Who Is Covered Under Family Health Insurance Plans?
Health insurance plans for families provide coverage for all the members of the family under one single policy. As per this plan, a set sum of money is insured and shared by all the members of the family assuming that not everyone falls sick at the same time. These health insurance plans for families provide cashless hospitalization facilities, and benefits in case of pregnancy both pre and post-hospitalization.
Who all are covered under the Family Health Insurance Plan?
The family health insurance policy covers all members of the family between the ages of 18 to 65 and the dependent children between the ages of 3 months to 30 years. In case a member is above the age of 65 years medical insurance for senior citizens should also be available to get maximum protection for the family.
Health insurance for senior citizens can be purchased as a separate family and has its benefits because it is tailored in a way to deal with all the ailments that arise due to old age.
What are the key features and benefits of a Family Health Insurance Plan?
The key benefits and features are as follows:
- Provides for an assured sum between 1.5Lakhs to 2 crores depending on the policy and allows for payment of medical bills of the whole family
- It provides hassle-free payment with affordable premiums and allows you to avail the best healthcare facilities for your family
- It also provides for saving under taxation laws.
- Additional members can also be added to the policy later on depending on the terms and conditions
- You can avail of numerous add-on benefits like maternity benefits, bariatric surgery etc all under a single policy
- There is no requirement to undergo a medical test to avail of the policy
- The policyholders also get the benefit of preventive health check-ups every three years, regardless of the claim
- Ambulance charges worth Rs 20,000 are provided in a policy year.
What are the inclusions under the Family Health Insurance Plans?
The following are the most common inclusions under the plan:
- Coverage for hospitalization that is more than 24 hours due to injury or illness
- Covers for daycare procedures that require more than 24 hours of hospitalization
- Coverage for the ambulance in case of a medical emergency
- Covers for medical charges that happen before and even after discharge from the hospital for a certain number of days
- Depending on the policy, cover can also be available for maternity-related issues or the same can be added to the main policy later
- It covers the cost of organ harvesting as well as donor-related fees in the event of an organ transplant.
- Coverage for treatments through Ayurveda, Homoeopathy etc
- Coverage for treatment at home if advised by the doctor
- Cash allowance post hospitalization to meet miscellaneous expenses
- Cover for mental health disorders such as anxiety, BPD, etc
What are the exclusions under the Family Health Insurance Plans?
The following are the exclusions under the plan:
- OPD treatments and regular medical examinations
- It does not cover cosmetic treatment or plastic surgery
- Expenses for life-support devices
- Treatment received abroad unless it is covered by the plan
- It does not cover any disease or damage caused by war conditions, nuclear reactions, insurrection, activities of foreign foes, and so forth.
- It does not cover Injury or disease as a result of unethical or illegal behavior
- It does not cover Pregnancy or childbirth difficulties (unless otherwise specified in the plan), such as intentional termination of pregnancy, loss or abortion, etc.
- It does not cover any pre-existing health issues and is not covered until the waiting period is ended.
Things to Factor in Before Getting a Family Health Insurance Plan
Make a note of these points before buying a plan:
- Whether the plan provides optimum coverage for all family members or any add-ons are required
- Go for a plan that allows you to enhance the sum insured as inflation in health care is very common.
- Go for a plan that allows for cashless hospitalization
- Check for the maximum age of renewal of the policy
Summing Up
To finance medical care today, your family’s financial security is critical. Individual or floater sum insured family health insurance protects your entire family from medical expenditures incurred during an emergency. The policy provides a wide range of family health insurance policies that include amazing benefits, a vast network of cashless hospitals, and speedy claim settlement.
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