Best Health Insurance Plans for Family in India
Health insurance is no longer a luxury but a necessity, especially for families. With rising medical costs and unpredictable health emergencies, having the best health insurance plan for your family ensures financial security and access to quality healthcare.
While awareness of health insurance is increasing in India, a significant portion of the population remains uninsured.
In this blog, we will discuss what is a family health insurance plan, the importance of this plan, and some of the best health insurance plans for your family.
Best Health Insurance Plans for Family
| Features | Aditya Birla Activ Health Platinum Enhanced | ManipalCigna ProHealth Prime Plan | Niva Bupa ReAssure 2.0 | Bajaj Allianz Health Guard Plan | HDFC ERGO Optima Secure | ICICI Lombard Elevate Plan | New India Yuva Bharat Health Policy | Tata AIG Medicare Premier | SBI Arogya Premier | Star Health Family Health Optima |
|---|---|---|---|---|---|---|---|---|---|---|
| Type of Pre-existing Conditions (PED) Covered | All declared and accepted, including chronic conditions (e.g., diabetes, hypertension) after waiting period | All declared conditions accepted, subject to underwriting. Includes diabetes, hypertension, etc. | All declared PED accepted, subject to waiting periods (e.g., diabetes, hypertension). | All declared PED, subject to medical underwriting. | All declared PED, subject to underwriting & standard waiting (24-48 months). | Covers declared pre-existing illnesses (e.g., diabetes, BP) after waiting, subject to underwriting. | All declared PED (hypertension, diabetes, etc.) subject to underwriting & waiting. | All declared PED, subject to medical underwriting & waiting period. | All declared PED after specific waiting. | All declared PED accepted after waiting period (common chronic ailments included). |
| Pre-post hospitalization expenses | 60 days pre / 180 days post | 60 days pre / 90 days post | 60 days pre / 180 days post | 60 days pre / 90 days post | 30 days pre / 60 days post | 60 days pre / 90 days post | 30 days pre / 60 days post | 30 days pre / 60 days post | 30 days pre / 60 days post | 60 days pre / 90 days post |
| Road Ambulance Charges | Covered up to a sub-limit (varies by SI) | Typically covered (₹2k-₹3k per hospitalization) depending on plan variant | Covered (e.g., up to ₹3k per event, subject to plan) | Covered up to sub-limit (e.g., ₹3k per hospitalization) | Covered up to a specified amount (plan-based) | Generally covered up to ₹2k-₹5k or as % of SI | Covered (sub-limit depends on SI chosen) | Covered up to ₹3k or a set sub-limit per event | Covered up to plan-defined limit | Generally covered up to a sub-limit (e.g., ₹750-₹3k per event) |
| Preventive Health Check-ups | Yes, annual health check-ups or wellness tests (some variants from day one). | Yes, free annual check-ups or wellness benefit (timing depends on variant). | Yes, yearly check-ups from day one or after first renewal (plan-based). | Yes, annual or biennial check-ups (plan-based). | Yes, post a certain renewal or with add-on. | Yes, typically after certain policy durations (or annual in higher variants). | Yes, once every renewal cycle (depending on SI). | Yes, free annual check-ups in certain variants. | Yes, annual check-up from second/third year onward (variant-based). | Yes, annual check-up or health screening in certain plan tiers. |
| Organ Donor Expenses | Yes, covers donor's hospitalization costs (excludes screening, donor complications, etc.) | Yes, up to sum insured sub-limit (excludes cost of donor screening). | Yes, donor costs covered up to sum insured. | Yes, covered under in-patient limit or a sub-limit. | Yes, typically under the in-patient section subject to policy terms. | Yes, included for in-patient transplant expenses, excludes screening/donor fees. | Yes, covers organ transplant up to SI (excl. tests, donor complications). | Yes, within overall SI or sub-limit. | Yes, typically under in-patient claim, excluding donor screening. | Yes, part of in-patient coverage (excludes screening tests). |
| In-patient Hospitalization Expenses | Yes, full coverage up to sum insured (room rent sub-limits vary by plan). | Yes, up to SI (single private or no room cap in prime variants). | Yes, includes room rent, ICU, doctor fees, OT up to SI. | Yes, up to chosen SI, some room category limits. | Yes, covers up to SI, with "Secure" enhancement removing room rent capping. | Yes, up to selected SI. Room rent capping or no capping variant. | Yes, up to SI. Room rent capping depends on plan slab. | Yes, up to SI. High or no room rent limit in Premier. | Yes, up to SI. Some variants have no room rent capping. | Yes, up to SI. Room type restrictions vary by sum insured. |
| Extended Hospitalization Allowance | May have "Hospital Cash Benefit" rider or add-on for daily cash. Not standard in base coverage. | "Hospital Daily Cash" optional rider or included in some prime variants. | Typically not standard, can add daily cash rider. | May offer daily cash add-on for extended stays. | Yes, "Daily Cash for Extended Hospital Stay" if chosen as add-on. | Option for daily cash rider if inpatient stay exceeds specified days. | Not standard in base plan; daily cash benefits might be an optional add-on. | Yes, daily hospital cash available with certain sub-limits. | May offer daily allowance as an add-on/rider. | Yes, "Hospital Cash" optional. Not included by default in Family Health Optima. |
| Outpatient Expenses (dental, hearing aid, etc.) |
OPD not in base. Some variants have optional "Activ Health Wellness" rider including coverage for dental, vision. | "ProHealth Prime" may include OPD coverage including dental, hearing if you pick a top variant or rider. | OPD coverage typically not in base ReAssure. Might be an add-on in higher sum insured variants. | Basic OPD not covered in standard; possible with add-ons (dental, vision) if available. | Standard plan excludes OPD. An optional OPD rider might be offered. | Elevate may have partial OPD benefit in top variants, including hearing/dental check. | Usually no OPD coverage in base plan. Possibly an add-on for limited OPD. | Some OPD reimbursements in Premier for dental/vision after waiting periods. | Typically no OPD in base. Might add "OPD rider" if available. | Minimal OPD coverage in base plan. Some add-ons might partially cover out-of-hospital expenses. |
| Vaccination Expenses | Typically covers post-bite vaccination (e.g., anti-rabies) if hospitalized. Routine immunizations not covered by default. | May cover post-bite or medically necessary vaccines; routine preventive vaccines typically excluded. | Typically excludes routine vaccination unless medically necessary post-hospitalization. | Usually only covers medically necessary post-exposure vaccines. Routine vaccines excluded. | Generally excludes routine or preventive vaccinations, covers only medically mandated ones. | Excludes routine immunization; coverage only if part of inpatient treatment after an incident. | Routine vaccinations excluded. Post-exposure prophylaxis may be covered if part of inpatient. | Usually excluded except if required during hospitalization for covered event. | Similar approach-no coverage for routine immunization. | Typically no coverage for standard vaccinations, only post-exposure prophylaxis if hospitalized. |
| Waiting Period for Pre-existing Conditions | 24-36 months typically, depending on health declaration & plan variant. | 24 months for declared PED in ProHealth Prime. | 24-36 months, depending on declared condition & chosen sum insured. | 36 months standard for PED. Some conditions have 24-month wait in lower sum insured. | Usually 24-48 months for PED (based on plan type). | Typically 24-36 months for PED. | Usually 36 months for PED, can vary if optional riders or underwriting. | 36 months for PED. Some variants might reduce if no claims. | 36 months for PED standard in SBI. | Typically 48 months or 36 months for declared PED (varies by condition). |
| Instant Cover | No - standard waiting periods (30 days for new illnesses, accidents day one). | No - standard 30 days for new conditions, 24 months for PED. | No - standard 30-day wait for new ailments, 2-3 years for PED. | No - same approach with standard 30-day initial wait. | No - "Optima Secure" has 30-day new illness wait, no day-1 coverage for non-accident. | No - 30-day new illness wait. | No - 30-day standard initial wait. | No - 30-day for new, 36-month for PED. | No - 30-day initial wait. | No - 30-day standard wait for new ailments. |
| Coverage for Complications | Yes, complications from covered PED or ailments after wait ends. | Yes, once PED waiting is served, complications are covered. | Yes, includes complications related to declared ailments post-wait. | Yes, after fulfilling the PED waiting period. | Yes, after relevant waiting periods, covers complication costs. | Yes, complications arising from covered conditions once waiting ends. | Yes, post-wait coverage for complications from covered conditions. | Yes, once waiting periods are over. | Yes, covers complications arising from PED or new ailments post-wait. | Yes, after applicable waiting period. |
| Cashless Facility | Yes, wide Aditya Birla network (~10,000+). | Yes, ~6,500+ network hospitals. | Yes, ~8,000+ network hospitals. | Yes, ~7,000+ network hospitals. | Yes, ~10,000+ network hospitals. | Yes, typically ~4,500-5,000+ network (can vary by region). | Yes, New India has ~3,000+ network hospitals (some sources mention more). | Yes, ~7,200+ network hospitals. | Yes, ~6,000-7,000 network hospitals. | Yes, up to ~14,000+ network hospitals. |
| Normal Waiting Period (for new illnesses) |
30 days (accidents day one). | 30 days | 30 days | 30 days | 30 days | 30 days | 30 days | 30 days | 30 days | 30 days |
| Premium Range (Approx. Annual) |
~₹8k-₹15k (family floater, 2 adults, SI ~₹10L, age ~30) | ~₹9k-₹18k (family floater, 2 adults, SI ~₹10L) | ~₹10k-₹20k (family floater, 2 adults, SI ~₹10L) | ~₹7k-₹14k (family, ~₹10L) | ~₹9k-₹16k (family, SI ~₹10L) | ~₹8k-₹14k (family, SI ~₹10L) | ~₹6k-₹12k (family, SI ~₹5-₹10L) | ~₹9k-₹15k (family, ~₹10L) | ~₹8k-₹14k (family, ~₹10L) | ~₹10k-₹18k (family, SI ~₹10L) |
| Coverage for OPD / Medication | Base plan does not include OPD. "OPD Add-On" available, covers doctor visits, meds, diagnostics. | "Prime" variants can include OPD for medication/consultation. | Base ReAssure ~ no OPD in standard. Add-ons for OPD possible. | Usually no OPD in standard. Some riders might offer limited OPD. | Standard plan excludes OPD, an OPD rider may be purchased. | Some variants might have limited OPD coverage, or optional add-on. | Typically no OPD coverage, unless you add a specific rider. | Some coverage for OPD (dental, vision) in higher variants, subject to sub-limits. | No OPD in standard. Possibly a rider. | No standard OPD coverage. Some add-ons provide partial outpatient benefits. |
| Network Hospitals | ~10,000+ | ~6,500+ | ~8,000+ | ~7,000+ | ~10,000+ | ~4,500-5,000+ (approx.) | ~3,000+ (New India official data) | ~7,200+ | ~6,000-7,000 | ~14,000+ |
| Claim Settlement % (Overall) |
~90-94% | ~90-92% | ~89-90% | ~93-95% | ~93-95% | ~90-93% | ~85-90% (varies year to year) | ~90-92% | ~86-90% | ~90-95% |
| Unique Benefits | - HealthReturns™ & wellness coaching - Chronic management for diabetes/hypertension - Multi-year discount |
- "Cashless OPD" in prime variants - No room rent capping in certain sub-plans - 60 days pre / 90 post |
- "ReAssure" unlimited reinstatement of sum insured - "Lifelong" 2.0 coverage - 20% discount for multi-year |
- "Global" coverage in higher variants - Maternity & newborn cover add-ons - Portable loyalty benefits |
- "Secure, Plus, Protect, Restore" add-ons effectively quadruple coverage - No room rent capping in Secure combos. |
- Digital health platform (ILTakeCare) - Possibly covers mental health sessions in some variants |
- Lower premium for younger segment (Yuva Bharat) - SI from ₹1L to ₹5L - Basic plan with wide coverage. |
- Worldwide emergency coverage - "Medicare Premier" with maternity benefits - High sum insured options |
- Enhanced "No Claim Bonus" - Extra coverage for day-care procedures - Arogya digital platform |
- "Family Health Optima" lumps multiple family members - Automatic restoration 3 times - Newborn cover included. |
| Is Portability Available | Yes (IRDAI norms) | Yes (IRDAI norms) | Yes (IRDAI norms) | Yes (IRDAI norms) | Yes (IRDAI norms) | Yes (IRDAI norms) | Yes (IRDAI norms) | Yes (IRDAI norms) | Yes (IRDAI norms) | Yes (IRDAI norms) |
| Sum Insured (in ₹) | ₹5L-₹2Cr (varies by plan) | ₹3L-₹1Cr or more, depends on variant | ₹5L-₹1Cr (ReAssure) | ₹1.5L-₹50L (higher coverage in top variants) | ₹5L-₹2Cr | ₹3L-₹50L (Elevate) | ₹1L-₹5L typical for Yuva Bharat (some expansions possible) | ₹5L-₹50L | ₹3L-₹50L | ₹2L-₹25L or more (Family Health Optima) |
| Entry Age | 18-65 years (adults). Children from day 1 if parent is covered. | 18-65 years (adults). Dependent children from day 1 or 91 days, variant-based. | 18-65 years. Kids from 91 days onward in family plan. | 18-65 years (adult). Children from 3 months up (floater). | 18-65 years, children from 91 days. | 18-65 years, children from 91 days or depends on plan. | 18-65 years typically. Might vary for Yuva. | 18-65 years (adults). Child coverage from 91 days. | 18-65 years typically, child from 3 months. | 18-65 years. Children from 61 or 90 days. |
| Policy Type (Individual/Family Floater) |
Both - Family Floater or Individual. | Both - Family Floater or Individual. | Both - Family Floater or Individual. | Both | Both | Both | Both | Both | Both | Both |
| Policy Tenure | 1 / 2 / 3 years (discounts for multi-year) | 1 / 2 / 3 years (discounts apply) | 1 / 2 / 3 years (multi-year discount) | 1 / 2 / 3 years | 1 / 2 / 3 years | 1 / 2 / 3 years | Usually 1 year, but might have 2/3-year options. | 1 / 2 / 3 years | 1 / 2 / 3 years | 1 / 2 / 3 years |
| Refill / Restoration Benefit | Yes, "Activ Health Reload" for unrelated claims once SI is exhausted. | Yes, typically unlimited restoration in "ProHealth Prime" for unrelated claims. | Yes, "ReAssure Unlimited" on first claim exhaustion for the same or different illness. | Yes, "Restore" or "Recharge" type benefit depending on variant. | Yes, "Secure + Protect + Restore" can quadruple coverage. | Yes, certain variants have 100% refill for different ailments. | Possibly "sum insured reinstatement" for new claims if base SI used. | Yes, sum insured restoration once in a policy year for unrelated claims. | Yes, re-fill or re-instatement up to 100% if exhausted. | Yes, automatic restoration up to 3 times in the same year for different ailments. |
| No Claim Bonus | Yes, up to 50-100% additional SI over 5 claim-free years. | Yes, up to 200% or more in prime variants for consecutive claim-free years. | Yes, progressive NCB up to 100% or more. | Yes, increments every claim-free year (10-50%). | Yes, up to 50-100% additional SI over time. | Yes, incremental SI for every year of no claims. | Yes, some increment in sum insured each claim-free year. | Yes, can accumulate to 100% or more. | Yes, typically 5-10% each year up to a maximum cap. | Yes, progressive bonus each claim-free renewal. |
*Please read the disclaimer at the end of this page before purchasing any of these policies.*
Our Top 3 Recommended Family Health Insurance Plans
Here is a more detailed breakdown of the top 3 recommended family health insurance plans in India, including additional standout features and limitations.
Aditya Birla Activ Health Platinum Enhanced
Aditya Birla Activ Health Platinum Enhanced is a comprehensive health insurance plan that offers extensive coverage, wellness benefits, and rewards for staying fit. It includes chronic care management, cashless hospitalisation, and HealthReturns™ for maintaining a healthy lifestyle.
Why It Stands Out
Comprehensive Wellness Benefits: Unique “HealthReturns™” program rewards healthy behaviors (e.g., fitness activities, check-ups) and can help reduce effective premiums.
Pre/Post Hospitalisation Coverage: Offers 60 days pre and 180 days post-hospitalisation, which is more than many competitors.
Chronic Management: Specifically caters to chronic conditions like diabetes and hypertension through a “Chronic Management Program,” potentially reducing out-of-pocket costs.
Restoration Feature: Once your sum insured is used, you can automatically “reload” or restore it for an unrelated claim in the same policy year.
Potential Limitations
OPD & Outpatient: The base plan typically excludes OPD (dental, vision) – must add riders for those.
Premium Impact: Additional wellness perks and chronic care coverage can make premiums slightly higher than basic no-frills plans.
Room Sub-limits: Certain variants may impose room-rent caps if not opting for top-tier coverage.
ManipalCigna ProHealth Prime
ManipalCigna ProHealth Prime is a feature-rich health insurance plan offering extensive coverage, including OPD benefits, chronic care support, and no room rent limits. It also provides preventive healthcare benefits and a restore feature to enhance sum insured availability.
Why It Stands Out
Cashless OPD in Prime Variants: One of the few plans offering OPD coverage (e.g., doctor consultations, diagnostics) on a cashless basis in select higher-tier options.
No Room Rent Capping (in specific sub-plans): Allows policyholders to choose any room category without additional co-pay, removing a common headache in health claims.
Shorter PED Waiting: A 24-month waiting period for pre-existing diseases is relatively competitive compared to some that require 36–48 months.
Preventive & Wellness Focus: Emphasises preventive check-ups, wellness incentives, and day-one coverage for certain features, promoting a proactive health approach.
Potential Limitations
Moderate Hospital Network: While 6,500+ is still sizeable, it may be less than some competitors touting 8,000–10,000+ network hospitals.
Disease-Specific Clauses: Certain advanced procedures or high-risk conditions might still have sub-limits or additional underwriting requirements.
Add-On Costs: Premium can increase if you want OPD, daily hospital cash, or other advanced riders.
Niva Bupa ReAssure 2.0
Niva Bupa ReAssure 2.0 is a health insurance plan with unlimited reinstatement of the sum insured, cashless hospitalisation, and chronic care coverage. It also offers booster benefits, no sub-limits on treatments, and rewards for healthy living.
Why It Stands Out
Unlimited ReAssure Refill: Once you exhaust your sum insured on a claim, the policy automatically reinstates it an unlimited number of times for new or even the same illness.
Long Post-Hospitalisation Coverage: Offers 180 days of post-hospitalisation coverage, easing follow-up treatment costs.
Tailored for Families: Designed to handle multiple claims in a single year without running out of coverage – beneficial for large families.
Quick PED Coverage: Depending on the plan variant, some pre-existing conditions may have a 24-month waiting period, which is on the lower side.
Potential Limitations
OPD Not Standard: The base plan typically excludes outpatient coverage; an add-on or a higher variant is needed for routine medical expenses like dental, consultations, or minor procedures.
Premium Range: Comprehensive coverage and unlimited refills can drive up premiums, especially for higher-sum insured options.
Claim Settlement Ratio: While overall in the 89–90% range, some competitors report higher. Individual experiences can vary.
What is a Family Health Insurance Plan?
A family health insurance plan is a single policy that covers the medical expenses of all family members under one plan. Instead of buying separate policies for each person, this plan offers a shared sum insured, which any member can use in case of hospitalisation, surgeries, or treatments. It is a cost-effective and convenient way to ensure everyone, from children to elderly parents, has access to quality healthcare without financial stress.
How Does a Health Insurance Plan for Family Work?
Family health insurance works by providing a single policy that covers multiple family members under a shared sum insured. The premium is calculated based on factors like the eldest member’s age, overall health conditions, and the total number of people covered. If any insured family member needs medical care, they can claim from the total coverage amount, making it a convenient and cost-effective option for households.
Importance of a Family Health Insurance Plan
Family health insurance goes beyond just covering medical expenses. It offers financial security and peace of mind for your loved ones. Here’s why it is a must-have:
Benefits of Buying a Health Insurance Plan for Your Family
Investing in a family health insurance plan is a smart way to secure your loved one’s well-being while protecting your finances. It ensures that medical emergencies do not disrupt your savings and provides access to quality healthcare without unnecessary stress. Here’s why a family health plan is a great choice:
What is Covered in a Family Health Insurance Plan?
A family health insurance plan provides comprehensive coverage to ensure your loved ones receive quality medical care without financial strain. Here’s what a typical plan includes:
What is Not Covered in a Family Health Insurance Plan?
While family health insurance provides extensive coverage, there are certain exclusions you should be aware of. Understanding these limitations helps avoid surprises during claims.
Here’s what is typically not covered:
Eligibility Criteria to Buy a Family Health Insurance Plan
Before purchasing a family health insurance plan, it is important to understand the eligibility criteria to ensure you choose a policy that suits your needs. Insurers consider several factors while determining eligibility and coverage. Here is everything you need to know:
Age Limits
Most plans cover adults between 18 to 65 years, while dependent children can be included from birth up to 25 years.
Medical History
Pre-existing conditions may require a waiting period before coverage begins, and some insurers may ask for medical check-ups before issuing the policy.
Family Size
The plan allows coverage for spouses, children, and in many cases, dependent parents, with a limit on the number of members included.
Premium Payment
The premium amount depends on factors like the sum insured, the number of insured members, and health conditions, and it must be paid regularly to keep the policy active.
Individual vs Family Health Insurance Plans
Choosing between individual and family health insurance depends on your specific needs, budget, and the number of people you want to cover. While individual plans offer personalised coverage, family plans provide a cost-effective way to insure multiple members under one policy. Here’s a detailed comparison:
| Aspect | Individual Health Insurance Plans | Family Health Insurance Plans |
|---|---|---|
| Coverage | Covers only one individual. | Covers the entire family under a single policy. |
| Premium | Calculated based on the individual's age and health. | Based on the number of family members, their ages, and health conditions. |
| Flexibility | Highly customisable with specific coverage and limits. | Less flexible but provides coverage for multiple members under one plan. |
| Policy Renewal | Renewal is done individually for each policyholder. | Renewal happens together for the entire family. |
| Sum Insured | Each individual has a separate sum insured. | The sum insured is shared among family members, which may limit coverage if one member uses a large portion. |
| Pre-Existing Disease Coverage | Subject to a waiting period (typically 2-4 years). | Covered after a waiting period, which varies across plans. |
| Maternity Benefits | Usually not included in basic plans. | Available in some family plans, often after a waiting period. |
| Hospital Network | Access to hospitals within the insurer's network. | Covers a hospital network that provides cashless treatment for all insured family members. |
| Tax Benefits | Premium qualifies for tax deduction under Section 80D. | Premium qualifies for tax deduction under Section 80D for the entire family. |
| Best Suited For | Ideal for singles, newly married individuals, or couples without children. | Ideal for families with children, elderly parents, or multiple dependents. |
| Premium Cost | Can be more expensive per person, especially for older individuals. | More cost-effective as the premium is shared among family members. |
| Claim Process | Claims are filed individually. | Claims are filed for the entire family but may require separate documentation for each member. |
| Exclusions | Based on the individual's health profile. | Common exclusions apply to all members, with some age-specific limitations. |
| Inclusions | Focuses on individual health conditions, surgeries, and critical illnesses. | Covers a wide range of family needs, including maternity, childcare, and hospitalisation. |
| Flexibility in Adding Members | Requires purchasing a separate policy for new members. | Family members can be added or removed during policy renewal. |
| Claim Settlement Ratio | Varies based on the insurer and individual policyholder. | Depends on the insurer and the specific family plan. |
Documents Required for Family Health Insurance Claim Reimbursement
To ensure a smooth and hassle-free claim reimbursement process, you need to submit the required documents to your insurance provider. Having all necessary paperwork in place helps speed up approvals and prevents delays. Here are the key documents required:
1
Basic Documents
Includes the policy document, ID proof (Aadhaar, PAN, or passport), and age proof of the insured member.
2
Medical Documents
Hospital bills, prescriptions, doctor’s certificate, and diagnostic reports serve as proof of treatment and are mandatory for claim approval.
3
Claim Forms
You must fill out and submit the claim forms provided by your insurance provider, detailing the nature of the medical expenses.
4
Bank Details
Account details, including cancelled cheque or bank passbook copy, are required to process the reimbursement.
5
Additional Documents for Special Cases
If the claim involves pre-existing conditions, surgeries, or specific treatments, additional medical reports, and specialist recommendations may be needed.
Key Factors to Consider Before Buying a Health Insurance Plan for Family
Choosing the right family health insurance plan requires careful evaluation of multiple factors to ensure your loved ones get the best possible coverage. From understanding the sum insured to reviewing policy terms, here are the key aspects to keep in mind:
Key Disclaimers & Notes
