Family Health Insurance

You are a parent trying to keep your family healthy and safe. But even with your most careful planning, medical emergencies can strike when you least expect themand hospital bills have a nasty way of piling up into the tens or even hundreds of thousands.

The last thing you want is to drain your savings or go into debt paying for medical treatments. That's why getting family health insurance coverage is so important. With the right policy, your family can get quality care without breaking the bank.

In this article, you will discover the essential benefits of family health insurance plans in India.

What is family health insurance?

A family health insurance plan, frequently called a family floater plan, is a valuable type of medical insurance for a family that safeguards the well-being of your entire family under a single policy. Instead of purchasing separate policies for each individual, a family plan offers a shared sum insured.

This functions under the assumption that not all family members will fall ill simultaneously, allowing for streamlined coverage. Medical insurance for families includes benefits like cashless hospitalisation, maternity coverage, and pre and post-hospitalisation expenses.

Why should you buy a family health insurance?

Investing in a family health insurance plan is one of the best ways to ensure your loved ones get the care they need without worrying about finances. Here are a few reasons why you should buy family health insurance:

Affordable premiums

Family health plan premiums are lower than the total premiums of individual health policies for each family member. Mediclaim policy for families covers newborn babies from day one without extra cost. Some insurers even provide maternity benefits and coverage for dependent parents.

Tax benefits

The premiums you pay for health insurance policies qualify for tax deductions under Section 80D of the Income Tax Act. The maximum deduction for those below 60 years of age is Rs. 25,000, and for senior citizens, it is Rs. 50,000.

Cashless hospitalisation

Family health plan premiums are lower than the total premiums of individual health policies for each family member. Mediclaim policy for families covers newborn babies from day one without extra cost. Some insurers even provide maternity benefits and coverage for dependent parents.

Additional coverage

Some mediclaim policies for families provide additional coverage for critical illness, personal accident, OPD, and wellness benefits. Critical illness coverage provides a lump sum payment if diagnosed with a listed critical illness. Personal accident covers accidental death or disability. OPD and wellness benefits cover routine medical checkups and preventive care.

What is included and excluded in family health insurance?

Family health insurance typically covers hospitalisation expenses for all family members in a single policy. This includes:

• Hospitalisation expenses: Coverage for in-patient hospital treatment costs due to illness or accidents.
• Pre and post-hospitalisation costs: Expenses incurred within a specific period before and after hospitalisation.
• Day-care procedures: Costs associated with procedures that don't require a 24-hour hospital stay.
• Ambulance charges: Reimbursement for transportation costs to the hospital.
• Maternity coverage: Expenses related to childbirth (depending on the plan).
• Critical illness cover: Provides a lump sum upon diagnosis of serious illnesses (depending on the plan).
• AYUSH treatment: Inpatient treatment is provided in authorised government hospitals for Ayurveda, Yoga, Naturopathy, Unani, Siddha, and Homeopathy systems of medicine.
• Nutrition allowance: This allowance covers the cost of nutritional food supplements and medicines, including calcium tablets, vitamins, tonics, fresh/dry fruits, and vegetables for the mother's recuperation after childbirth.

However, certain things are typically excluded from family health insurance plans:

• Pre-existing conditions: Pre-existing health issues that existed before purchasing the policy are usually not covered for the first few years. After a waiting period, however, the insurer may cover pre-existing conditions at its discretion.
• Cosmetic surgery: Procedures done purely for cosmetic reasons and not medically necessary are typically excluded. This includes cosmetic dental work, facelifts, liposuction, etc.
• Alternative treatments: Standard family health insurance plans usually do not cover the costs of alternative or complementary treatments such as ayurveda, homeopathy, naturopathy, and unani.
• Dental and vision care: Routine dental checkups, fillings, braces, glasses, and contact lenses are generally not covered, though separate dental and vision insurance plans can be purchased.
• Outpatient medication: Costs for prescription drugs, over-the-counter medicines, and other pharmaceuticals are usually excluded. Some insurers may provide limited outpatient medication coverage as an add-on benefit.

How to claim family health insurance?

When a family member requires hospitalisation or medical treatment, you can easily claim the expenses under your family health insurance policy. Here are the steps to claim your policy:

Inform the insurance company

As soon as any family member requires hospitalisation, inform your insurance company about the hospitalisation and provide relevant details like diagnosis, hospital name, estimated expenses, etc. For reimbursement claims, you need to inform the insurance company within 48 hours of hospitalisation.

Submit claim form

You need to submit a claim form along with original bills, receipts, discharge summary, diagnostic reports, etc., within 60 days of discharge from the hospital. The claim form can be downloaded from the insurance company's website, or you can request them to send you one. Fill in all the required details in the form and submit it with the necessary documents.

Claim processing

The insurance company will scrutinise all the documents and verify the details before processing the claim. They may also call you for more information or clarification. Once all the details are verified, the company will process the claim and pay the approved expenses within 15-30 days.

Follow up

After submitting the claim, follow up with your insurance company regularly to ensure there are no pending requirements from your end, and the claim is processed smoothly within the stipulated time. Provide any additional details or documents the company requests promptly to avoid delay in claim settlement.

Why choose Royal Sundaram for family health insurance?

Royal Sundaram offers a range of the best health insurance plans for family with several advantages:

Comprehensive coverage

Royal Sundaram's Family Plus Health Insurance Plan provides comprehensive coverage for your whole family. It covers hospitalisation expenses for medical conditions, emergencies, and accidents. The plan also covers daycare treatments and pre and post-hospitalisation expenses for up to 30 days. With Family Plus, your family members can avail of quality treatment at leading hospitals.

Maternity and newborn benefits

The Family Plus plan offers maternity coverage for up to two deliveries during the policy's lifetime. It also provides coverage for vaccination and medical check-ups for newborn babies up to 90 days from birth. The plan reimburses expenses incurred for consultations, tests, and prescribed medicines. This ensures your new bundle of joy gets the best care from day one.

Coverage for extended family

The Family Plus plan allows you to include your extended family, such as parents, in-laws, children, siblings, etc., under a single policy. This means your entire family can take advantage of the benefits and coverage offered under the plan.

Tax benefits

The premiums paid for the Family Plus health insurance plan are eligible for tax deductions under Section 80D of the Income Tax Act, 1961. You can claim tax deductions up to ₹ 25,000 per year for covering your family. For senior citizens, the deduction goes up to ₹ 50,000 per year.

Wide range of sum insured

Family Plus plan offers sum insured options ranging from ₹ 3 lakhs to ₹ 50 lakhs. You can choose a sum insured based on your family's needs and budget. Higher sum insured options provide enhanced coverage and more comprehensive benefits.

Bottom line

Mediclaim policy for families can provide vital financial protection and peace of mind when illness or injury strikes your loved ones. Take action now to get the coverage your family needs before it's too late.

Protect your family's well-being with the comprehensive best health insurance plans for your family. Consider Royal Sundaram for its trusted and adaptable solutions.