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    Importance of Family Health Insurance Plan In India

    Importance Of Family Health Insurance Plan In India

    Last Updated On 09-06-2023

    Anyone who has ever experienced a medical emergency in their family knows what a blessing the right family health insurance plan can be. Since medical expenses can easily stack up and become quite a burden, the comprehensive coverage offered by a health insurance policy for your family ensures that dealing with bills doesn’t hamper the recovery process. 

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    What is Family Health Insurance?

    Definition of Family Health Insurance

    What is family health insurance? Essentially, family health insurance refers to a specific type of health insurance plan that covers the whole family. This usually includes the spouse and dependent children and may even include the policyholder’s parents. In most instances, there is only one premium and features a single insurance amount.

    How Does a Family Health Insurance Plan Work?

    A family health plan is geared at providing families with enough coverage to reduce any additional costs incurred during a medical situation. This can include surgery, dental, and other medical expenses.

    Importance of Health Insurance Policy for Family

    There are several reasons that highlight the importance of health insurance. The most significant are listed below.

    1. Financial Assistance for Medical Emergencies

    It’s important to invest in a health insurance plan for your family because it provides financial assistance for medical eventualities. This refers to a wide range of medical issues that may suddenly arise and require funding.

    2. Tax Benefits

    Wondering how to save tax? Many of the best family health insurance plans in India boast tax benefits and rebates. Speak to your advisor or check online about the best options.

    3. Investment and Savings Benefits

    With an investment and savings benefit, the policyholder will be able to plan or save for future medical or health-related expenses.

    4. Annual Health Checkups

    Annual health checkups are among the basic benefits that health coverage provides. This will ensure that potentially life-threatening illnesses are detected early enough for adequate treatment.

    5. Deal with Medical Inflation

    An effective family health insurance policy offers high sum assured amounts that can easily beat inflation costs

    6. Covers Complex Procedures

    More complex procedures such as dental treatments will also be covered in a family or individual health insurance plan.

    7. Benefits for Organ Donor

    There are also considerable benefits available for organ donation and AYUSH treatments.

    8. Health Coverage for Alternative Medical Treatments

    Many family health plans also provide cover for alternative treatments such as Yoga, Siddha, Homoeopathy and Unani.

    Categories of Health Insurance Family Plans

    Indemnity Health Insurance Plans

    An indemnity health insurance plan is a health policy that reimburses the insured for the full costs of medical expenses as determined in the sum assured. It’s important to check with your insurance broker about the conditions associated with this type of health insurance policy.

    Fixed Benefit Health Insurance Plans

    A fixed benefit health insurance plan refers to a type of health insurance wherein the sum insured paid to the insured is pre-determined and fixed. This type of policy allows for a lump-sum amount to be paid out, irrespective of the hospitalization or treatment cost.

    Advantages of Health Insurance Family Plans

    1. Covers Medical Expenses

    One of the top benefits of a health insurance policy is that it provides comprehensive coverage. This includes pre and post-hospitalization, ambulance costs and surgeries.

    2. Quality Medical Attention

    Having extensive health insurance in place ensures that you and your family will receive quality medical attention when it’s needed. The type of medical care received will be the determining factor in how successful the treatment is.

    3. Preventive Health Check-up

    Health insurance plans allow easy access to annual health check-ups. This will help detect a disease or condition in its early stages, making it possible to receive proper treatment timeously.

    4. Beats Inflation

    Having a fixed family health plan ensures that you don’t have to deal with medical inflation with rising premiums. Your health plan will ensure that you always have access to the medication and treatment you need.

    5. Saves Tax

    Another one of the more impressive benefits of family health insurance includes the various tax benefits on offer. This can be in the form of income tax deductions and rebates.

    6. Peace of Mind

    With a family health plan in India, you’ll be able to enjoy peace of mind knowing that a single policy protects your whole family in the event of a medical emergency.

    What Are the Health Coverage for Family Health Insurance?

    What’s Covered by Health Insurance Family Plans

    • Pre And Post Hospitalisation (Including COVID-19)
    • All Day Care Treatments
    • Preventive Health Check
    • Up At No Cost
    • Emergency Road and Air Ambulance
    • Daily Hospital Cash
    • E Opinion For 51 Illnesses
    • Organ Donor Expenses
    • Lifelong Renewability
    • Alternative Medical Treatments

    What's Not Covered by Health Insurance Family Plans

    There are several factors not covered by a health insurance family plan. These are listed as follows:

    • Adventure sports injuries
    • Breach of law
    • War
    • Excluded medical providers
    • Congenital external diseases, defects or anomalies
    • Treatment for alcoholism & drug abuse

    Individual vs Family Health Insurance: What is the Difference?

    Review the table below for a side-by-side view of the key differences between individual vs family health insurance policies.

    Criteria Individual Health Insurance Family Health Insurance
    Definition Health policies that only provide cover to the policyholder (the insured individual) Health plans that cover the entire family under one single premium
    Insurance coverage Averages Rs 5 lakh Averages between Rs 7-10 lakh
    Payment premium Averages between Rs 10,000-15,000 Averages between Rs 15,000-20,000

    Things to Consider When Purchasing Health Insurance Family Plan

    The factors to consider when reviewing the different health insurance family policies are listed below.

    Check the Health Insurance Plan Coverage

    Always check the total plan coverage as well as the period of coverage. Sometimes children or elderly people in the family require a special type of health care. So, plans that have comprehensive coverage for all family members irrespective of their ages should remain on the priority list.

    Check Cashless Hospitalization Availability

    Choose a Health Plan with Sum Insured Enhancement Feature Health plans with a sum insured enhancement features ensure that your loved ones are adequately protected against potential health expenses. The Mera Mediclaim Plan offers up to 150 % increase in Sum Insured as well as an automatic recharge.

    Receive Hassle-Free Claim Settlement

    The last thing a policyholder wants is to have to struggle with medical bills and tiresome claim procedures. Claim settlement should be a hassle-free experience for the policyholder. Read the policy terms and conditions carefully before choosing it finally.

    Check the Maximum Age for Renewal

    Ideally, you want a family health insurance plan that will provide you with coverage for your whole life. Insurance plans with a longer age limit provide you with more flexibility and security for your family. In addition, go for a plan that offers coverage for your spouse as well.

    Conclusion

    Investing in a family health insurance plan will ensure that everyone - your spouse, children and parents can have the best options for medical care should it be needed. 

    Frequently Asked Questions (FAQ)

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    Who are eligible to purchase family health insurance plans? 

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    Anyone under the age of 65 can qualify to purchase a family health plan in India. 

    What are the documents required to purchase family health insurance plans? 

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    Essentially, the documents required include the following:

    • Age proof
    • Address proof
    • Identity proof
    • Passport-size photograph
    • Medical reports 

    How do you raise a claim under the family health insurance policy? 

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    Reimbursement claim process

    In a reimbursement claim, the policyholder requests reimbursement after the procedure has been finalized and paid for. Bills, discharge summaries, doctor reports and prescriptions are among the types of documents that should be submitted for reimbursement.

    Cashless claim process

    For a cashless claim, the insurance company directly settles the bill with the hospital or healthcare facility. In addition to regular treatment, this process also covers cashless hospitalization. This requires pre-authorization from the insurance company. 

    How much does health insurance cost for a family? 

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    The health insurance cost will depend on the number of family members who need coverage as well as the type of plan chosen. Additional factors such as age and medical history also determine the anticipated cost. On average a premium of Rs 10 lakh for a family of four can cost between Rs 858 per month to Rs 2769. 

    Is there any waiting period for family health insurance policies?

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    As with most health coverage plans, there may be a waiting period while claims are being assessed or submitted. While the insurance policy is valid from the day it’s activated, it’s essential to review the waiting period before a claim can be submitted. 

    Can you include non-family members under your health insurance? 

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    Adding non-family members to your family health plan can be done under special circumstances. Speak to your specific broker for clarity on the types of circumstances where this is allowed. 

    Disclaimer:

    The aforesaid article presents the view of an independent writer who is an expert on financial and insurance matters. PNB MetLife India Insurance Co. Ltd. doesn’t influence or support views of the writer of the article in any way. The article is informative in nature and PNB MetLife and/ or the writer of the article shall not be responsible for any direct/ indirect loss or liability or medical complications incurred by the reader for taking any decisions based on the contents and information given in article. Please consult your financial advisor/ insurance advisor/ health advisor before making any decision.

    PNB MetLife India Insurance Company Limited Registered office address: Unit No. 701, 702 & 703, 7th Floor, West Wing, Raheja Towers, 26/27 M G Road, Bangalore -560001, Karnataka
    IRDAI Registration number 117 | CIN U66010KA2001PLC028883

    Terms & condition apply, Benefits stipulated are subject to premiums paid and policies in-force. For more details on risk factors, please read the sales brochure and the terms and conditions of the policy, carefully before concluding the sale. Tax benefits are as per the Income Tax Act, 1961, & are subject to amendments made thereto from time to time. Please consult your tax consultant for more details. Goods and Services Tax (GST) shall be levied as per prevailing tax laws which are subject to change from time to time. The marks "PNB" and "MetLife" are registered trademarks of Punjab National Bank and Metropolitan Life Insurance Company, respectively. PNB MetLife India Insurance Company Limited is a licensed user of these marks. Call us Toll-free at 1-800-425-6969, Phone: 080-66006969, Website: www.pnbmetlife.com, Email: indiaservice@pnbmetlife.co.in or Write to us: 1st Floor, Techniplex -1, Techniplex Complex, Off Veer Savarkar Flyover, Goregaon (West), Mumbai – 400062, Maharashtra. Phone: +91-22-41790000, Fax: +91-22-41790203.

    Beware of Spurious Phone Calls and Fictitious / Fraudulent Offers!
    IRDAI is not involved in activities like selling insurance policies, announcing bonus or investments of premium. Public receiving such phone calls are requested to lodge a police complaint.

    AD-F/2023-24/101       

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    Disclaimer

    Collapsed Expanded

    As your trusted life insurance partner, PNB MetLife is with you amidst the current COVID-19 outbreak. Our policies also cover COVID-19 Claims. In case of a Death Claim, kindly submit the signed Claim Intimation Letter mentioning the policy number, brief of the insured event and other claim documents on the email mentioned herewith. Please write-in to us at claimshelpdesk@pnbmetlife.com or indiaservice@pnbmetlife.co.in. You can also call us on 1800-425-6969 for death claims intimations and for any queries on Monday - Saturday between 10:00 am - 7:00 pm.

    PNB MetLife Insurance, amongst the trusted Life Insurance companies in India, aims to provide a wide range of Life Insurance products that suits the needs of an individual at every stage of his life. Life Insurance Plans range from Term Life Insurance PlansTerm PlanProtection PlansLong Term Savings Plans , Retirement Plans & Child Education Plan.

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