Last Updated on 22/03/2022 by Deepak Singla
Inflation is a thing that we have to live with and cannot deny the existence of. We have been witnessing the increase in food costs, petrol costs, and overall living costs:
One thing you have to acknowledge is that healthcare costs are also rising by the day like wildfire.
In India, more than half of the population cannot afford the high medical costs. In the event of an accident or a critical illness calls for even costlier medical bills. Hence, the need for health insurance!
Getting health insurance is a must and people are gaining awareness about it bit by bit. Especially, with the onset of COVID-19 pandemic, health insurance sale has surged. However, purchasing separate health insurance plans for each member of your family would involve a lot of hassles. So, it is better to get a best family health insurance plan that will cater to the health expenses of all your family members.
If you are confused about the concept of family health insurance plans, then this article will tell you everything you must know before buying a family health insurance. Keep reading to know about the top 10 health insurance plans for family in India 2020-21.
What is a Family Health Insurance Plan?
Family Health Insurance is a type of health insurance plan that provides medical cover to you and all of your family members in exchange for an annual premium.
You can include your spouse, your children, your dependent parents, your parents-in-law and your siblings into an existing family health insurance policy. A family health insurance will cover pre and post hospitalization costs, in-hospitalization costs, ambulance costs, and other medical costs for each member of your family.
Why should you get a Family Health Insurance Policy: Benefits of Family Health Plan
1. Affordable Premium
With a family health insurance plan, you won’t need to pay individual premiums for each member of the family. You just have to buy one plan and your entire family including your spouse, children, parents, and even your parents-in-law will be covered under the same plan. Also, the premium will be affordable. With different individual plans, the premium could add up to a huge sum.
2. New family members shall be covered
You can add your newly born child in this plan too. If you get individual covers, then for each family member, you will have to buy new policies. But, if you have an existing family health policy, then you can add new members to it.
Also, if the eldest member of your family who was insured with you dies, then you and the other insured members will get added coverage benefits.
3. Health Insurance Cover for Parents
This is one of the most important benefits you get with family floater plans. You can cover the health expenses of your parents and even those of your parents-in-law under a single plan.
But, it is always recommended that you buy individual health covers for your parents if their health conditions are suited better that way.
4. Hospitalization expense cover for all family members
If you have a family, then it would become a hassle to choose a different health insurance policy for each member. Besides, you’d have to pay the premiums separately.
So, for a family, it’s better to go for family floater plans. This will narrow down your task of choosing the plan.
5. Additional Benefits
The Health insurance for family in India comes with several added perks like maternity cover, critical illness cover, accident cover, etc. for the entire family. However, there might be some clauses associated. So, you should always read the policy documents carefully before buying one.
6. Discounts
One of the many perks of getting a mediclaim for family is that you can get access to attractive discounts and incentives from the policy.
7. Coronavirus Cover
The number of coronavirus cases is on the rise. The expenses of the COVID-19 treatment can go up to several lakhs which is not quite affordable for a common man. So, it is better if you cover yourself and your family with a Coronavirus health policy on a family floater basis.
Two new plans, namely Corona Kavach and Corona Rakshak have been launched recently. You can purchase these plans on a family floater basis. The plan will not only cater to COVID-19 expenses like hospitalization costs, treatment, medicine costs, etc. but also cover the cost of PPE kits, ICU charges, doctor’s fees, etc.
8. Tax Benefits on Premium
Your family health insurance premiums will enjoy tax exemption under Section 80D of the Indian Income Tax Act.
Top 10 Best Family Health Insurance Plans in India 2022
Here is the list of Top 10 Best Family Health Insurance Plans in India
[table id=13 /]
1. HDFC ERGO Health Optima Restore Plan (formerly known as Apollo Munich Optima Restore)
HDFC ERGO Health Optima Restore Plan is one of the best health insurance plans in India for people who want advanced benefits. This health insurance plan has 3 basic features: Restoration, Multiplier, and Stay Health Benefit. The best part about this plan is that insured family will enjoy several other perks like no claim bonus up to 50%, critical illness cover with e-opinion option, lifelong renewability, no co-payment, etc.
Some of the unique benefits you get with the HDFC ERGO Optima Restore plan are as follows:
- This plan provides you with full Sum Assured for alternate treatment (non-allopathic) as well.
- It also has ‘no-cap limits’ and ‘no room rent capping’ feature.
- You also get a discount of 2% to 8% for every renewal if you achieve the average step count target they give with the mobile app. To avail of the same, you need to download the app within 30 days of policy purchase.
- The HDFC ERGO Optima plan also covers the complete cost in case of a critical illness
- It also has the feature of daily cash benefit.
- You basic insured sum will be increased by 50% for each no-claim year
- If the basic sum gets exhausted, then an auto-reinstatement of the assured sum will be done.
| Incurred Claim Ratio (ICR) of 2018-2019 | 62% |
| Minimum entry age | For dependent children: 91 days
For others: 5 years onwards |
| Maximum entry age | 65 years |
| Minimum sum assured | INR 3 lakhs |
| Maximum sum assured | INR 50 lakhs |
| Maximum number of people covered | 6 |
| Waiting period for Pre-Existing Diseases | 36 months |
2. Max Bupa Health Companion Family Floater Plan
Max Bupa Health Companion Family Floater Plan is one of the most affordable health insurance plan in India. This plan is available in 3 variants and offers several benefits like direct claim settlement, lifelong renewability, cashless hospitalization, etc. You can stay insured for INR 3 lakhs to INR 1 crores.
Some unique features of this plan are as follows:
- Lifelong renewability
- You also get ‘no claim bonus’
- This plan also provides free health checkups
- It covers non-allopathic treatment too.
- Max Bupa Health Companion family floater plan also covers daycare procedures
| Incurred Claim Ratio (ICR) of 2018-2019 | 54% |
| Minimum entry age | For children: 3 years
For adults: 18 years |
| Maximum entry age | No limit |
| Lifetime Renewability | Provided |
| Minimum amount assured | INR 3 lakhs |
| Maximum amount assured | INR 1 crores |
| Waiting period for Pre-Existing Diseases | 48 months |
| Waiting period for the diseases specified in the policy | 24 months to 36 months |
3. Star Family Health Optima Health Insurance Plan
Star Family Health Optima Health Insurance Plan is one of the best health insurance plans in India that provides coverage for all family members at a very affordable rate. This policy offers 3 times automatic restoration of the insured sum by 100% for each complete exhaustion.
The key features of this policy are as follows:
- You get 100% restoration benefit
- Free health checkups
- No claim bonus
- Lifetime Renewability
- The Star Health Family Optima Plan comes with no co-pay feature too
| Incurred Claim Ratio (ICR) of 2018-2019 | 63% |
| Minimum entry age | For children: 16 days
For adults: 18 yrs |
| Maximum entry age | 65 yrs |
| Lifetime Renewability | Provided |
| Minimum amount assured | INR 2 lakhs |
| Maximum amount assured | INR 15 lakhs |
| Waiting period for Pre-Existing Diseases | 48 months |
| Waiting period for diseases specified by the policy | 24 months |
4. HDFC Ergo My: Health Suraksha Plan
HDFC Ergo My: Health Suraksha Plan provides multiple insurance options of sum ranging from INR 3 lakh to INR 75 lakhs. You can buy any of the three variants they offer: Silver Smart, Gold Smart, and Platinum Smart Plans. This plan will provide lifetime renewability to people and comprehensive benefits at affordable premiums.
HDFC ERGO Health Suraksha policy covers several of your medical costs. Some of such covers and benefits are provided below:
- Pre-hospitalization expenses.
- Post-hospitalization expenses.
- Ambulance expenses are covered.
- In-house treatment cover.
- Also, every non-claimable year will lead to the collection of a 5% NCB.
| Incurred Claim Ratio (ICR) of 2018-2019 | 62% |
| Minimum entry age | For children: 3 yrs
For adults: 18 yrs |
| Maximum entry age | No maximum entry age |
| Lifetime Renewability | Provided |
| Minimum amount assured | INR 3 lakhs |
| Maximum amount assured | INR 10 lakhs |
| Waiting period for Pre-Existing Diseases | 48 months |
5. Religare Care Health Insurance
Religare Care Health Insurance has been one of the best family health plans in India for quite some time now. The reason being the excellent perks it provides. You can also buy a customized health insurance that caters to your and your family’s health care requirements.
Some of the same are given below:
- Every year that you don’t claim will translate to a 50% waiver on your premiums. This figure can rise to 150%.
- Room rent cover in case of hospitalization
- Pre and post hospitalization expenses of up to 30 and 60 days respectively, shall be covered.
- You can also avail of a private room in case of hospitalization.
- You are allowed 1 free medical check-up every year.
- You can also add several perks like air ambulance cover, personal accident cover, and so on.
| Incurred Claim Ratio (ICR) of 2018-2019 | 55% |
| Minimum entry age | For children: 3 months
For adults: 18 yrs |
| Maximum entry age | No max entry |
| Minimum amount assured | INR 3 lakhs |
| Maximum amount assured | INR 60 lakhs |
| Waiting period for Pre-Existing Diseases | 48 months |
| Waiting period for diseases specified under the policy | 24 months |
6. ManipalCigna Family Floater: ProHealth Protect Plan
ManipalCigna Prohealth Plus plan is one of the most preferred health insurance plans in India. Also, this is one of the most affordable health plans in India. This plan offers you with Restoration of Sum Insured (SI) along with several other perks.
Some of those are listed below:
- You get access to free health checkups with this plan
- You also get maternity cover unlike many other plans that do not offer the same
- Pre-existing diseases are also covered
- While hospitalization, you can avail a single private room
| Incurred Claim Ratio (ICR) of 2018-2019 | 62% |
| Minimum entry age | For children: 91 days
For Adults: 18 yrs |
| Maximum entry age | 23 yrs |
| Minimum amount assured | INR 2.5 lakhs |
| Maximum amount assured | INR 50 lakhs |
| Members Insured | Self, spouse, dependent parents, and children |
| Waiting period for Pre-Existing Diseases | 48 months |
7. Oriental Health Family Floater Health Insurance Policy
Oriental Insurance Happy Family Floater Silver plan provides coverage for the entire family. The sum insured under this policy ranges from INR 2 lakhs to INR 20 lakhs. This plan is available in three variants, namely Silver, Gold, and Diamond.
Check out some of its benefits below:
- Allopathic treatment cover
- The premiums are pretty affordable
- Lifelong renewability
- Pre-existing diseases cover
- Domiciliary hospitalization
| Incurred Claim Ratio (ICR) of 2018-2019 | 108.80% |
| Minimum entry age | For children: 3 months
For adults: 18 years |
| Maximum entry age | 55 years |
| Minimum amount assured | INR 1 lakh |
| Maximum amount assured | INR 10 lakhs |
| Waiting period for Pre-Existing Diseases | 48 months |
8. TATA AIG Medicare Health Insurance Plan
TATA AIG Medicare Health Insurance Plan is a simplified yet extensive health insurance policy. This plan is available in three variants and all of them cover your pre-, post-, in-hospitalization and several perks. Some of those are as follows:
- Free health checkups
- No co-payment
- No limit on room rent
- Cover for pre-existing diseases
- The premium is affordable
| Incurred Claim Ratio (ICR) of 2018-2019 | 78% |
| Minimum entry age | 91 days |
| Maximum entry age | 65 years |
| Minimum amount assured | INR 3 lakhs |
| Maximum amount assured | INR 10 lakhs |
| Max. number of members covered | 7 |
| Waiting period for Pre-Existing Diseases | 36 months |
9. Bharti AXA Smart Super Health Insurance
Bharti AXA Smart Super Health Insurance is a plan that helps you cope with the rising medical costs and also covers your basic needs. You can choose the policy for a period 1 year, 2 years, and 3 years.
Some features of the Bharti AXA Smart Super Health Insurance plan are as follows:
- You get this plan in 3 variants: Value, Classic, and Uber.
- Some of the major covers provided by this plan are hospitalization cover, AYUSH Treatment, Domiciliary cover, critical illness coverage, etc.
| Incurred Claim Ratio (ICR) of 2018-2019 | 89% |
| Minimum entry age | 5 yrs |
| Maximum entry age | 65 yrs |
| Minimum amount assured | INR 5 lakhs |
| Maximum amount assured | INR 1 crore |
| Members covered | Self, spouse, dependent children between the age group of 90 days to 23 years |
| Waiting period for Pre-Existing Diseases | 48 months |
10. Future Generali Health Suraksha Family Plan
Future Generali Health Suraksha Family Plan provides coverage for you, your spouse, and your 3 dependent children up to the age of 25 years. This plan offers several discounts as well such as Loyalty discount, family discount, etc.You can avail of the Future Generali Health Suraksha plan in both individual and family floater options. You can opt for any of the three variants of the plan: Basic, Silver, and Platinum.
Some features of this policy that make it stand out are as follows:
- 60 days pre-hospitalization and 90 days post-hospitalization expenses are covered.
- You get a lifetime renewability option as well once you are insured with this plan.
| Incurred Claim Ratio (ICR) of 2018-2019 | 73% |
| Minimum entry age | For children: 5 months
For adults: 18 yrs |
| Maximum entry age | Children: 25 yrs
Adults: 70 yrs |
| Minimum amount assured | INR 5 lakhs |
| Maximum amount assured | INR 10 lakhs |
| Waiting period for Pre-Existing Diseases | 48 months |
Features of Family Health Insurance Plan
- All the members of your family will be covered under single insurance.
- You would need to pay just a single premium for the family every year.
- You can change, exclude, or include your family members into the policy any time after purchasing the policy.
- You will be able to avail cashless hospitalization for any of your family members at the network hospitals of the insurance company.
- You can also include your parents in the policy.
- The option of including your parents-in-law and siblings is also offered by certain best health insurance companies.
Difference between Family Health Insurance and Individual Health Insurance
| Individual Health Insurance | Family Health Insurance |
| Each family member has a separate health insurance | All the family members are covered under one policy. |
| The insurance premium will be higher even after the discount.
It is calculated based on a person’s age. |
The insurance premium is very low and the figure is decided by considering the age and health status of the eldest family member |
| Ideal for young families and individuals who have any critical illness. | This is ideal for families with a large number of members who are not quite prone to serious illnesses. |
| For example, you have an individual health plan but have included your child and spouse too. Suppose you insure yourself for INR 1 lakh and the same amount for each of your family members. Now, if you make a claim, then only your insured sum will be impacted. But, the insured sum of your spouse and child will remain the same. | For example, you purchased a family health insurance of INR 4 lakhs that would cover you, your wife, and your child. A single premium would be paid. If you happen to make a claim of INR 1 lakh, then the entire insured sum will shrink to INR 3 lakhs. Now, this remaining sum can be kept for future needs and claims. |
Inclusions of Family Health Insurance
- Cashless Treatment at any network hospital of the insurance provider
- Pre-hospitalization and post-hospitalization cover
- Routine medical check-up expenses
- Ambulance fees
- In-patient hospitalization expenses
- Treatment of pre-existing disease.
- In-home treatment.
Exclusions of Family Health Insurance
- Cosmetic surgery
- Treatment at an unrecognized institution
- Injuries caused due to war, self-harm, riots, etc.
- No coverage provided during the waiting period of 30 days of policy commencement.
- The waiting period for Pre-existing diseases is 2 to 4 years.
Eligibility for Family Health Insurance
Different insurance providers can have different eligibility criteria for health insurance. Generally, most of the health insurance providers ask for the following eligibility criteria:
Entry Age:
For dependent children: Most insurance companies keep the minimum age for a child as 91 days but some also allow 30 days and some ask for 3 years or older.
The maximum entry age for dependent children is 25 years.
For adults: Min. – 18 yrs, Max. – 65 years (Some insurers also allow a person of 70 years)
Medical Tests:
Some health insurance providers might ask you to perform some medical tests. But some might allow you to go without them up until 45 years.
Also, you need to inform them about your family members and your pre-existing diseases (if any).
Renewability:
You need to keep renewing your family health insurance plan to keep it active. Nowadays, most companies offer a lifetime renewability option.
Keep in mind that you need to renew your policy before the given renewal due date or the grace period of 30 days.
Factors to Consider before buying a Health Insurance for Family
1. Coverage
While deciding which health plan to choose, make sure to compare the coverage provided by all the plans. More or less, all the plans cover in-hospitalization expenses, ambulance charges, pre and post hospitalization expenses, daycare charges, etc.
Make sure that the plan meets your needs. If you or any of your family members have any pre-existing disease then see if the plan covers that. In case you want to have a child shortly, then opt for a plan that will cover maternity and infant costs.
2. Cashless Hospitalization
If your insurance provider offers cashless hospitalization, then you would be spared of all the extra documentation needed for the claim procedure. So, check if your insurance provider’s network hospitals are within accessible distance to your home. Also, make sure that there are reputed and good hospitals included in their network hospitals list.
3. Renewability
These days, more or less every health insurance company provides you with lifetime renewability. But, some also offer renewal facility up till the age of 60 to 65. Make sure that your needs are covered with whichever plan you choose.
4. Claim Settlement
More or less all the health insurance companies go through the same claim procedure, but there could be some differences. So, make sure that you fully understand your insurance provider’s claim settlement policy.
Collecting documents, filling up forms, etc. can seem like a mammoth task. But if your insurance provider offers cashless hospitalization, then such hassles can be avoided.
5. Flexibility to Increase the insured sum
The medical costs are increasing by the day. So, you need to make sure that you upgrade the sum insured to an amount that will hopefully cover your future health expenses.
Also, if your health insurance provider offers ‘no claim bonus’ then some companies might also increase your insured sum. Try to look for this feature as well.
Claim Procedure for a Family Health Policy
Step 1: Duly fill up the claim settlement form and mention all the information that is asked for.
Step 2: Attach original copies of hospital bills, medical bills, receipts, prescriptions, etc. These documents should be attested from the hospital where the treatment has been done.
Step 3: Submit copies of your ID card, policy documents, insurance card, and all other documents your health insurance provider asks for.
Step 4: Then, your documents and for claim settlement form will go through a verification process.
Step 5: After successful verification, the insurer will deposit the reimbursement amount in your bank account.
FAQs About Family Health Insurance
Can we receive cashless treatment through a family health insurance policy?
Yes, if your health insurance provider has network hospitals then they do provide cashless hospitalizations. However, you can avail of the cashless claim only if you receive treatment in one of the network hospitals of your insurer.
When can I renew my family health policy?
You can renew your policy before the due date given by the insurance company. Also, a grace period of 30 days will be provided within which you need to pay your premium to renew the policy.
Nowadays, most of the health insurance providers offer lifetime renewability but some still offer renewability of policy up till the age of 65 yrs or so.
Will my next claim be affected if I make a mediclaim now?
Yes, it will. If you file a claim and the insurance provider approves it, then the amount claimed will be deducted from your insured sum.
For example, if you get health insurance for INR 5 lakhs and claim INR 1 lakh: Then after this claim is approved and processed, you will have an insured sum of INR 4 lakhs.
Do family health insurance policies have a waiting period?
Yes, they do. Family health insurance plans generally have a waiting period of 30 days and during this period, you cannot file a claim from your insurer.]
How will I be able to add my family members into the existing family health insurance?
You can add or exclude any of your family members after the family health policy purchase. This is done at the time of policy renewal. But, you cannot add dependent children in the middle of the health policy if they are not newborn babies.
What tax-benefits can you avail on your health insurance premium?
You can claim a deduction of up to INR 25,000 under the section 80D of the IT Act if your family insurance covers yourself, your spouse, and your dependent children. If your parents less than 60 years of age are insured as well, then an additional deduction of INR 25,000 can be claimed. Also, if the insured parents are more than 60 years of age, then INR 50,000 can be claimed as per the Budget 2018.
What is the difference between individual and family floater policy?
An individual health policy provides medical cover for one individual only. But, a family floater policy provides medical cover for each member of your family under a single plan.
Which family members are included in a family health policy?
You could include yourself, your spouse, dependent children, dependent parents, parents-in-law, brother, sister, uncle, aunt, nephew, niece, grandchildren, and grandparents in a family health policy.
Should I buy a health insurance for a long term?
A long term health policy has some advantages. Insurance companies provide discounts for 2 years, and 3 years. So, you can save some money on your premiums if you choose a long term policy.
What will happen if my policy lapses during hospitalization?
There are two possible cases in this situation:
If admission to a hospital happens before the expiry date of the policy and if you inform your insurer before the policy lapses, then the insurer will honor the claims as per the terms and conditions of your policy.
If the hospitalization happens during the grace period or after the policy lapses, then the insurance company will not accept any claims. However, you should inform the insurer immediately after hospitalization because the decision on claim payment could be discretionary and very much subject to circumstances of the case.
What will happen if the person in whose name the family health insurance is dies?
The person who buys a family health insurance and pays its premium is called the proposer. If the proposer dies, then you can have the policy transferred in the name of another family member provided that he/she is a major member.
Will I get medical cover from day one of buying the policy?
No, most insurance companies have a waiting period of 30 days after which the coverage commences. But, you will get coverage from day one in case of accidents. Also, for pre-existing diseases, coverage will be provided after the pre-defined waiting period for pre-existing diseases (which is usually 3 to 4 years). However, certain diseases like hernia, piles, knee replacement, tonsillitis, etc. have a waiting period of 1 to 2 years only (for most insurance companies).
