Health is Wealth. Health is an Asset. We are happy, only if we are healthy. But, we all know that medical treatment has got more expensive, is getting more expensive and may continue to be more expensive. Health care has become a costly affair.
You should have health insurance to protect you and your family from extra financial burden during medical emergencies.
General Insurance Companies (or) Stand-alone health insurance companies like Star Health / Apollo Munich or Max Bupa, Religare Health) offer various types of health insurance plans. These can be individual Mediclaim pans or Family Floater Health insurance plans.
In this post let us understand – What is Family Floater Health Insurance Plan? Which are the best Family Floater health insurance plans? What are the factors to keep in mind before buying a family floater medical insurance policy? Individual Mediclaim Vs Family Floater, which one to buy?
What is Family Floater Health Insurance Policy?
Family floater is a policy that covers more than one family member for a fixed cover. The amount of sum insured floats over the entire family – that is, the limit can be used by any member of the family and for any number of times.
A Family Floater health plan is similar to individual health plan, the only difference is that is extended to cover your entire family. A Family Floater Plan acts as an umbrella of coverage for the entire family and therefore the name.
For example : If you buy a family floater plan with Rs 5 lakh as sum assured, for four members of your family. All four people put together can spend a maximum of Rs.5 Lakhs in one year. If one of your family members uses Rs 3 lakh of the sum insured then only Rs 2 lakh would be left for the rest of the family to use in one policy year.
Family floater health insurance plans usually covers the individual, spouse and children. However, some insurance providers do have provision to cover dependent parents, siblings and parents-in-law.
How to select the best Health Insurance Plan for Family?
When it comes to health insurance, there is no one-size fits-all plan that you can rely on. Medical Insurance is a contract based policy with legal jargon thrown in. Besides this, a Health Insurance policy has medical terminologies. Of the numerous medical insurance plans in the market, you may find that each one is unique in some way or the other, with its own benefits and limitations.
You have to do lot of research before you find the right and best health insurance plan for you. You have to make a comparison of health insurance plans offered by multiple companies.
Each family may have unique health insurance requirements. So, it is advisable and very beneficial to visit ‘best health insurance plans comparison portals’ and do your own research.
However, below are some of the important factors that you can keep in mind before buying a family floater health insurance plan.
- Premium: Insurance premium is generally the first thing that most of us evaluate while buying an insurance policy. A family floater plan provides health insurance to the whole family at a lower cost compared to individual Mediclaims.
- Co-Pay clause: Co-payment means the policyholder will bear a specified percentage of the claim amount. For example, in an 80%-20% clause, the policyholder will bear 20% of the cost and the remaining amount (80%) can be claimed.
- Sub-limits: Health insurance companies may specify limits for certain illnesses or treatments. For ex: the policyholder can claim only Rs 20,000 for a cataract operation but the policy sum assured might be Rs3 Lakhs. The policies without sub-limits are better but may charge higher premiums.
- Waiting period for Pre-existing diseases: You need to check if the existing diseases are covered by the policy. In some policies all the existing diseases may be covered and in some, the policy holder has to wait for few years before making a claim.
- Alternative Treatments : Some policies also cover non-allopathic or alternative treatments such as homeopathic, ayurvedic etc.,
- Waiting period for specific diseases.
- Disease wise capping (if any).
- Definition of family i.e., who and all can be included in a Family Floater plan with the insurance cover.
- Check if any of the (or) all day-care procedures are covered?
- Find out if any complimentary free-health check-ups are allowed?
- Maximum Renewal age : This criterion states up to what age the policy can be renewed.Find out If life-long renewal is allowed or not?
- No claim bonus: These are incentives provided by the company in case of a claim-free year. It varies from company to company.
- Check out the list of ‘exclusions’ provided in ‘Product brochure’ or consult the customer care of the concerned insurance company.
- Claim Settlement Record : Given the nature of the product, claims settlement is important. However, the data that is available in the public domain is not user friendly, but it’s important to include them in your evaluation. (Incurred Claims ratio of some of the best health insurance companies.)
- Restoration of Sum Assured : Make sure your health insurance has ‘restoration benefit’. For instance, you have a floater plan with a Sum Insured of Rs. 4 lakhs, and your spouse falls ill, and the entire coverage is consumed. If, unfortunately, another one of your family members get hospitalized later in the same policy year, this feature would help you in this situation by restoring your Sum Insured.
- For most health insurers, the total sum insured is restored only if the entire sum insured is exhausted under a single claim. But there are also some health insurers who offer restore benefit as soon as there is any hospitalization required. There are also some plans which can be restored unlimited times in the policy year. So, it is always advisable to check with your health insurer before opting for this benefit.
Latest Article : ‘Enhanced Health Insurance Benefits – IRDA’s latest Guidelines (2019-20)’
Top & Best Family Floater Health Insurance Plans 2020-21
Below are some of the popular & best Health Insurance Plans for Family (family floater medical insurance plans) based on affordability and key benefits;
- Apollo Munich’s Optima Restore
- Max Bupa Health Companion – Family Floater
- Star Health’s Family Optima Health Insurance Plan
- HDFC Ergo’s my:Health Suraksha
- Religare CARE Plan
(The above plans are for a family of four ie 2 Adults + 2 kids aged 35 years, 30 years, 8 years & 5 years respectively. Sum Assured is Rs 5 Lakh, with no pre-existing diseases)
Below are my observations on the key features and exclusions of best family floater insurance plans;
- Star Health has one of the widest cash-less hospital networks.
- Max Bupa Health Companion plan has lot of features at affordable premium rates.
- Star Health Family Optima has a very comprehensive ‘Restoration benefit’ feature which is a key feature of a health insurance plan.
- If you are looking for ‘no room rent capping’ feature, HDFC Ergo and Apollo Munich plans have ‘no-cap limits’.
- Max Bupa’s Health Companion plan offers cover for Dental and Eyesight treatments as well.
- Max Bupa’s & Apollo Munich plans offer full Sum Assured for Alternate medicine treatment (non-allopathic).
- Most of the Insurers have started offering ‘reward amount or wellness benefit or discount in Premium’ for keeping yourself fit.
- For example : Apollo Munich’s Optima Restore plan offers a discount (2% to 8%) at each renewal if the insured member achieves the average step count target on the mobile application provided by the Insurer. The mobile app must be downloaded within 30 days of the policy risk start date to avail this benefit.
- Aditya Birla’s Active Care plans are also good but premium quotes are on the higher side for comprehensive package.
- Some of the important value added features that are offered by the Health Insurers are;
- Critical Illness optional rider
- Optional Maternity Cover
- Optional or in-built Personal accident cover
- Buy-back Pre-existing Disease : For example – Under Star’s Family Health Optima, the prospect has the option to opt for reduction of waiting period in respect of Pre-existing Diseases from 36 months to 12 months by paying additional premium.
- Global Coverage option offered under Religare Care plan.
Important Points & FAQs on Family Floater Health Insurance Plans
- Can I claim tax benefits on Family Floater plan? – Yes, you can claim tax deduction on the premium paid towards health insurance plan. Click here for more details on this point.
- Is portability allowed? – Yes, you can port your family floater plan from one company to another one. You can also port from an individual plan to family floater plan (subject to certain conditions).
- Can the policy be continued on the proposer’s death? – Yes, any other eligible floater member can write to the insurer, seeking to be the new proposer and the cover will continue. The premiums for other policyholders may come down. But, most policies are silent about renewal in case the proposer dies. So, it is better to get this clarified with the company directly.
- What other factors should I consider before buying a family floater plan? – The factors mentioned above are the basic ones. You may keep in mind certain other factors like – critical illness benefit, restoration of sum assured on full utilization, maternity cover applicability, pre & post hospitalization expenses covered or not, Domiciliary expenses covered or not etc.,
- What happens to the insurance cover on Kids becoming major? – Most of the plans provide insurance cover for kids till they attain 18 or 21 years of age. You can buy individual health insurance plans from the same company and you can get the benefits of policy continuity.
- Can I enhance my Family Floater Plan sum assured by buying another Super Top up plan? – Yes, some of the companies offer optional deductible. You may also buy a stand-alone Super Top up. To know more about Super-top up plans and their benefits, click here.
- Are medical tests compulsory? – For most of the plans they are not mandatory. However, some companies may ask for medical tests based on the age criteria.
- For example : Under HDFC Ergo’s my:Health Suraksha Plan, medical screening tests are mandatory for the prospects who are aged above 45 years.
Individual Mediclaim Vs Family Floater Health Insurance Plans – My Opinion
- The main advantages of Family Floater Health Insurance plans are – they are less expensive than Individual Policies and are very beneficial for younger families with members having low health risk.
- If one of your family members has an adverse health history then it is not advisable to include him/her in the family floater plan. You can buy an individual plan for that family member.
- It is advisable to buy a floater for individuals with no health risk factors and an individual policy for individuals with any health risks or with any pre-existing diseases.
- The premium is determined by the age of eldest member in the family. So, it may not be prudent to include your parents in the family floater plan. You can buy separate individual plan(s) or consider buying comprehensive plans for Senior Citizens. (Read – Best Health Insurance Plans for Senior Citizen parents)
- An elderly family, with higher medical needs will benefit from individual Mediclaim plans. Another option is, the elderly parents can buy a Family Floater plan and a separate family floater plan for the kids.
- You can only add your immediate family members like your spouse and kid Very few companies accept the extended family members to be part of a family floater plan.
- Some family floaters plans have a maximum renewable age limit of say 60 or 65 years. They may offer portability to a senior citizen mediclaim plan after the policyholder completes 60 years, but it is better to find a family floater that has maximum age of 75 years or life-long renewability.
- If you have an existing Family Floater Medical Insurance cover, you can enhance the cover by taking a stand-alone Super Top up plan.
- You can also consider buying both family floater plan as well as an individual plan for a family member based on his/her health and age profile.
Do not consider buying a Health Insurance plan as an additional expenditure. Having sufficient health cover is a must for both salaried and non-salaried individuals. Have a separate individual plan or family floater plan even if you are covered by your Employer’s group mediclaim plan.
It is very difficult to shortlist the best health insurance plan. There are multiple factors that should be considered before buying a family floater health insurance plan. The one that is easy on pocket may be restrictive on benefits, while the features in the expensive one may compensate for the cost.
So, I strongly recommend visiting ‘best portals for comparing health insurance plans’ to shortlist suitable and best health insurance plan for family (family floater health insurance policy) based on your requirements.
Continue reading :
- 11 vital factors to consider when choosing the Best Health Insurance Plan!
- Understanding Maternity Benefits of Health Insurance plans in India
- Health Insurance Tax Deduction FY 2019-20 / AY 2020-21 | Income Tax Benefits u/s 80D
- Should NRIs buy Health Insurance in India?
Kindly note that Relakhs.com is not associated with any of the above mentioned Insurance companies. This post is for information purposes only and we do not endorse any specific insurer. Please refer to product brochures and policy wordings documents before buying a Health Insurance Plan.
(Reference : Insurance Plan Product brochures) (Image courtesy of Master isolated images at FreeDigitalPhotos.net)