x
x
  • fam-alt

What is Family Floater Health Plan?

A family health plan is a kind of health insurance where more than one member of a family is covered for a fixed sum assured against a single annual premium. In case multiple members of the family get hospitalized or an ailment is diagnosed, two or more family members get assured coverage by such policies at the same time.

Any family that has a medical history should take health insurance. It easily covers a family that includes parents and a maximum of four children. There are some insurance companies that also include parents in your existing health insurance policy.

Medical Insurance

A medical insurance policy characteristically compensates:

  • The hospitalization cost
  • Charges subject to healthcare treatment
  • Reimbursement
  • Cashless treatment

Critical Illness Insurance

This kind of policy covers a policyholder against various chronic diseases like heart attack, kidney failure, stroke among others. The policyholder gets the entire sum assured from the insurance company in a lump sum, subject to the policy coverage. A point to remember is that the entire family cannot purchase a single critical illness policy for all of them.

Is a Family Health Plan better than an Individual Health Plan?

Different health plans have different benefits. No one plan can be declared better with proper comparisons between the various coverage and benefits that the both plans offer and the circumstances surrounding it.

The entire family is covered by a family health plan for a single assured sum and the insurance company is paid a single premium for the same. In case of family health plans, single plan is valid for the entire family with single premium in the year.

On the other hand, only one person is covered by an individual health plan and in order to cover all the members of the family there has to be separate health plans for each of them with separate premiums to be paid for each policy. Thus, if we take both the options of individual plans and the combined family plans then it will be seen that the premium to be paid for all individual plans will be higher than the combined ones.

Even families with health insurance are quite vulnerable to a severe economic reversal if someone gets sick. Elizabeth Warren


Our Partners are very excited happy about our works

More than 300 CUSTOMERS USE AUM BIMA FOR ALL THEIR INSURANCE NEEDS.

FAQs

Health insurance is a type of insurance coverage that protects an individual or a group of people against medical and surgical costs against payment of regular premiums.

Mounting healthcare and surgical costs are a major strain on household budgets. Like any other insurance, mediclaim or health insurance is the best possible protection you or your family may have against any medical (usually hospitalization or surgical) costs. Health insurance also makes medical help affordable for everyone.

Mediclaim or health insurance makes you eligible for tax benefits on premium paid under 80D of the Income Tax Act.

Given the current healthcare scenario, there is no right age to get medical insurance – the earlier, the better. Children can be added to either parent’s mediclaim policy. Many health insurance providers also have special plans for senior citizens and old age related health costs.

Most health insurance providers offer customized mediclaim or health plans. They are broadly of 4 types –

  • Individual health plan
  • Family health plan
  • Critical illness plan
  • Senior citizen health plan

Accident-related medical costs are generally covered by all health insurance plans or may be taken as an add-on rider.

Health insurance costs vary depending on the following factors –

  • Number of persons covered
  • Age of the person/persons assured
  • Health of the person/persons assured
  • Location (health risks in metros is deemed more than that of people residing in small cities and villages)
  • Additional riders (if any are opted for)

When a person signs up for a health insurance, the insurance company ascertains premium based on a number of criteria. Once determined, the company usually charges the same premium for that age group. The older a policy holder gets, the more the premium amount is. In the meantime, if there is a claim in any year, the premium may be hiked upon policy renewal. This is called load premium. The insurance company may sometimes offer a discount on premium, if no claim is registered for a number of years.

Mediclaim health insurance policies usually do not cover the following –

  • Congenital medical conditions and diseases
  • Pre-existing diseases diagnosed prior to policy issuance
  • Medical costs arising out of self-inflicted injuries and/or attempted suicide
  • Cosmetic surgeries and/or treatments including dental treatment
  • Drunken driving related accidents
  • Cost of spectacles or contact lenses
  • Treatment of HIV/AIDS

Planned hospitalization – Submit a written application with the TPA. Include doctor’s recommendation for hospitalization, medical records, and planned expenses. Once approval comes through go ahead with hospitalization. Notify TPA and make a claim through the hospital to avail cashless benefits.

Unplanned hospitalization/Accidents – Notify TPA within 24 hours of hospitalization. Submit a notification statement with name, policy number, and known medical details. The insurer is likely to clear your eligibility details within a day or two. Stake cashless claim through the hospital to avail cashless services or pay cash and stake claim with all bills and records at the completion of treatment.