax benefits under Section 80D of the Income Tax Act. Premiums paid can be deducted from your taxable income, reducing your tax liability while securing your family’s health.

· Focus on treatment and recovery

The cashless treatment facility offered under family health insurance plans in India 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.

What documents do you need to buy family health insurance?

Here’s the list of documents that you need to buy the family health insurance plan.

  • Proof of identity – passport, driving licence or Aadhaar Card.
  • Proof of address – utility bill, ration card, or driving licence.
  • Birth certificates of each family member enrolled under the plan.
  • Medical history if any pre-existing conditions or surgeries undergone in the past.
  • Income proof, a salary slip, or any other document that proves your income.

However, if you are buying health insurance from Bajaj Finance Insurance Mall, you can enjoy the convenience of purchasing health insurance for your family through a 100% paperless journey. This streamlined process makes it easier to secure comprehensive coverage for your entire family without the hassle of traditional paperwork.

How to apply for online family health insurance plans

Here are some steps for applying the best mediclaim policy for families:

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.

Why should you buy family health insurance plan online?

Here are a few reasons to purchase the best health insurance policy for your family online:

Easy convenience:

With just a few clicks, you can compare different health insurance plans and choose the one that suits your needs.

Payment security:

Insurers provide a safe and secure online payment gateway, ensuring you can make transactions securely.

Instant quotes and policy issuance:

You can get instant quotes and policy issuance for your chosen policy. No need for lengthy negotiations with agents.

Download policy document instantly:

You can access the policy document anywhere and at any time without the need for a physical copy.

Transparency:

Online purchase of health insurance plans for family provides complete transparency about policy benefits, coverage, and terms and conditions.

How to file a claim for a family health insurance?

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 a medical 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 best 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 consistently provided efficient and affordable insurance policies across various sectors, earning its reputation as one of the top distributors of the best health insurance plans for family 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.

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Frequently asked questions

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

Health insurance primarily covers an individual's medical expenses, whereas family health insurance is designed to provide coverage for the entire family. This includes the policyholder, their spouse, and dependent children. The premium for a family medical insurance policy is generally higher than an individual health insurance policy, as it offers coverage for multiple members. A family medical insurance policy is an affordable way to provide comprehensive healthcare coverage for the entire family. It ensures that medical expenses do not cause a financial burden to the family in case of an illness or accident. Moreover, it offers peace of mind to the policyholder. So, they do not have to worry about the medical expenses of their spouse or children in case of a medical emergency.

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 member. 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 enroll 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 new-born baby in family floater health insurance?

Yes, you can add your new-born baby in the family health insurance policy. You can enroll the baby after three months from the date of birth. The age criteria to enroll 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.

What is the age limit for mediclaim policy for family?

The age limit for family mediclaim policy may vary between different insurance companies and policies offered by them. Generally, most insurance companies offer family mediclaim policies for individuals aged between 18 to 65 years. However, some insurers may offer policies that provide family medical insurance coverage up to the age of 70 years or even 80 years. It depends on the policy terms and conditions. It is always advisable to check the policy documents or contact the insurer to get a better understanding of the age limit for family health insurance plans.

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.

How do I add a family member to my existing health insurance policy?

Adding a family member to an existing health insurance policy is simple. You need to contact your health insurance provider and provide them with the necessary details of the family member, including their name, age, and medical history. You may need to pay an additional premium for the added member.

How much does a health insurance plan for a family cost?

The cost of a health insurance plan for a family varies depending on several factors. It depends on the coverage that you choose, the age of the family members, pre-existing medical conditions, and the sum insured. The premium may also differ from one insurance provider to another. However, it is important to consider the benefits offered by the policy before choosing one. You can get an idea of the cost by obtaining quotes from different health insurance providers and comparing them.

Do I need a separate health insurance for my family while I am already covered under a corporate health policy?

While your corporate health insurance policy may provide coverage for you, it may not cover your family members. In such cases, you may need to consider purchasing separate health insurance policies for your family. Some corporate policies may allow you to add family members, but it depends on the employer's policy.

How long can kids stay on family health insurance?

The age limit for kids to stay on family health insurance depends on the insurance provider and policy. Most policies allow children to stay on the family health insurance until the age of 26. However, certain policies may have different age limits, so it is important to check this clause in your insurance policy.

What is the average cost of health insurance for a family of 4 in India?

In India, the average cost of health insurance for a family of 4 typically ranges between Rs. 15,000 and Rs. 30,000 annually. This cost depends on factors such as the sum insured, coverage benefits, and the age and health of family members. Comprehensive plans with extensive coverage may cost more.

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Disclaimer

*T&C Apply - 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, ICICI Lombard General Insurance Company Limited, HDFC ERGO General Insurance Company Limited, Tata AIG General Insurance Company Limited, The New India Assurance Company Limited, Cholamandalam MS General Insurance Company Limited, Niva Bupa Health Insurance Company Limited , Aditya Birla Health Insurance Company Limited, Manipal Cigna Health Insurance Company Limited and Care 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. Tax laws are subject to change. BFL does NOT provide Tax/Investment advisory services. Please consult your advisors before proceeding to purchase an insurance product. Visitors are hereby informed that their information submitted on the website may also 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., Bajaj Finserv Health 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 Assistance service provider company.

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