You're at home, surrounded by your family, and suddenly, one of you falls ill. It's a stressful situation, right?
Now, think about how much easier it would be to know that everyone in the family is covered when it comes to healthcare expenses. This is where family floater health insurance comes in. It's a type of health coverage designed to protect not just one individual but the entire family under a single plan. But how exactly does it work and why is it becoming a popular choice?
Well, we’ll dive into that in the next section.
Family Floater Health Insurance Meaning
A family floater health insurance plan is a convenient way to get health coverage for everyone in your family under one policy. Instead of buying separate policies for each member, you get a single larger sum insured, and all family members share that coverage. This means you only need to pay one premium, making it simpler and more cost-effective. Typically, a family floater plan covers immediate family members like yourself, your spouse, and dependent children. However, some policies also allow you to include dependent parents, in-laws, and even siblings, depending on the terms. It’s a great way to ensure that everyone in your family is protected without the hassle of managing multiple policies.
How a Family Floater Plan Works
Let’s break down how a family floater plan works using a simple example.
Imagine the Sharma family: Mr. Sharma, his wife, and their eight-year-old son. Mrs. Sharma buys a health insurance plan with coverage of ₹15 lakh. Now, let’s look at two different scenarios:
In Scenario 1, their son falls ill and needs to be hospitalised. The treatment costs around ₹8 lakh. Since the claim is within the sum insured, the insurance company will cover ₹8 lakh. This leaves ₹7 lakh remaining in the policy for any future medical emergencies.
In Scenario 2, both Mr. and Mrs. Sharma are involved in a car accident and need to be hospitalised. The medical bills total ₹9 lakh. The insurance company will cover ₹7 lakh of the expenses, but the remaining ₹2 lakh will need to be paid by Mr. Sharma.
This is how a family floater plan works—one policy covers the entire family, but the sum insured is shared among all members based on their individual needs.
Benefits of Buying a Family Floater Health Insurance Plan
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Saves Money Compared to Buying Separate Policies
Getting individual health insurance policies for each family member can be expensive. A family floater plan offers a single sum insured that covers everyone under one policy. Since the premium is shared, it is often more affordable than buying separate policies for each person.
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Easier to Manage
Instead of keeping track of multiple policies, renewal dates, and documents, you only need to manage one policy. This makes it convenient and reduces the chances of missing an important renewal or claim-related detail.
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Adjust Coverage as Your Family Grows
Life changes, and so do insurance needs. A family floater plan gives you the flexibility to include a newborn baby or remove a child who has reached adulthood and now needs separate coverage. This way, your policy evolves with your family.
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Shared Coverage Means Better Protection
Since the entire family shares the sum insured, it acts as a backup for medical expenses. If one family member does not use much of the coverage, the remaining amount can be used by others in case of an emergency. This is especially helpful for younger families with fewer medical needs.
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Pre-Hospitalisation Expenses Are Covered
Medical bills start piling up even before admission. The plan covers expenses like diagnostic tests, doctor consultations, and medications for up to 30 or 60 days before hospitalisation.
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Ambulance Charges Are Taken Care Of
Ambulance services can be expensive, especially in emergencies. A family floater plan covers road ambulance expenses during hospitalisation. Some policies even include air ambulance coverage for critical cases.
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In-Patient Hospitalisation Costs Are Covered
If someone in the family needs hospitalisation, a family floater plan covers major expenses. This includes room rent, doctor’s fees, ICU charges, surgery costs, anaesthesia, oxygen and other essential medical services. It provides peace of mind knowing that hospital bills are taken care of.
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Post-Hospitalisation Expenses Are Included
Medical expenses do not stop once you leave the hospital. Follow-up consultations, tests, and medications after discharge are covered for a set period, reducing the financial burden on your family.
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Coverage for Home Treatment When Hospitalisation Is Not Possible
Sometimes, hospitalisation is not possible due to a lack of beds or if the patient is unable to travel. In such cases, a family floater plan covers the cost of home treatment. This ensures that the patient gets the required medical care without worrying about hospital availability.
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Annual Health Check-Ups for the Whole Family
A family floater plan includes an annual health check-up for all insured members. This helps in detecting health issues early and encourages regular medical monitoring.
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Organ Donor Expenses Are Covered
If you or any insured family member needs an organ transplant, the policy covers the medical expenses of both the recipient and the donor. This can significantly reduce the financial stress associated with organ transplant procedures.
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Coverage Continues for Life
As long as you renew the policy every year, the coverage remains intact for a lifetime. This ensures that you and your family stay protected, regardless of age.
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Cashless Hospitalisation for Hassle-Free Treatment
With cashless hospitalisation, you do not need to arrange money upfront for treatment. If admitted to a network hospital, the insurer settles the bills directly with the hospital, allowing you to focus on recovery instead of worrying about payments.
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Daycare Treatments Are Included
Not all treatments require a long hospital stay. Medical procedures that are completed within 24 hours, such as cataract surgery or chemotherapy sessions, are covered under daycare treatment benefits.
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Preventive Health Check-Ups Are Part of the Plan
Preventive check-ups help identify health problems before they become serious. Routine screenings are included, ensuring that medical conditions are detected and treated at an early stage.
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Coverage for AYUSH Treatments
If you prefer alternative treatment methods, you are covered. AYUSH treatments, which include Ayurveda, Yoga, Unani, Siddha, and Homeopathy, are included in family floater plans. This allows you to choose treatments based on personal preferences and medical needs.
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Tax Benefits Under Section 80D
Apart from health security, a family floater plan also provides tax benefits. Under Section 80D of the Income Tax Act, you can claim deductions on the premiums paid.
- If all insured members are under 60 years, you can get a deduction of up to ₹25,000 per year.
- If you are covering parents above 60 years, the deduction increases to ₹50,000.
This helps you save money while ensuring your family gets the best healthcare.
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Get Insured—Download Freo Today!What is Covered in Family Floater Health Insurance?
Family floater health insurance is designed to cover your entire family under one plan, it offers a wide range of medical benefits that ensure financial protection during health emergencies. Here’s what is usually covered under this policy.
- Hospitalisation Costs: Covers expenses like room rent, surgery, doctor’s consultation, nursing charges, and medicines during hospital stays.
- Pre and Post-Hospitalisation: Medical costs incurred before and after hospitalisation (usually 30 to 60 days prior and up to 90 to 180 days after discharge) are included.
- Daycare Procedures: Covers treatments that require less than 24 hours of hospitalisation, such as cataract surgery or dialysis.
- AYUSH Treatments: Provides coverage for alternative treatments like Ayurveda, Yoga, Unani, Siddha, and Homeopathy, based on policy terms.
What’s Not Covered in Family Floater Health Insurance?
When you get a family floater health insurance plan, it’s important to know what it doesn’t cover. Understanding these exclusions can save you from surprises down the road. Here are a few things that are typically not covered under these plans:
- Treatment for Sexually Transmitted Diseases (STDs): Health insurance usually doesn’t cover treatments for diseases like AIDS and other STDs. This is something you’ll need to consider separately if needed.
- Diseases During the Waiting Period: Every insurance policy has a waiting period, and during this time, certain treatments or diseases may not be covered. This means if you develop a health issue during the waiting period, you may have to pay for treatment out of pocket.
- Treatment for Diseases Due to Substance Abuse: Health insurance plans typically exclude treatment for conditions caused by the abuse of alcohol, drugs, or other substances. If someone in your family is dealing with such issues, this might not be included in your family floater coverage.
So, when you’re choosing a plan, make sure to check the terms carefully. It’s always a good idea to read through the fine print so there are no surprises later on.
Comparison of Family Floater and Individual Health Insurance
Family floater health insurance covers all family members under a single sum insured, whereas individual health insurance provides separate coverage for each insured person with their sum insured.
| Feature | Family Floater Health Insurance | Individual Health Insurance |
|---|---|---|
| Coverage | One sum insured shared by all family members. If one person makes a claim, the remaining amount is reduced for others. | Each person gets a separate sum insured, ensuring full coverage for individual medical expenses. |
| Premium | More cost-effective when covering multiple family members, as the premium is lower than buying separate policies. | Higher overall cost if multiple individual policies are taken, as each person has their own premium. |
| Benefits | Works well for families with young, healthy members who don’t require frequent medical care. | Better for individuals who want full coverage without sharing benefits with others. |
| Members Covered | Covers spouse, children, and sometimes parents under one plan. | Covers only the policyholder. Separate policies are needed for each family member. |
Who Should Consider a Family Floater Health Insurance Plan?
If you're a young family with healthy members, a Family Floater Health Insurance Plan can be a great option for you. However, if your family includes seniors, it's a good idea to rethink the Family Floater plan. Here's why:
- Higher Health Risks for Seniors: Older family members are more likely to face health issues, and their treatments can be expensive. A Family Floater plan might not cover these high medical expenses adequately, leaving other members with less coverage.
- Better Protection with Individual Plans for Seniors: For seniors, it's usually better to purchase separate health insurance plans. This ensures that their medical needs are covered fully without affecting the coverage of younger family members.
Things to Consider When Choosing a Family Floater Plan
When you're picking a family floater plan, it's important to think through a few important points to make sure you're getting the best coverage for your needs. Here's a quick guide to help you out.
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Sum Insured
First, you need to think about how much coverage your family might need. Look at things like age, existing health conditions, and your family's lifestyle. A good rule of thumb is to choose a sum insured that can cover any major medical expenses that might come up, so you're not caught off guard later.
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Family Composition
Decide who will be covered under the plan. This might include your spouse, children, parents, or in-laws, depending on the terms of the plan. Not all family floater plans are the same, so make sure the plan includes everyone you want covered.
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Coverage Options
Make sure you fully understand the coverage offered by different plans. This includes:
- Hospitalisation expenses: Covers the costs of staying in the hospital for treatment.
- Pre- and post-hospitalisation costs: Includes expenses before and after hospitalisation, like doctor's consultations and medication.
- Daycare expenses: Covers treatments that don’t require 24-hour hospitalisation.
- Critical illness coverage: Protects you against serious conditions like cancer, heart disease, etc.
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Claim Settlement Ratio
Before finalising the plan, take a look at the insurance provider’s claim settlement ratio. This tells you how often they settle claims and how smoothly the process goes. A higher ratio generally means a better chance of your claim being processed quickly and without hassle.
Closing Thoughts
In the end, a family floater health insurance plan can be a smart choice for many families, offering coverage for everyone under one policy. It simplifies the process and helps save money, while also providing peace of mind in case of health emergencies. Just be sure to choose a plan that fits your family’s needs and take the time to understand all the details.
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