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Family Floater Health Insurance: The Key to Family Health Security

Learn all about family floater health insurance and how it compares to individual health plans. Discover the ideal choice for your family’s healthcare needs.

8 min read

September 11, 2024

Lakshya Singhvi

When it comes to health, nothing matters more than ensuring the well-being of your family. But managing health insurance for each family member can feel like a juggling act. That’s where family floater health insurance steps in—a simple yet comprehensive solution that covers the healthcare needs of your entire family under a single policy.

 

Imagine having just one policy to take care of everyone's medical expenses instead of managing separate policies for your spouse, children, or even elderly parents. Not only does this streamline the process, but it also makes health coverage more affordable and easier to manage.

In this blog, we’ll dive deep into what family floater health insurance is, how it works, why it’s necessary, and how it compares to individual health insurance plans.

 

What is Family Floater Health Insurance?

It is a type of health insurance plan that offers coverage for multiple family members under one policy. The policyholder chooses a fixed sum insured, which is shared among all covered family members. This means any family member, whether it’s you, your spouse, children, or parents, can use the available sum insured for medical treatment as needed.

For example, if you choose a family floater plan with a sum insured of ₹10 lakhs, the total amount can be used by any family member for hospitalisation or medical treatments. Unlike individual health insurance, where each person has a separate coverage amount, the family floater model provides flexibility by allowing the sum insured to "float" among all family members.

 

How Does it Work?

The core concept of a family floater policy is sharing the sum insured. Let’s break down how it works with a practical example.

Suppose you, your spouse, and your two children are covered under a single with a sum insured of ₹10 lakhs. If one of your children requires hospitalization and the medical expenses amount to ₹3 lakhs, that sum is deducted from the total coverage. The remaining ₹7 lakhs is still available for other family members to use for the rest of the policy term.

Since healthcare needs can vary between family members, this shared coverage can be particularly useful. The unused portion of the coverage can be used by other members or by the same person in the future, giving the policyholder flexibility.

 

Key features 

Here are the key reasons why family floater health insurance is a must-have:

(i)  Cost-Effective

One of the most significant advantages of buying a single policy for the entire family is the cost savings it offers. Instead of buying separate health insurance policies for each family member, you only need to pay a single premium. This typically results in lower overall costs compared to individual policies, making it an economical option for families.

(ii) Flexibility of Coverage

Such plans provide a flexible sum insured, meaning the entire family shares the coverage. This is particularly beneficial if your family’s healthcare needs fluctuate. For example, some family members may not require medical attention in a given year, while others may need extensive treatment. The shared pool of funds can be used as needed by any family member.

(iii) Easy to Manage

Managing multiple health insurance policies can be a hassle. With family health plans, you only need to keep track of one policy, one premium, and one renewal date. This makes life much simpler for families, as you don’t have to juggle different documents or worry about separate renewal timelines for each member.

(iv) Comprehensive Coverage

Insured person receives a wide range of medical expenses, from hospitalization and surgery to pre- and post-hospitalization care, ambulance services, and more. Depending on the insurer, the policy may also offer additional benefits like wellness programs or preventive health check-ups for the entire family.

(v) Tax Benefits

Like individual health insurance plans, family floater policies are eligible for tax deduction under Section 80D of the Income Tax Act. You can claim a deduction of up to ₹25,000 per year for premiums paid towards health insurance for yourself, your spouse, and children. If you include your parents in the plan, you can claim an additional deduction of ₹50,000 if they are senior citizens.

(vi) Peace of Mind

Nothing is more important than your family’s well-being. Knowing that your entire family is covered under a single health insurance policy provides peace of mind. In the event of a medical emergency, you won’t need to worry about whether or not a specific family member is covered. Family floater plans ensure that everyone gets the medical attention they need, when they need it.

 

Coverage

The best health insurance in India for family covers medical expenses for an entire family under a single policy. Here's what it typically includes:

> Hospitalization Expenses: Covers costs for inpatient treatment, including room charges, doctor fees, surgical expenses, and nursing care.

> Daycare Procedures: Covers treatments that don’t require 24-hour hospitalization but need special procedures or treatments, such as chemotherapy or dialysis.

> Pre and Post-Hospitalization Costs: Includes expenses incurred before hospitalization (like diagnostic tests and consultations) and after discharge (like follow-up visits and medication).

> Preventive Health Check-ups: Some plans offer coverage for routine health check-ups to monitor and maintain health.

> AYUSH Treatment: Many plans include coverage for AYUSH (Ayurveda, Yoga, Unani, Siddha, and Homeopathy) treatments, offering options for alternative and traditional medicine.

> Cashless Hospitalization: Enables cashless treatment at network hospitals, making the payment process easier during emergencies.

 

Exclusions

A family floater health insurance plan typically does not cover the following:

> Cosmetic Procedures: Treatments or surgeries for cosmetic purposes or aesthetic improvements are usually not covered.

> Exclusions in Policy Terms: Specific conditions and exclusions mentioned in the policy document, such as specific diseases or procedures, may not be covered.

> Pre-existing Conditions: Coverage for pre-existing conditions is often excluded or subject to a waiting period before claims can be made.

> Self-inflicted Injuries: Injuries or conditions resulting from self-harm or attempted suicide are generally excluded.

> Lifestyle-Related Diseases: Some policies may have limitations or exclusions for conditions related to lifestyle choices, such as obesity or certain diseases linked to tobacco and alcohol use.

 

Challenges 

Some challenges that policyholders need to navigate when exploring family health plans are:

> Age-Based Premium Increase: The premium is determined based on the age of the eldest family member. If a senior citizen is included, the premium can be higher than individual policies for younger members.

> Exhaustion of Sum Insured: Since the coverage is shared, if one family member requires extensive medical treatment, the entire sum insured may get exhausted, leaving other members with no coverage for the rest of the year.

> Limited Coverage for Large Families: For larger families or families with high medical needs, a family floater plan may not provide sufficient coverage. In such cases, the sum insured may not be enough for multiple members' medical expenses.

> Renewal Issues with Age: Many family floater policies have an upper age limit for renewal, typically around 65-70 years. This could pose a problem if a family member reaches the age cap.

> Not Ideal for Families with Elderly Members: Family floater policies may not be the best option if you have elderly members with frequent or severe health conditions, as the coverage may get used up quickly.

 

Family Floater Health Insurance vs  Individual Health Plans

Family floater health insurance offers several advantages over individual health plans, such as:

 

> Cost Savings: A family floater plan is usually more affordable than buying separate individual plans for each family member. The premium you pay for a family floater policy is generally lower, offering better value for money.

> Flexibility: Family floater plans offer greater flexibility. Any family member can access the entire sum insured as needed, making it a convenient option for families with diverse healthcare needs.

> Simplicity: Managing a single policy is far easier than dealing with multiple individual policies. Family floater plans streamline the process, ensuring that you only need to remember one renewal date.

 

Here is a clear illustration of the differences between each:

 

AspectFamily Floater Health InsuranceIndividual Health Insurance
CoverageCovers multiple family members under one policy.Provides coverage for a single individual.
Sum InsuredThe sum insured is shared by all family members.Each individual has a separate sum insured.
PremiumGenerally more cost-effective than buying individual plans for each member.Premiums are higher for families as you need to buy separate policies.
Policy ManagementOnly one policy to manage with a single renewal date.Multiple policies with separate renewal dates.
EligibilityTypically covers spouse, children, and sometimes parents.Covers a single individual per policy.
FlexibilityAllows any family member to use the sum insured as needed.Each individual’s coverage is limited to their own policy.
Ideal ForFamilies looking for comprehensive coverage in a single plan.Individuals with specific healthcare needs or families with large differences in medical expenses.

 

Who Should Buy a Family Floater Plan?

Family floater health insurance can be an ideal addition to the protection fund in the following scenarios:

> Young Families: If you’re a young family with children and are looking for an affordable and convenient way to cover everyone under one policy, a family floater plan makes perfect sense.

> Families with Varying Healthcare Needs: If your family members have different health requirements, such as children with minimal medical needs and adults with more significant healthcare demands, the flexibility of a family floater plan allows you to balance those differences efficiently.

> Middle-Income Families: For middle-income families looking for comprehensive coverage without high premiums, family floater plans provide a cost-effective solution without sacrificing protection.

 

Points to Consider Before Buying

Before opting for a family floater health insurance plan, it’s important to keep these factors in mind:

> Age of Family Members: The premium for a family floater plan is based on the age of the eldest member. If you’re including senior citizens in the policy, the premium could be higher.

> Healthcare Needs: If one family member has frequent healthcare needs, the sum insured may get used up quickly, leaving little for others. Consider a higher sum insured to account for these potential situations.

> Policy Exclusions: Always read the fine print of the policy to understand any exclusions, such as pre-existing conditions or waiting periods for specific treatments.

> Claim Settlement Ratio: Review the insurer's claim settlement ratio to gauge their reliability in processing claims. A higher ratio indicates better performance in settling claims.

> Waiting Period: Be aware of the waiting period for pre-existing diseases and certain treatments. This period varies between policies and can affect your coverage.

> Sum Insured: Choose a sum insured that adequately covers the healthcare expenses of all family members. Ensure it is sufficient to cover major medical expenses without exhausting the coverage.

 

Buy Family Floater Health Plan from Oneassure

Step 1: Go to oneassure insurance page.

Step 2: Enter your personal information like name, mobile no., email etc.

Step 3: Choose the most suitable plan and proceed to book your free call.

 

Bottomline

Choosing the right health insurance for your family is crucial, and a family floater plan offers a convenient and cost-effective solution. By covering multiple family members under one policy, you not only save money but also simplify your insurance management. With flexible coverage and the ease of handling a single policy, family floater health insurance can be a smart choice for many families.

Remember, the right policy should match your family's unique needs, so take the time to compare options and consider factors like age, healthcare needs, and coverage limits. By choosing a family floater plan, you can ensure that your loved ones are protected and can focus on enjoying life together, knowing that their health is in good hands.

So, take the first step today and explore your options with OneAssure. Your family’s future is worth it!

Request for a free health insurance consultation