Family vs individual health insurance plan: Which one should you choose?

A Family floater Health Insurance Plan offers comprehensive coverage for the entire family at a cost-effective premium, thus removing the hassle of managing multiple policies. Read further to know more

Amit Ganorkar, MintGenie Team
Updated23 Jan 2023, 01:14 PM IST
Health insurance is a contract between the insured and the insurance provider that guarantees you financial protection in the event of a medical emergency.
Health insurance is a contract between the insured and the insurance provider that guarantees you financial protection in the event of a medical emergency.(Image by fernando zhiminaicela from Pixabay)

Juggling with your family’s multiple health insurance policies, different premiums and their separate due dates? There’s an easy solution at hand – switch from the individual health insurance plan to a family floater plan. Sounds complicated? It’s definitely much simpler than it sounds. 

While an individual health insurance policy offers coverage to just one person, family medical insurance plan covers the entire family. You can, not only, cover your spouse and children but also your dependent parents/parents-in-law under the family health insurance plan.

Umbrella coverage

The sum insured floats for the entire family and pays a unified premium in return instead of separate premiums. To elucidate, you take a family floater plan with an insurance cover of Rs 8 lakh to insure yourself, your spouse, and your two dependent children. If you happen to undergo a surgery and claim Rs 2 lakhs from the total sum insured, all the people insured in the plan would still have Rs 6 lakhs left in the floater kitty to avail in future.

Individual plan makes sense if you don’t have dependents to care for. Like in the case of a bachelor. However, when the same person gets married and has children, it is prudent for him/her to shift to a family floater health insurance plan so that the dependents get covered too. The unified protection assures that you get the best treatment available without making any compromises financially.

The advantages

Family floater health insurance plans score over individual plans on a number of grounds. One, the family floater plan accrues saving the additional costs otherwise incurred on getting several individual plans. And you get the same insurance benefits by paying just one cost-effective premium.

Secondly, they also help organise finances to a great extent because it is a unified plan. It removes the hassle of remembering the premium payment due dates or renewal dates of separate policies. Third, it makes it possible to cover dependent members who may not be able to afford a health insurance plan on their own.

Moreover, even the family plans are eligible for tax deduction of up to Rs 25,000 (under the age of 60) or Rs 50,000 (over the age of 60) under Section 80D of the Income Tax Act, 1961. You can claim another tax benefit of up to Rs 50,000 if you’ve bought a health insurance plan for your parents, taking the total allowed health insurance tax deduction limit to Rs one lakh.

Decoding the plan

Family health insurance plans generally include a family floater discount on premium, hospitalisation including pre and post-hospitalization, ambulance costs, organ donation, maternity expenses, preventive health check-ups, daily cash for choosing shared accommodation and daily cash in case an Insured Child is hospitalised. Some even cover alternative treatments such as Ayurveda, Yoga, Naturopathy, Unani, Siddha, Sowa-Rigpa, and Homoeopathy.

Opt for a cashless mediclaim policy so that the entire experience is hassle-free and seamless for you. Make a list of medi claim desirables as per your family’s needs and then check the inclusions/exclusions of the policy options available in the insurance market. List the expected as well as the unexpected expenses to ensure protection from all possible costs. Account for the age and medical history of your dependents.

You are the best to judge whether your family needs a policy that offers OPD treatment, dental treatment, accidental death benefits, global cover for planned hospitalisation, consumables benefit, day-care procedures, restore benefit, etc besides the usual benefits.

The last word

The inclusions, medical cost of the city where insured persons reside and size of family will determine the sum insured – ranging anywhere between Rs 5 lakhs to Rs 50 lakhs or more. Premiums of health insurance plans for family floaters are decided on the basis of every insured person’s age, health status, family history, lifestyle habits, occupation, etc. however, few policies also consider customer’s address to derive the premium. To save costs further you may opt for a long term (i.e. multi-year policy) policy.

Just make sure to get a plan that is adequate in all respects. Look at the claim settlement ratio of the insurance company and also whether or not they offer round the clock customer support for your queries.

An ideal plan is one that irons out your stress about future medical expenditures in the face of a medical need and also gets you the much-deserved peace of mind to know you, and your loved ones, are covered in case of any medical eventualities and most importantly “With You Always”.

Amit Ganorkar is the President & Chief Operating Officer, Tata AIG General Insurance Co. Ltd.

Here we describe the common exclusions for health, life, motor and general insurance policies.
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First Published:23 Jan 2023, 01:14 PM IST
HomeMoneyPersonal FinanceFamily vs individual health insurance plan: Which one should you choose?

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