A healthy family is the need of the hour. Unpredictable health and well-being can take its toll. Proper selection of family health insurance will help ward off all untoward medical expenditures, hospitalizations, doctor consultations, and preventive measures. Balancing premium costs and adequate coverage always becomes an issue. Let’s learn how to make a suitable choice from the various options available through a family health insurance plan based on the essentials discussed in this blog.
How does family health insurance work?
A family health insurance policy covers more than one member. The sum insured is spread amongst all the covered members based on the policy, which has mostly been issued on a floater basis. For instance, for a policy sum that works out to be ₹10 lakhs, any family member can take the same amount of treatment for illness if it does not surpass the sum insured over the policy tenure.
Family insurance plans cover all family members, from spouses to children and sometimes parents. They are usually calculated based on the age of the oldest member, which adds to the cost again. This may be more feasible than having individual policies for each member, as the coverage will be streamlined, and the premium payments will come under the same umbrella.
Cost vs. Coverage: Essential Balancing Factors
Ideally, you want to identify the right balance between sufficient health coverage and a plan that does not break the bank. The cheapest policy would save money initially but leaves a person vulnerable to out-of-pocket expenses at times of crisis. On the other hand, premium policies may feature a whole range of benefits but may be financially unbearable in the long run.
Some critical factors to consider when weighing cost versus coverage include:
- Family’s Health Requirements: Maintain all existing medical conditions, chronic illnesses, or potential medical expenditures. This would help determine a suitable cover amount.
- Availability of a Good Hospital Network: Choose an insurer with an extensive hospital network, preferably local hospitals, through which one can enjoy cashless treatments.
- Age and Demographics: The family plan premium is age-based. If you cover older parents, the options may be some senior plans or add-ons.
Methods to Get an Affordable Health Insurance Plan without Compromising on Essential Coverages
Proper planning is required to get an affordable health insurance plan without compromising on essential benefits. Instead, choose strategies that offer higher coverage and a low premium.
All family members are covered under a single policy, which is more economical than individual plans. If the base policy is insufficient, you can add a top-up plan that gives coverage over and above a certain threshold. Most insurers increase the sum insured every claim-free year without increasing the premium. Nearly all insurance companies offer discounts if you purchase an online policy. Thus, it is even easier to get comprehensive plans at reduced rates.
What to Expect from a Family Health Insurance Policy
Ensure that the plan you opt for covers all or most of the essential medical expenses; otherwise, there will be nothing but unwelcome surprises. A good family health policy should include the cost related to hospitalization, accommodation charges, and ICU charges following hospitalization. Daycare procedures, such as minor surgical procedures without overnight stays, should also be included.
If you plan to expand your family size, maternity benefits, and newborn coverage should be available. Ambulance service and emergency transportation costs should not be incurred since medical attention is the most important now. One final consideration is the waiting period before pre-existing condition coverage takes effect, which varies from provider to provider.
Common errors to watch out for during policy selection
Among the few things to avoid while choosing a health insurance policy are the risks of compromising financial security or access to care, underestimating coverage needs, and choosing a policy with limited or insufficient coverage that leads to huge bills during emergencies. It would have been better to choose a slightly higher sum insured than get underinsured for all family members.
Most policies cap rent in rooms or specific treatments. Always review these sub-limits to understand the complete scope of the policy. Critical illness coverage can expand the scope of your policy. While they make premiums slightly more expensive, they add an extra layer of protection against unforeseen events. Claiming cash without going through paperwork will be very smooth. One would want an insurer to have a proper network of hospitals with claim procedures so smooth that claims do not hold anyone up in emergencies.
Government health schemes
In addition to private health insurance plans, families in India can benefit from government initiatives like the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PMJAY). This scheme offers free health coverage to economically weaker families, covering significant surgeries and treatments. Even if you have private insurance, these schemes can provide additional support, reducing your financial burden in times of need.
According to a comparative analysis of premium costs and covered benefits, family health insurance plans can now be chosen wisely to suit your spending per premium and coverage. Your family can have a specialized health care service need concerning requirements. Compare several policies and understand which might offer adequate cover without exerting too heavy a price on your budget. Amongst the better options, you can buy family floater plans. Top-up policies, the more you get no-claims bonuses with more savings at every corner.
The essence of health insurance lies not in investing in anything but being a gold investment into your family’s health. An appropriate medical insurance package leaves peace for the entire family when considering getting health care minus the bills from surprises regarding healthcare issues.
