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    Everything You Need to Know About Health Insurance Policy for Family | PNB MetLife

    Why Do We Need Health Insurance Policy for Family?

    Last Updated On 09-05-2023

    A recent survey has shown that about 30 percent of Indian population are devoid of any health insurance. Essentially, this stems from not having the correct healthcare plans. With that said, group healthcare insurance is offered to their employees by many organisations in an attempt to alleviate the healthcare crisis.

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    Why Do We Need Health Insurance Policy for Family?

    A family health insurance policy is a single plan with one premium that covers all members when it comes to paying for medical expenses and health-related emergencies. Having health insurance for yourself as well as for your spouse and children relieves you of unnecessary financial burdens or having to dig deep into your savings.

    Additional family members such as your elderly parents can be added to the same plan if necessary.

    Benefits of Health Insurance Policy for Family

    There are numerous benefits of family health insurance worth noting!

    Stress-Free Hospitalization

    If you or one of your family members have to be hospitalized, health insurance will cover all expenses related to this event. Furthermore, you can receive premium in-patient hospital care knowing that all the bills are covered by your medical insurance plan. Health insurance gives you access to cashless hospitalization in India, reducing the stress of managing a difficult time.

    Easy to Add New Family Members

    Planning for a new family or taking care of retired parents can become a financial burden with rising living costs and health expenses. Having a medical insurance plan that allows you to add new family members at any time reassures you that your family can get the best treatment whenever they need it.

    Health Insurance Cover for Parents Under the Same Policy

    Taking care of aging parents comes with additional medical expenses that can be costly and unexpected. Putting your parents under the same policy gives them the health insurance cover they need to support them when having medical treatments.

    Tax Benefits Offered

    In India, citizens purchasing a health insurance plan will get tax benefits under Sections 80(C) and 80(D) of the Income Tax Act 1961. A tax deduction can be claimed by the policyholder (taxpayer) for medical insurance premiums paid.

    Lower Dependency on Group Plans

    Some organizations in India offer their employees perks such as medical insurance. However, these plans may include exclusions that prevent you or your family members from getting extensive coverage. Taking out your own health insurance plan that fills in this gap gives you full protection while lowering your dependency on group plans.

    Keeps You Prepared for All Emergencies

    Health insurance plans allow you to plan for unexpected medical crises while safeguarding you against expensive bills that could threaten your financial security.

    Comprehensive Health Coverage Including COVID-19 Health Insurance for Family Members

    Coronavirus has given rise to many families facing a range of health problems as well as costly medical bills. Comprehensive health coverage that includes COVID-19 is essential if you want your family to get the best treatment possible.

    Types of Health Insurance Policy for Families

    Understanding the types of health insurance policies for families in India will help you make a well-informed choice when picking a plan for your and your family’s medical needs.

    Medical Insurance

    Medical insurance protects you in times of emergencies and provides you and your loved ones with financial peace of mind during challenging times.

    Features of Medical Insurance

    • Cashless hospitalization
    • Coverage for daycare procedures
    • Ambulance transportation
    • Health check-ups
    • Post-treatment coverage including medicines

    Benefits of Medical Insurance

    • Protection against unexpected and costly medical expenses
    • Safeguards you and your loved ones against financial loss
    • Allows for state-of-the-art in-patient hospital care
    • Tax benefits

    Critical Illness Insurance

    Critical illness insurance covers you and your family members for conditions such as cancer and heart attacks by paying out a lump sum amount to cover medical expenses.

    Features of Critical Illness insurance

    • Coverage for chosen life-threatening diseases
    • Flexibility to pick Sum Insured depending on personal needs
    • Additional cover on your base policy

    Benefits of Critical Illness Insurance

    • Protects you and your loved ones from costly medical bills
    • Tax benefits
    • Reasonable premium

    Family Health Insurance/Family Floater Insurance

    A family floater insurance plan extends coverage to all loved ones listed as beneficiaries on a single plan.

    Features of Family Health Insurance

    • Single cover for all family members sharing the sum insured
    • Pre- and post-hospitalization coverage
    • Ambulance transportation
    • Daycare treatment coverage
    • Health checkups

    Benefits of Family Health Insurance

    • Whole family insured with a single premium
    • Tax benefits
    • Reduces financial liability
    • Stress-free with cashless claims

    Individual Health Insurance

    Individual health insurance offers single cover for the policyholder and shares many of the features of a family medical plan.

    Features of Individual Health Insurance

    • Pre- and post-hospitalization coverage
    • Cashless hospitalization
    • Daycare treatment coverage
    • Surgical procedures coverage
    • Ambulance transportation
    • Health checkups
    • Access to alternative therapies

    Benefits of Individual Health insurance

    • Compensates costs related to illnesses and accidents
    • Can add family members with additional premium

    Senior Citizen Health Insurance

    Senior citizen health insurance in India provides coverage for persons older than 65.

    Features of Senior Citizen Health Insurance

    • Hospitalization coverage
    • Post-treatment cover including medicines

    Benefits of Senior Health Insurance

    • Protects senior citizens from costly medical bills
    • Can be purchased for parents or grandparents

    Personal Accident Insurance

    Road accidents continue to rise in India and the consequences can be expensive if you’re injured or disabled during such an event. Having personal accident insurance mitigates such costs.

    Features of Personal Accident Insurance

    • Covers accidental disability
    • Additional protection against impairment due to accident
    • Option to pick sum assured depending on varying needs

    Benefits of Personal Accident Insurance

    • Additional health cover
    • Flexibility to meet your personal needs
    • Tax benefits
    • Financial protection for loved ones

    Mediclaim Policy

    Mediclaim policy for family members are designed to give you coverage in the event of an emergency or when you need treatment.

    Features of Mediclaim Policy

    • Life cover
    • No claim bonus
    • Cashless treatment with network health providers
    • Daycare treatment coverage
    • Health checkups
    • Ambulance transportation
    • Access to alternative therapies

    Benefits of Mediclaim Policy

    • Joint health and life cover
    • In-built terminal illness rider (depending on the insurer)
    • Financial protection for you and your loved ones
    • Tax savings
    • Reasonable premium

    How to Choose the Best Family Health Insurance Plan in India for You

    When choosing the best family health insurance plan in India for you and your loved ones, take note of the following factors.

    1. Look for the Right Health Policy

    When looking for the right health policy ensure it covers each member of your family’s medical needs sufficiently. Features should include pre-and post-hospitalization treatment, ambulance cover, critical illness coverage, maternity benefits, and daycare procedures. Other must-have features should include cashless claims.

    2. Look for Flexibility to Add New Family Members

    Having the flexibility to add new family members is essential if you’re planning to have children, The same applies if you intend to add elderly parents.

    3. Check the Waiting Period Clause

    A waiting period clause may be included for pre-existing medical conditions, maternity, and specific treatments such as hernia. Checking the waiting period clause allows you to plan ahead. Picking a plan with minimal waiting periods is optimal if possible.

    4. Check the Co-Payment Clause

    Co-payments are the percentage you need to pay out of pocket towards medical bills. Checking the co-payment clause will help you estimate what portion you’ll need to pay when covering treatment costs.

    5. Choose a Family Health Plan With Lifetime Renewability

    Choosing a family health plan with lifetime renewability keeps you covered in your later years without having to buy another policy for this purpose. Some health insurance plans come with limited tenure so check this before purchasing a health plan for your family.

    6. Room Rent Limit

    Going for a higher room rent limit protects you from having to pay more out of your pocket during hospital stays. The type of policy you pick will stipulate whether you get a private or semi-private room or a shared room and comes with limitations worth noting.

    Frequently Asked Questions (FAQ)

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    How to save tax with family health insurance plan?

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    Indian citizens can claim for tax deductions on premiums paid towards family health insurance plans according to Section 80(D) of the Income Tax Act 1961. Tax savings on medical expenses amount to Rs. 25,000 for policyholders under 60 years old. This amount increases to Rs. 50,000 for policyholders over 60 years old.

    How many members can be covered under family medical insurance plans?

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    The number of members allowed on a family insurance plan varies and depends on specific insurance company requirements. In most cases, you can add your spouse (if legally wedded), dependent children, parents, and grandparents onto your family medical insurance policy.

    Who are eligible to purchase health insurance for family?

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    Anyone seeking financial support for medical emergencies and treatment is eligible for purchasing health insurance for family members. Most insurance companies stipulate an age entry of 18 years old for policyholders. However, dependents on the plan can range from 91 days to 75 years old depending on the terms and conditions of the insurer.

    Is a family health insurance plan better than an individual health plan?

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    A health insurance family plan is better than an individual medical policy if you’re looking for an umbrella cover that offers coverage for all your loved ones. It allows you to manage the process all in one place and means you only pay one premium whether monthly, quarterly, semi-annually, or annually.

    How much is good health insurance for a family of 4?

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    The cost of a good health insurance plan for a family of 4 differs from one insurance company to another. The cost is dependent on a number of factors including the health and age of the policyholder, if you have elderly parents on the plan, and optional riders.

    Exclusions under family floater health insurance plans

    Waiting Period

    Most insurers include a waiting period of 30 days after the commencement of the policy. Speak to your insurance company to find out if this applies.

    Expenses Incurred Due to Participation in Adventure Sports

    Some insurance companies won’t cover any medical costs arising from injuries caused by participation in adventure sports.

    HIV/AIDS

    If HIV/AIDS is a pre-existing a waiting period clause could be included in your policy. Depending on the insurer, the waiting period could be up to four years of continuous coverage.

    Intake or Abuse of Tobacco

    Expenses related to the intake or abuse of tobacco may be excluded depending on the terms and conditions of the insurance company.

    Self-Inflicted Injury

    Most insurance companies in India won’t cover medical expenses related to self-inflicted injuries such as attempted suicide.

    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/2023-24/065

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    Disclaimer

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    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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