10 tips to help you choose the best family health insurance plans in India

While doing your research for a health insurance policy, you must have come across the fact that buying a family floater plan is cheaper than buying individual plans for all the family members. Well, then, what are you waiting for?

This is where the situation gets a little tricky because finding a plan that fits not only the insurance needs of the family but also the family’s budget is quite difficult. To make matters worse, many family plans have several restrictions ranging from the age of the family members to pre-existing diseases they may be suffering from.

But worry not; we have compiled useful tips to help you find the right family health insurance plan.

Understanding family health insurance

Family health insurance is a type of healthcare plan that covers all the household members under one policy. You can include yourself, your spouse, dependent children, parents, and parents-in-law. The sum insured is common for all members, and you need to pay a single premium. The premium is calculated based on the age of the eldest family member. It is cost-effective compared to buying individual health plans for each member.

Tips to pick the best family health insurance plans in India

Here are some tips to help you choose the best family health plans —

1. Select the right coverage: This is the first step when choosing health insurance plans for a family. A healthcare plan for a family must have comprehensive coverage to protect you and your family financially against a wide of medical costs, both in emergencies and planned hospitalisations. The plan must cover expenses of hospitalisation, pre- and post-hospitalisation, daycare procedures, domiciliary care, emergency ambulance charges, AYUSH treatments, etc. 

2. Choose the right sum insured: The sum insured, as you know, is the maximum amount you will receive from the insurer when you file a claim. So, evaluate the medical needs of the family members and choose the sum insured accordingly. Remember, the sum insured has a direct impact on the premium. So, if you choose a high sum insured, your premium will increase. However, if you choose a lower sum insured, it might not be sufficient to meet your medical expenses fully, and you will end up paying from your pocket. So, what’s the option, you may ask? Well, there are 2 options. You can opt for the right sum insured after having a talk with the insurance provider. Alternatively, you can pick a plan with basic coverage and opt for a Top-Up cover that will provide additional coverage. Once the sum insured by your base plan gets exhausted, the top-up plan will kick in. This is also an affordable option.

3. Check waiting periods: Health plans have waiting periods for pre-existing ailments like diabetes, high blood pressure, heart problems, specific diseases like hernia, and maternity benefits. The waiting period may vary between insurers; you cannot raise any claims during this waiting period. So, check for a policy with low or zero waiting periods, though you may have to pay a higher premium for such plans.

4. Look for plans with lifetime renewability: Make sure the plans offer lifetime renewability so you can continue with the same plan without any break. Some plans have restrictions on entry age, and it may be difficult to find a suitable plan for old age that easily meets your healthcare needs and budget.

5. Plan flexibility: Buy a family health insurance policy that offers flexibility to add new members, such as your spouse, parents, or newborn. Instead of buying separate policies, you should be able to easily add new members to the existing policy. Family floaters cover all members under one plan and are cost-effective. However, remember that the sum insured will be shared amongst all members.

6. Network hospitals: The most significant benefit of getting treated in a network hospital of the insurer is cashless hospitalisation. There is no stress of paying upfront as the insurer will settle the bills directly with the healthcare establishment. You just need to inform the insurer about the hospitalisation. So, when you are purchasing a family floater plan, check the insurer's in-network hospitals and whether your preferred ones are included in the list. Always choose an insurer with a wide network of hospitals for quick and convenient cashless claim settlements.

7. Check deductibles: A deductible determines the premium of your family floater plan. It is the portion of the claim amount you need to pay first, and then the insurer will cover the remaining. A healthcare plan with a high deductible will have a lower premium, but it will increase your out-of-pocket expenses. So, decide the deductible amount based on your affordability. 

8. Sub-limits and copayments: Look for a plan that doesn't have any sub-limits or a copayment clause because these will increase your financial burden. While sub-limits will limit the coverage of your plan, a copayment is the share of the claim amount you agree to pay at the time of settling claims.

9. Compare plans: This is an important factor before purchasing any health insurance plan, whether an individual policy, family floater, or senior citizen health insurance. Comparing multiple plans online helps you find the best plan that perfectly fits your family's needs and is easy on the pocket.

10. Check the company’s reputation: Check customer reviews and ratings online before proceeding with any insurance company. The reviews will give an idea about the insurer's efficiency in settling claims, their after-sales service, etc. You must also check the claim settlement ratio (CSR) of the insurer, which talks about their credibility. Go for an insurance provider with a high claim settlement ratio. For the unversed, the claim settlement ratio is the proportion of claims settled against the total number of claims filed in a financial year. You can find the CSRs of insurance companies on the official website of the IRDAI.

Conclusion

Purchasing health insurance plans for your family is a wise investment. However, before investing in a family floater plan in India, make sure you keep the above factors in mind for maximum protection against medical expenses. You need to understand the specific needs of your family members, look at the available plans offered by different insurance providers, make a comparison, and then take a call. This will help you get the best coverage as per your needs and budget. So, do your homework well before investing in any plan.