Children Health Insurance

Know the benefits of having health insurance plans for children.
Health insurance for children
3 mins

Children need special attention and care for their health, especially in their growing years. This includes timely doctor consultations or medical intervention as and when required. In such cases, the availability of funds should not bother you, especially when it comes to children’s well-being. Hence, having a comprehensive health insurance policy for children is critical.

With a wide variety of insurance options from multiple insurance providers, finding a budget-friendly health insurance policy for children can be challenging. This article aims to make the process of purchasing child health insurance and medical insurance for newborns simpler and easier.

What is a child health insurance plan?

Children can be susceptible to a range of illnesses and diseases, particularly toddlers, and newborns. Thus, securing yourself financially with a health insurance policy for children to meet their medical expenses for their healthcare is a wise choice.

Children’s health insurance policies cover a wide range of medical ailments. These include infections, diseases, and the cost of vaccinations.

Benefits and coverage of child health insurance

With the right children’s health insurance plan, you have access to a range of benefits, as given below:

● Ambulance costs
● Hospitalisation expenses
● Daycare procedures
● Medical treatment
● AYUSH Treatments

Besides this, many health insurance providers also offer family or family floater health insurance policies. These policies allow you to include your spouse, parents, and dependent children in the insurance coverage. This helps to ascertain the medical and financial coverage of all the loved ones, without having to purchase multiple policies.

Therefore, when considering a health insurance plan for children, it is important to look for a plan that has the following:

● Comprehensive coverage
● Flexible options
● Positive market reputation

By choosing the right plan, parents can ensure that their children receive the best possible care in the event of a medical emergency.

Things to consider when buying children’s health insurance policy

Below are a few things you should check while purchasing health insurance for kids:

1. Comprehensive coverage

Get comprehensive medical coverage for the entire family under one plan. A comprehensive plan includes pre-hospitalisation, hospitalisation, post-hospitalisation, ambulance, daycare treatments, and more.

2. Cashless facility

Check if you can claim for a cashless facility with the chosen health insurance policy. Cashless insurance services make the medical treatment and hospitalisation process less stressful. As the bills are taken care of by the insurer and settled directly with the network hospitals.

3. High claim settlement ratios

The claim settlement ratio in health insurance is very important to understand the credibility of the insurance company. It helps you know the number of claims settled successfully in a year by the insurer. Usually, the claim settlement ratio should be around 90%, ensuring a smooth and efficient claim process that policyholders can trust.

Types of health insurance policies available for children

Children’s health insurance plans fall within two major categories:

1. Family floater health insurance

This type of plan offers medical coverage for children and family members under one insurance plan. It offers comprehensive coverage for the child while also serving as a child health insurance plan. These plans typically cover 4 to 7 family members, including children. Opting for a family health insurance plan is more economical as it provides broader coverage at a reasonable premium.

A family floater health insurance policy includes the following types of coverage:

● Pre-hospitalisation costs
● Ambulance services
● Hospitalisation expenses
● Daycare procedures
● Post-hospitalisation costs
● Medical check-ups

Additionally, having a family floater health insurance plan helps save on the premium costs as compared to buying separate plans for each family member. With a family floater plan, any member of the family can avail of the entire sum insured of the policy.

Individual health insurance for children

This policy provides tailored coverage for one single child under an individual health insurance policy. The sum insured on this policy is completely dedicated to the enrolled child.

Why is having a health insurance policy for children necessary?

Here are five reasons to include your children in a health insurance policy:

1. Rising medical costs

The expenses of medical treatment are increasing at a much faster rate than general retail goods. Even a simple doctor’s visit can result in a significant financial burden. Hence, it is wise to protect children by obtaining a child medical insurance policy.

2. Lower immunity

Children, especially newborns and premature babies, have weaker immune systems than adults. So, they are susceptible to a wide range of infections and illnesses, both minor and major. This heightened health risk for children makes health insurance a necessary consideration.

3. Affordable premiums

The premiums for child health insurance are typically low, making it an affordable way to get coverage for your children’s medical expenses.

4. Health-related threats

The ongoing global pandemic has demonstrated that viral infections pose a threat to people of all ages, including children. With vaccines for children still in the development stage in many countries, securing a child with health insurance is advisable.

5. Protect your savings

A child health insurance policy helps you meet your child’s medical expenses without facing any shortage of funds. It helps you not to compromise on your financial goals.

What is the right time to buy health insurance for my child?

A newborn child can be prone to a range of medical conditions. To prepare yourself financially, it is advisable to buy a children’s health insurance plan right after the child is born. You can also choose a health plan that covers maternity and newborn benefits.

Eligibility criteria for child health insurance plans

The eligibility criteria for children’s health insurance plans vary based on your insurer. Here are some common eligibility criteria for buying child health insurance:

● If the parents already have a family floater policy, the newborn child will be covered from the first day to 90 days.
● By paying an additional premium, a baby older than 91 days can be added to the current family floater coverage. 
● If either of the parents has a health insurance plan, a kid as young as one day can be covered under an individual child health insurance plan.
The maximum age limit to be included in a family floater policy is between 20 and 25 years. (Relative to the insurance).
●To add your child to an existing family floater plan, you need to submit certain documents. These can be maternity discharge summary, birth certificate, or medical reports (in case child is suffering from any medical condition).

What are the key inclusions of child health insurance plans?

Given below are the key inclusions that are generally covered under a child health insurance policy:

Hospitalisation expenses: Child health insurance plans cover hospitalisation expenses, including room rent, medicines, and doctor consultation fees.

Pre- and post-hospitalisation expenses: Comprehensive health insurance plans cover pre- and post-hospitalisation expenses, including lab tests, medications, and other medical costs incurred before and after hospitalisation.

Daycare procedures: Child health insurance plans also provide coverage for daycare procedures like chemotherapy, dialysis, hernia, cataract, and others.

Vaccinations: Most health insurance plans provide coverage for routine vaccinations provided to children.

Ambulance services: Ambulance services are also covered under child health insurance plans to ensure that your child is transported safely and timely to the hospital.

What are the key exclusions of child health insurance plans?

Given below are the common exclusions under the child health insurance plans:

Pre-existing conditions: Child health insurance plans do not cover pre-existing conditions. That is, if your child is diagnosed with any medical condition before purchasing the policy.

Cosmetic procedures: Child health insurance plans do not cover cosmetic procedures that are performed for aesthetic purposes.

Experimental treatments: Experimental treatments and surgeries that are not approved by medical authorities.

Self-inflicted injuries: Child health insurance plans do not cover injuries that occur due to self-harm or injuries resulting from criminal activities.

A child health insurance policy keeps you financially prepared for any emergency. It lets you access quality healthcare services without having to dig into your savings. Hence, while your insurer can take care of the expenses, you can focus on your child’s treatment and recovery.

Frequently asked questions

Can I get health insurance for my child?

Yes, you can get health insurance for your child. In fact, children's health insurance plans are becoming increasingly popular in today's world. These plans offer comprehensive medical coverage for various medical emergencies and unforeseen circumstances. When purchasing a children's health insurance plan, it's important to understand the key inclusions and exclusions of the policy to ensure that you pick a policy that suits your child's healthcare needs.

What is the minimum age for health insurance?

The minimum age for health insurance varies from one insurance provider to another. However, most health insurance plans cover children from the age of 91 days to 6 months. It's important to check with your insurance provider to understand the minimum age requirements for health insurance coverage.


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