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- Meaning of a Family Floater Health Insurance plan
- Before buying a Health Insurance plan, consider the following questions:
- Floater vs. individual insurance policy
- Exclusions
- Difference Between Individual Policy and Family Floater
- Benefits of a Family Floater Health Insurance
- How floater insurance works
- Number of members allowed
- Special Features of a Family Floater Policy
- How is the premium calculated?
- FAQS - FREQUENTLY ASKED QUESTIONS
A family Health Insurance plan covers expenses for your family members. A family floater health insurance manages your expenses for prescriptions, bills, hospital visits, etc. With it, you will not have to worry about medical costs for seniors or infants.
Meaning of a Family Floater Health Insurance plan
Purchasing separate Health Insurance plans for each family member can be tedious. An efficient alternative is opting for a single policy encompassing all family members. A Family Floater Health Insurance Policy covers two or more family members under one plan.
Before buying a Health Insurance plan, consider the following questions:
- What and how is your current health condition?
- How much coverage do you require?
- How much does the insurance policy cost?
- What is your annual income?
You must know beforehand how many members you want to add to the policy. Also, check the maximum renewability age, especially if you plan to include your parents. When you are looking for the best Family Floater Health Insurance Plan in India, look for one that has no age limit for renewing the policy.Family Floater Plans are an easy and excellent way to secure the health of your whole family under one policy. They provide coverage like an individual plan and have umbrella coverage for all family members.
Floater vs. individual insurance policy
Large families could opt for individual Health Insurance . A Family Floater Policy might also not be sufficient for families with senior parents. A young family or small nuclear family can opt for floater policies as it would be better for them. But as to which is better, it's always best to gauge based on your situation and requirements.Individual health insurance policies offer specific advantages tailored to one person's needs, while Family Floater Plans provide broader coverage for families, proving beneficial when specific criteria align.Before choosing between the two, it's essential to evaluate both based on the family's health needs, the age of the members, financial considerations, and future planning.
Exclusions
1. Pre-existing diseases
Many Family Floater Health Insurance plans include a waiting period before covering pre-existing conditions. These are medical conditions that you had before purchasing the policy. The waiting period varies among insurers.
2. Waiting period for specific illnesses
Some illnesses, such as certain surgeries or treatments, may have a waiting period before coverage kicks in. Make sure to understand the waiting periods mentioned in your policy.
3. Cosmetic procedures
Health Insurance policies typically exclude coverage for cosmetic procedures that are not medically necessary.
4. HIV/AIDS treatment
Many policies exclude coverage for HIV/AIDS-related treatments and complications.
5. Maternity expenses (if not covered)
SomeFamily Floater Plans do not cover maternity expenses. If you're planning a family, ensure your policy includes maternity coverage.
6. Out-of-network treatment
If you get treatment from a healthcare provider that your insurer does not recognise or include in their network, your policy might not cover it.
7. Wellness and lifestyle services
Health insurance usually does not cover services like gym memberships, spa treatments, and weight loss programs.
8. Dental and vision care (unless specifically included)
Routine dental and vision care expenses are often not covered unless your policy specifically includes dental and vision coverage.
9. Congenital conditions
Congenital disabilities or congenital conditions might not be covered if not explicitly mentioned in the policy.
10. Daycare procedures
Many plans cover daycare procedures but might exclude certain specific procedures.
11. Repeated hospitalisations for the same illness
Some policies limit the number of times you can raise a claim for the same illness within a certain period. Also read : Waiting Period in Health Insurance
Difference Between Individual Policy and Family Floater
| Individual Policy | Family Floater | ||
| 1 | Coverage Scope | Covers a single individual against medical expenses and hospitalisation costs. | The entire family, including the policyholder, spouse, children, and sometimes dependent parents, is covered under a single policy with a shared sum insured. |
| 2 | Premiums | Premiums are usually based on the insured individual's age, health history, and coverage needs. | Premiums are calculated on the age and health history of the family's eldest member. It's often more cost-effective compared to multiple individual policies. |
| 3 | Sum Insured | Each individual has their sum insured, the maximum amount the insurance company will pay for their medical expenses. | All family members share the sum insured. If one member exhausts the sum insured, it might impact the coverage for other family members. |
| 4 | Flexibility | Offers personalised coverage tailored to the insured individual's health needs and risk profile. | Provides shared coverage for the entire family, which might not suit individual health requirements. |
| 5 | Policyholder |
The policyholder is the insured individual. |
The primary policyholder covers the entire family under a single policy. |
| 6 | Renewal Age | The policy can be renewed even if the insured individual crosses a certain age limit. | Some policies might have an upper age limit for renewal, beyond which coverage might not be available for the eldest member. |
| 7 | Claims Utilisation | Each individual has coverage, and claims do not impact other family members' coverage. | Claims made by one family member can deplete the shared sum insured, affecting coverage for other members until the policy is renewed. |
| 8 | Necessity of Coverage | Suitable for individuals who want tailored coverage based on their health needs. | Ideal for families with multiple members, offering a cost-effective way to cover the entire family under a single policy. |
| 9 | Portability | The insured can switch to a different insurance company without affecting family members' coverage. | The primary policyholder can switch insurers, but porting might involve complexities regarding the shared coverage for family members. |
| 10 | Coverage Continuity | Even if one family member makes a claim, others can continue with their policies unaffected. | Claims made by one member can impact the remaining family members' coverage until policy renewal. |
Read more about their difference here.
Benefits of a Family Floater Health Insurance
1. Comprehensive coverage for the whole family
Family Floater Health Insurance covers the policyholder, their spouse and children, and sometimes dependent parents under a single policy. It ensures that the entire family has access to medical coverage.
2. Cost-effective
Family Floater Plans are often more economical than purchasing separate policies for each family member. The insured sum is shared and used collectively, optimising premium expenses.
3. Flexible utilisation of sum insured
Any family member can utilise the shared sum insured as needed. This flexibility is beneficial if some members are healthier than others.
4. One policy, less administrative hassle
One Policy, Less Administrative Hassle: Managing a single policy is simpler than handling multiple individual policies. You can manage renewals, premium payments, and claims more efficiently.
5. Shared coverage for multiple health needs
Family members might have different healthcare requirements. A family floater policy can accommodate diverse medical needs while providing financial protection for various illnesses.
6. Savings in premiums
Premiums for a Family Floater Plan are often lower than the combined premiums of individual policies, resulting in potential savings.Read more benefits of Family Floater Insurance here.
How floater insurance works
Let us look at an example to understand how family floater health insurance works:Mr Aakash covers his family in a floater plan with a ₹ 20 lakhs cover. The plan covers him, his wife, and his two children. During the policy period, doctors diagnosed Mr. Aakash with malaria and hospitalised him. He incurred treatment costs of ₹ 5 lakhs. Using his family floater insurance, he claimed and received reimbursement after submitting the necessary documents. Now, his plan has a balance of ₹ 15 lakhs available for his entire family. If any family member uses up this whole amount, the policy will have no funds left for any subsequent claims during its duration.
Number of members allowed
Family Floater Health Insurance Plans usually cover families comprising the primary holder, a partner, and up to four children. Some plans will also allow you to include your parents in the same policy. Other family floater policies permit you to add your in-laws and siblings.However, the more people the plan covers, the more insurance you will need, thereby increasing the premium. Thus, including your spouse and your kids in the policy may be best. While you can add your parents to many policies, it may not always be prudent. Consider buying a separate policy for them.Read more about who all can be included in the policy here.
Special Features of a Family Floater Policy
Family Floater Plans have many features that make them attractive. Some of the major ones include:
Tax benefits
A Family Floater Health Insurance policy gets a higher tax deduction than individual policies under section 80D if you have included your parents.
Sharing the sum assured
It is the best advantage of having a Family Floater Health Insurance plan. When a member gets hospitalised, they can utilise a portion of the sum assured, leaving the balance available for other family members. Individual policies do not offer this flexibility.
Ease of management
Managing one policy is much easier than managing many individual policies for each household member. Family floater insurance plans make renewing the policy for all family members much easier.
How is the premium calculated?
The premium for this policy is calculated depending on the oldest family member enlisted. Thus, this is also a bit more expensive than the individual policy, especially if you have ageing parents included in the plan.
FAQS - FREQUENTLY ASKED QUESTIONS
Who is eligible for coverage under a Family Floater Plan ?
Family Floater Plans cover the policyholder, their spouse, dependent children, and sometimes parents or in-laws. The specific list of covered family members varies among insurers. Benefits include shared coverage for the whole family, cost-effectiveness compared to individual policies, flexibility in utilising the sum insured, simplified administration, and the convenience of a single policy for multiple family members.
When buying the plan, the policyholder selects the sum insured, representing the maximum amount allocated for the family's medical expenses. All family members covered under the policy share this amount.
Which medical expenses does a Family Floater Plan cover ?
Depending on the policy terms, Family Floater Plans cover various medical expenses, including hospitalisation, surgeries, doctor consultations, diagnostic tests, pre- and post-hospitalisation expenses, ambulance charges, and more. Family Floater Plans have exclusions, which might include pre-existing diseases (for a waiting period), certain specific illnesses, non-medical expenses, cosmetic procedures, self-inflicted injuries, and more. Exclusions vary among insurers. Many Family Floater Plans allow you to add new family members, such as newborns or adopted children, during the policy period without purchasing a separate policy.
Can I customise the coverage for different family members ?
Family Floater Plans offer shared coverage, so customisation is limited. However, some plans provide add-ons like maternity coverage, critical illness coverage, etc., to enhance coverage for specific family members. If one family member uses up the entire sum insured, the coverage for that individual is exhausted until the policy's renewal. However, other family members can continue to use the remaining coverage. You can switch to a different Family Floater Plan or insurer. It is known as portability. However, it might involve complexities related to shared coverage and eligibility of family members.
How are claims processed in a Family Floater Plan ?
If any covered family member incurs medical expenses, you can file a claim for reimbursement. The claims process is usually straightforward, and one claim can cover expenses for multiple family members. Consider the coverage limit, premium cost, network hospitals, waiting periods, coverage exclusions, add-on benefits, and the specific medical needs of your family members when selecting a plan. Some insurers might allow you to convert an individual policy to a Family Floater Plan, usually during specific periods or under certain conditions. Check with your insurer for their conversion policy.
The information contained herein is generic in nature and is meant for educational purposes only. Nothing here is to be construed as an investment or financial or taxation advice nor to be considered as an invitation or solicitation or advertisement for any financial product. Readers are advised to exercise discretion and should seek independent professional advice prior to making any investment decision in relation to any financial product. Aditya Birla Capital Group is not liable for any decision arising out of the use of this information.
