What is Family Health Insurance?

Today, with changing lifestyle choices, eating habits, and the rise of new diseases, it has become absolutely imperative for everyone to have a health insurance policy.   

With rising medical costs, any treatment or surgery can cost a fortune. A health insurance policy will help you cover such expenses without creating a hole in your pocket. 

A family health insurance policy is a policy that is specifically designed to cover you and your family members under a single policy by paying a single annual premium. The sum insured is shared among all family members and can be used till it gets exhausted. 

A family health insurance plan provides a host of benefits such as hospitalisation expenses, daily cash benefits, day care procedures, expenses for home care treatments, critical illness, etc. 

Imagine a big umbrella that can easily accommodate you and your family and protect you all from rain. A family health insurance policy is like that umbrella only. Your entire family is covered under one single policy. 

Why does your family need a health insurance policy? 

Family health insurance can prove to be really beneficial because: 

• Helps keep your finances intact: Given the rising medical costs, if any family member falls ill, the cost of treatment and medication can be really high. If you have to bear such expenses regularly, this might start affecting your savings and your financial situation. A health insurance policy will help you cover such expenses, thereby keeping you financially afloat. 
• Affordable: If your family is on the younger side, a family policy can be a lot cheaper compared to an individual plan. By paying a single premium, you can cover all your family members, which otherwise would have cost you a lot if you had gone for an individual plan for each member. 
• Covers all minor medical expenses as well: There is this popular notion that family health insurance will cover any major illness or accident. However, you can cover all minor medical expenses arising due to any common illnesses as well. 
• Benefits for children: Including your child in a family plan is really beneficial because by the time they grow up, any major waiting period related to PEDs or critical illnesses will be over and they won’t have to go through it. 
• Tax Benefits: You can claim an exemption of up to Rs. 25000 for premiums paid under Section 80D of the Income Tax Act. If your family are senior citizens and you include them in your policy as well, the exemption limit can go up to Rs 50,000. 
• Peace of Mind: With family health insurance in place, you can relax and plan your long-awaited vacation without any financial worries, because your policy will act as a cushion in the event of a medical emergency. 

Types of Health Insurance Plans 

There are two ways you can cover your family with health insurance. 

• Individual Health Insurance Policy: Under an individual plan, all members of the family will have a separate policy with their own dedicated sum insured. Here the premium has to be paid separately for each individual member and claim files by one member will not impact any other member’s sum insured and claims can be filed by different members of the family at the same time. 

This policy is suitable for a large family or whose members are senior citizens, because it will ensure a sufficient sum insured is available for each member. 

• A Family Floater Health Insurance Policy: A family floater plan, as explained initially, is a common policy for all members. It is a single sum insured that is shared by all family members and the premium paid is also common. 

This policy is suitable for small and relatively younger families because the premium paid under this policy is based on the age of the eldest family member covered. Also, for a large family, there will not be sufficient coverage because a single sum insured might not be enough for a large number of members, which can very well defeat the purpose of having health insurance in place. 

Difference Between Individual and Family Health Insurance Plans: 

Eligibility Criteria for Family Health Insurance Plans: 

There are several criteria when you want to purchase medical insurance plans for your family. This typically revolves around the age and family structure. Here’s what you need to know: 

1. The policyholder and their spouse should be between 18 and 65 years to be eligible for purchase. Sometimes, the policy might allow up to 70 years.  

2. Dependent children (usually up to 2 of them, sometimes more), can be covered between 3 months and 25 years.  

3. Coverage is usually available for the policy holder, their spose and their children. It might also extend to parents or parents-in-law.  

4. If you have pre-existing conditions or are close to the upper age limit, then you have to submit medical reports with your policy.  

What is covered under a family health insurance policy from Chola MS? 

Flexi health is one of the most sought-after health insurance policy available in the market by Chola MS and will cover a plethora of medical expenses for your family, such as: 

Hospitalization due to illness: Some illnesses can turn out to be serious and may require hospitalisation or even surgery in acute cases. Your policy will cover the medical expenses of your family in such situations. 

Accidental Hospitalization: If any of your family members face an accident, any medical or hospitalisation expenses due to the same will be covered. 

Pre and Post Hospitalization: If there are any medical tests one needs to go through or a need to take regular consultation before or after hospitalisation with regard to the same illness, such expenses will also be covered in the policy. 

Domiciliary Hospitalization: If a family member is unable to be transported to a hospital or if there are no available beds, treatments may have to be administered at home. These treatments are known as domiciliary hospitalization. Expenses pertaining to these will also be covered under your health insurance policy. 

Day Care Treatments: Due to the advancement of technology, there are treatments or surgeries like cataracts, chemotherapy, etc., that can now be completed within 24 hours without the need for hospitalization. These treatments are called day care treatments and are covered under a policy. 

Critical Illnesses: Certain illnesses like cancer, stroke, kidney failure, etc. are life threatening. Their treatments can take a long time and may require huge sums of money to get the required treatment. A health insurance policy will cover expenses pertaining to such illnesses. However, there might be certain waiting periods in regards to certain diseases. 

AYUSH Treatments: Now, you get yourself treated with your choice of medication and get that covered as well. If you wish to go for non-allopathic treatments like Ayurveda, Siddha, Unani, etc., the cost of such treatments will also be covered under your policy. 

What’s not covered in a family health insurance? 

Initial Waiting Period: Every policy has an initial waiting period of 30 days, during which no claims can be filed except in the case of an emergency, accidental hospitalization. 

Pre-existing diseases: PEDs are illnesses for which you have been diagnosed or have received treatment within the previous 48 months of the purchase date of your policy. For pre-existing diseases, health insurance policies have a waiting period of 2 to 4 years before which no claims can be made. 

Self-harm: Any treatments or hospitalisation required as a result of intentional self-harm or suicide attempt will not be covered. 

War: Any injuries suffered due to war or hostilities, whether war has been declared or not, are not covered. 

Listed Illnesses: There are certain listed illnesses for which there might be a waiting period of a year or so, before which claims for these diseases cannot be made. 

Things you should consider while buying a health insurance policy for your family? 

With regards to medical insurance policies for families, there are plenty of choices available on the lookout. To pick the one that best meets your family's requirements, the following are a couple of pointers to remember. 

Policy Coverage: An all-around developed health care policy will cover you for In- patient hospitalization expenses, health check-ups, room rent charges, pre and post hospitalization expenses, cost of surgeries, medical bills, ambulance charges, etc. 

Affordability: The cost of a health insurance policy varies depending on the organization. Pick the one that is reasonable for yourself as well as your family. Look at the advantages against the expense and track down the one that suits you the best. However, try not to go for the most minimal premium. Zero in on the advantages you can get and pick a top-notch rate that is reasonable. 

Critical Illness: Diseases like cancer, heart stroke, kidney failure, and so forth are truly genuine and their medicines require broadened hospitalisation and may even require medical procedures. As one gets older, they are more inclined to get such a sickness or infection. The expense of medicines, medical tests and any medical procedures required can add up rapidly. Find a health insurance policy that covers such diseases with a high sum insured and lower waiting period. 

Claim Settlement Ratio: It is a significant measurement in breaking down the effectiveness and validity of the organization. It is the level of cases that have been settled out of the complete number of claims received. You can look into the claim settlement ratio online through any insurance broking site. Pick an organisation with a high claim settlement ratio. 

Pre-existing infections: There are sure basic ailments for which one can get analysed inside four years before the strategy's initiation date. These are known as previous infections. Normally, medical coverage strategies have a long holding up time of 2 to 4 years before such cases are acceptable. Select a strategy that has a lower sitting tight period for such PEDs, so you don't need to stand by should any such circumstance emerge. 

Add-ons: Add-on covers are presented by insurance agencies to give you extra, upgraded covers to your current base health insurance at an extra charge. Some of these extra covers are for medical second opinions, outpatient covers, home care treatment covers, and so on. It is a reasonable way of improving the advantages under a health insurance policy, and the extent of those advantages can go much beyond covering clinical costs. 

Easy Claim Settlement: Find out with regards to the case settlement cycle of the organization. During crises, the last thing you need to stress over is getting a claim from your insurance agencies. Read online reviews, check whether they give sufficient client service, and so forth, and select the one that has a solid claims settlement network set up. Chola MS has made claim settlement significantly simpler. You can visit our website and click claims, or you can use our Whatsapp Chatbot to do the same. You can likewise call us on our complementary number and we will be there for you instantly. 

Sub-limits: In a health insurance policy, there are different limits and sub-limits that confine your claim pay out. Look into the different sub-limits that various organisations have, and track down the one that has the lower sub-limits. 

Network Hospitals: Every insurance agency has organisations and tie ups with hospitals and emergency clinics to give cashless claim settlement and quality clinical help. 

How to Get Family Health Insurance: 

Here’s a step-by-step of how to buy medical insurance for your family through Chola MS: 

1. Compare all the different plans available on our website. We have different plans for different medical needs like Flexi Health, Flexi Supreme, Arogya Sanjeevani, Critical Healthline, Super top-up plan and more.  

2. Once you have chosen the plan depending on your needs and budget, click on it and enter the details. 

3. Details such as duration of the plan, your and your family’s medical history, your coverage needs and more are input into the online family insurance plan premium calculator.  

4. Once you hit “Get a quote”, it will generate a premium for you.  

5. Make any other adjustments to the plan like adding members and any other health information. The premium will adjust accordingly. 

6. Submit required documents like ID proof, relationship proof, address proof and past mediclaim histories. 

7. Pay securely via debit/credit cards or UPI.  

8. The policy will be emailed to you in minutes! 

Documents Needed to Purchase Family Health Insurance Plans: 

Keep these documents ready when you apply for a medical insurance plan for your family: 

1. ID proof copies for Aadhaar card, PAN or passport 

2. Address proof copies (including Aadhar card) but also ration card, rental agreement, etc.  

3. Birth Certificate or School Certificate, especially for dependent children 

4. Medical records of all members opting for this family health insurance plan. If your dependent parents or in-laws have pre-existing conditions, these records will help. 

5. Passport-sized photographs. 

How to Claim Online Medical Insurance for Your Family: 

The family health insurance plan’s claims process involves: 

1. Inform your insurer about the medical emergency or hospitalization within 24 hours. 

2. Keep all the medical bills, prescriptions and investigation records ready along with your family health insurance plan document. 

3. Wait for the insurer to review the claim and verify the documents. 

4. The insurer returns with a coverage amount they can reimburse/cover. 

Documents Needed to Claim for Family Health Insurance Plans: 

Medical health insurance for a family needs the right documents for a smooth claims processing: 

1. Claims form completed accurately and signed. 

2. Hospital bills with payment receipts.  

3. Discharge summary from the doctor. 

4. Prescriptions and pharmacy bills. 

5. Investigation reports like X-rays or bloodwork. 

6. A copy of your family health insurance plan. 

Why buy a policy from Chola MS? 

• Network Hospitals: Chola MS has a network of 14000 partner hospitals across India that provide you cashless claims facilities. 
• Completely digitised process: With Chola MS, you can buy, renew, modify, and file a claim easily from the comfort of your home just at the tap of a button. As we have made the entire process online, you don’t have to go and stand in long queues to get a policy. 
• Restoration Benefits: Our flexi-health policy offers you 100% restoration of the sum insured in case of unrelated claims. 
• A Cumulative Bonus: For every claim free year, you are rewarded in the form of an extra sum insured at the time of renewal without charging any extra premium. 
• Continuous customer support: No matter the time of day, reach out to us on our toll-free number 1800 208 9100 or use our WhatsApp chatbot by sending ‘Hi’ on 73052 34433. We are available 24x7. 

Conclusion: 

Know all the details available about how to get family health insurance plans before making a decision. For a small premium, you and your entire family will be secured in case of any medical emergencies. It is always better to be prepared! 

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FAQs: 

What documents are needed to raise a reimbursement claim under medical insurance for family? 

To raise a reimbursement under family health insurance, you’ll need a few essential documents. The most important one is a signed claim form which is filled out accurately. Then, attach your doctor’s prescription and reports.  Include the hospital’s discharge summary, all the hospital bills, and payment receipts. If you got x-rays, blood tests or other investigations done, attach that and prescription bills as well. Add a copy of your medical insurance for family and bank details for the reimbursement.  

Can I add my family members to an existing family health insurance policy? 

Yes, you can add a new family member to an existing family health insurance policy in India. To do this, contact your insurance provider and inform them. Submit the necessary documents for the new member such as ID proof, relationship proof and the complete medical history. The insurer may adjust the premium to accommodate a new person into this umbrella medical insurance for family. Your updated policy document after approval will reflect a new premium and policy structure. 

Which health insurance plans are best for a family? 

There are many health insurance plans for family that provide in-depth coverage for competitive premiums. Check out Chola MS’ wide suite of family health insurance plans such as Flexi Supreme, Flexi Health, Arogya Sanjeevani, Critical Healthline and more. Depending on your family’s needs, you can pick a family insurance plan that works best. If you want a plan that is tailormade for your medical needs, check out the Flexi Health or Flexi Supreme options. If you are looking for an alternate medical treatment-based health insurance plan for family, check out Arogya Sanjeevani. 

How much does a family insurance plan cost per month? 

The cost of family insurance plans can vary based on different factors like level of coverage, number of family members and their age, pre-existing conditions and the insurance provider. But on average, you can expect a basic medical insurance plan for a family of 4, with 2 adults and 2 children, to cost about Rs. 1,000 to Rs. 3,000 a month. The coverage for this amount can range from Rs. 5 lakhs to Rs. 10 lakhs. If your family members are older and you want higher coverage, then it can go higher than that too. Comparing plans can help find one that meets your family’s needs and budget. 

How to get family health insurance, and is it better than an individual health plan? 

It is easy to purchase medical insurance for a family. All insurance websites have a family floater option for every health insurance, making it easy to get for both you and your family. You can add the number of members and enter medical information about them online. The quote calculator will generate a premium for you. Pay and the family health insurance plan is yours. It is better than an individual plan only if you have a family and need umbrella coverage. However, if you are a single, working professional, then an individual plan works just fine.