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Family Floater Health Plan

What is a Family Floater Health Plan?

Want to secure your family’s medical needs? Buying a family floater health plan is the answer. Unlike individual health plan, the family floater plan is a tailor made health plan that provides coverage for your entire family in a single plan. If any member of your family falls ill and needs hospitalization, this health plan covers the medical expenses up to the sum insured available under the plan.

Moreover, choosing a family floater health policy is quite a cheaper option than buying individual health plan for every member of your family. With this health plan, families can also get a higher sum assured. The family floater plan covers the individual, spouse and children. However, some insurers also cover dependant parents, siblings, and parent-in-laws under the plan.

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Why should I buy Family Floater Health Plan?

There are various factors listed below which will make it imperative to buy a Family Floater Health Plan.

Affordable Health Cover

Everyone nowadays are looking for an affordable health cover that can provide an adequate sum assured for the entire family. Buying a right family floater health plan is a beneficial and cost-effective option than taking individual health plans for every member in the family.

Combat Rising Health Care Costs

The cost of medical treatment is rising at a fast pace and it has become unaffordable for a common masses to pay for the hospitalization expenses from their pocket. A family floater health plan is quite helpful in case of medical emergencies, as it pays for the medical expenses during medical exigencies.

One Plan for Family’s Healthcare Needs

In the present age of hustle & bustle, everyone like to buy a health plan that can easily cater the healthcare needs of the entire family. Buying a family floater health plan fulfill your family’s healthcare needs under one plan. Lifestyle choices such as lack of physical activity, consumption of junk & processed food, Watching too much television, addiction to gadgets, and other factors are adversely affecting the health of young adults and children. These unhealthy lifestyle habits lead to several serious health issues that require urgent medical attention. It becomes quite imperative to buy a family floater health plan to fulfill the medical needs of your family.

To Get Financial Protection

Planning your finances is quite essential to take care of all your family expenses smoothly. The rising medical treatment costs can bring panic to your finances and unstabilize your financial integrity. Buying a family floater health plan helps you with a financial protection which will take care of the medical expenses for your entire family.

What are the Benefits of Buying a Family Floater Health Plan?

The listed below are the benefits of buying a family floater health insurance plan.

1. Policy Benefits

Covers Hospitalization Expenses

Family floater health insurance plan covers your entire family for paying the hospitalization expenses, which include

  • Inpatient Hospitalization Expenses

    A family floater health plan covers the medical expenses that are arising from 24 hours of hospitalization of any of the family members. Hospitalization expenses occurred due to an accident or illness are covered under the plan. It usually pays for room rent, nursing, medical practitioner, anesthesia, blood, oxygen, surgical appliances, operation theater charges, medicines, drugs, consumables, and other devices required during a surgical procedure.

  • Pre Hospitalization Expenses

    The medical costs that are incurred 30 days (may differ from insurer to insurer) before the actual hospitalization are reimbursed as specified under the scope of the plan and it may include medicine expenses, laboratory tests, doctor visit, etc.

  • Post Hospitalization Expenses

    The medical costs that are incurred 60 days (may differ from insurer to insurer) after discharge from the hospital are reimbursed as specified under the scope of the plan and it may include expenses incurred for a follow up with the doctor, diagnostic tests, etc.

Day Care Procedures

Certain medical treatments that do not require minimum 24 hours of hospitalization are also covered under this health insurance policy. Medical expenses incurred in day care procedures are reimbursed as specified under the scope of the plan.

Domiciliary Treatment

Expenses incurred from the medical treatment done at home on the advice of the Medical Practitioner, due to non-availability of the hospital bed or when the patient is not in a condition to be transferred to the hospital, are also reimbursed as applicable under the policy.

Hospital Cash Benefit

A hospital cash allowance is payable on a day to day basis. The hospital cash benefit depends on the terms of the policy. A minimum stay in the hospital as specified is required to avail this facility.

Organ Donor

The medical expenses incurred in the donation of an organ are reimbursed subject to the terms specified in your family floater health insurance plan.

Cashless Treatment

With a family floater health plan, you may avail cashless medical treatment for an illness or disease of any member of your family, provided the insured is hospitalized in one of the network hospitals as specified by the insurer.

No Claim Bonus (NCB)

You are entitled to receive a no claim bonus under a family floater health insurance policy in the event of claim free policy year. You will obtain the NCB benefit as a discount towards reduction in the future premiums for the health plan.

2. Add on Benenfits

Higher Cover

Each family member can use the entire sum assured available under the plan. With this, each insured person gets higher coverage and it helps them get the treatment done without any worries.

Cheaper

The premiums under the family floater health plan is quite less for the premiums paid in individual plans for each and every family member. It provides you an option to get an adequate health cover in a cost-effective manner.

Cover for Senior Citizens

Usually, insurers deny renewing individual health policies for senior citizens beyond a certain age. When getting a health cover in a family floater plan, such issues don’t arise.

Flexibility to Add Members

A family floater plan provides you an easy option to add members in the health policy in case you get married, the birth of a child, or can add parents in this policy too.

Hassle Free

A family floater plan requires you to pay for a single plan. Now, you don’t need to maintain separate policies and tracking renewals. It’s quite easy to manage.

Tax Benefits

The premium amount you pay for the health policy is considered for tax benefit under section 80D of the Income Tax Act 1961. These benefits are subject to change in tax laws.

Free Health Checkups

Insurers also offer you to undertake free health check ups at the time of renewal of your policy or as an inbuilt add on cover as applicable under your policy.

(Note: The benefits mentioned above may differ from one insurer to another. Read your chosen Family Floater Health policy wordings carefully for more details)

How is my Premium Calculated?

Following are the key determinants for computing the premium amount for your chosen Health Insurance Plan.

Sum Assured

The sum assured you opt for, determines the premium amount for the family floater health plan. Choosing the adequate sum assured keeps you covered during medical emergencies. The higher sum assured under your health plan attracts higher premium amount.

Age

In family floater plans, the insurer determines the premium amount on the basis of the eldest member under the plan. More is the age of the eldest member, higher will be the premium amount. If the age of the eldest member is 40+ years, you need to pay higher premiums than a family whose elder member is having the age of 25 years.

Number of Insureds

The number of family members included under a family floater health plan also determines the premium amount for the plan. More, the number of insureds covered under the plan, higher the health risk involved and you are required to pay the higher premium amount.

Pre-existing Health Condition

If any member of your family covered under the plan has the pre-existing health condition, your insurance company will charge the higher premiums, considering the health risk involved.

Present Health Condition

Personal health is a key determinant that decides the premium amount for the plan. If the family members included under the plan is healthy, it tends to reduce the chances of getting hospitalized, so the lesser premium amount needs to be paid. If one of the insureds covered under the plan has any genetic disease the health insurance premium will be high or the disease would be omitted from the coverage, depending on the terms and conditions laid by the insurance company. Moreover, if insured’s are in a habit of taking drugs, consumption of tobacco, or smoking, you are charged at higher premium rates.

Claim Free Years

Getting a claim free year may result to discount on the premium rates on the renewal premium or an increase in the sum assured under the plan. No claim bonus earned under your health plan may reduce your premium amount in the subsequent years.

Co-Payment

It is a portion of the claim amount that the insured agrees to pay and the remaining claim amount is then paid by the insurer. A co-pay in the health plan leads to a reduction in the premium amount.Higher the co pay amount or percentage, lower the premium.

Voluntary Deductibles

It is a potion of the claim amount not covered by the insurance company as applicable under the policy. Opting for voluntary deductibles could lower the premium amount for the health plan.

Add on Covers

By taking the add-on covers, the additional premium amount for the riders attached to the family floater policy needs to be paid. So, on choosing add-on covers, you need to pay higher premium amount as the coverage for the policy is also increased.

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What are some Smart Buyings Tips?

Following are some of the key buying tips you can follow to buy the Family Floater Health Insurance Policy.

Buy Adequate Health Cover: When buying a plan, you need to choose the sum assured that can easily cover the medical expenses and is adequate for your family’s health treatment expenses. If you are under-covered, you need to pay bills from your pocket, and if over-covered, you need to pay high premiums for a health cover that your family don’t require. It is thus recommended to be prudent in choosing the right sum assured amount.

Co-Pay Clause: Under this clause, a specific percentage of the claim amount is borne by the insured. The higher the co-pay amount, lower will be the premium amount, but it is imperative to ensure that in order to save premium you do not have to pay the claim amount from your pocket that you can’t afford.

Sub-Limits: A Sub-limit clause under the health plan provides a monetary cap towards the amount of coverage available in case of health insurance claim. Usually, the sub-limits are available on room rent and certain illness or treatments. Due to health complications, if your medical bill costs Rs. 1 lakh and the sub-limit for that specific treatment is Rs. 45,000 then in that case you need to pay the remaining bill amount Rs. 55,000 from your pocket. The health condition of the insureds is a key factor you need to assess before opting the sub-limit under the family health plan.

Waiting Period: Waiting period comes into effect after the issuance of the health policy. It is a time period during which claim is not admissible by the insurer. It is thus advised to read through the conditions laid down under waiting period section of the policy.

Day Care Procedures: There are some medical treatments that don’t require 24 hours of hospitalization. Most of the insurers offer coverage for day care procedures. It is thus recommended to go through the list of day care procedures covered under the family health plan, you are going to opt for.

Opt for Plan with Auto Restoration Facility: Auto restoration facility health plans will restore your health cover in case the same is exhausted due to claims in the policy year without an additional cost. As the sum assured available under the family floater plan is used by every member of the family, so chances are higher that it may exhaust early and in this scenario, it would be a wise move to opt for plans offering Auto restoration facility.

Check the Network Hospitals: You should verify the list of network hospitals and make sure that those hospitals have specialty services and equipped with advanced technology, so that it can easily cater your and your family’s health care needs. You can also check the distance of listed network hospitals from your home, as it would be helpful in case of medical emergency.

Inquire about Insurer: Prior buying a health plan, it is quite essential to check the insurer’s background, servicing capability, and claims efficiency. The claim settlement ratio is a major factor to assess before buying a plan. It is recommended to choose the insurance company with higher claim settlement ratio and fastest claim settlement turnaround time.

Opt for Requisite Add Ons: Don’t rush into getting all add on covers under your plan. Every family member has a different requirement based on the health condition. Choose the requisite riders, providing adequate coverage.

Read Plan Reviews: Before buying a health plan, it is recommended to read customer reviews online. It helps you assess whether the plan you are going to buy would be the right fit to your family’s healthcare needs.

Consider Policies with NCB Benefit: NCB benefit is provided to the insured in case of a claim free year. It would be a better option to choose a health plan that offer NCB benefits, as it helps you lower the future premiums in case of a preceding claim free year.

Compare and Buy Online: It is prudent to compare family health plans from several insurers available online. Assess the benefits of health plans and then choose as per your family’s health condition. Buy a family floater health plan to ensure your family is having an adequate cover. Buying the plan online also offers you opt for discounts.

Read the Policy Wordings Carefully: You may get excited to buy the cheapest plan offering a bundle of benefits, but don’t forget to read the terms & conditions and inclusions & exclusions of the policy contract carefully before buying, to avoid any issues later. Your insurer also provides you with a free look period during which if you are not satisfied with the plan, you may get it cancelled.

Is there any Add on Cover/Rider with Family Floater Health Plan?

Add-on covers attached to your family floater health plan simply help you enhance the protection level. Listed below are the options.

Critical Illness Cover

Critical Illness refers to illness, disease, or sickness which even after the treatment drastically affects the lifestyle of the patient. With Critical Illness add on the cover, the insured is provided with an immediate fixed amount plus the rider cover expenses incurred during the medical procedure as well. By having critical illness cover, you and your family are covered for a wide range of critical illnesses. Critical Illness can also be taken as a stand alone policy. Many insurers have separate Critical Illness plans under their health portfolio.

Hospital Cash Cover

Hospital cash rider provides for the daily cash that you may need for compensating the medical expenses during the stay in the hospital. Typically, you can claim benefits an amount depending on the nature of your stay. You can also claim a higher payout in case you are admitted to ICU. You will be eligible for the rider payout in case you or any other insured under the plan is hospitalized for a minimum of 24 hours.

Room Rent Waiver

This add-on cover enables you to enjoy higher sub-limits for room rent in case of hospitalization. A basic family health plan typically provides a defined sub-limit on room rent. With the help of a room rent waiver cover, you can choose a better room for your hospitalization which would not eat the sum insured available in the family floater health plan.

Personal Accident Cover

Many insurers have this as an inbuilt rider in their health plans. With this add-on cover, the insureds under the plan are covered against the risks that may arise due to the total or partial disablement or death caused by accidents. Personal accident plans are typically offered as an add on cover by paying an additional premium amount. The Personal Accident Plan can also be taken as a stand alone policy. Many insurers have separate Personal Accident Plans under their health portfolio.

Top Up/Super Top Cover

A top-up health policy provides additional coverage to those who have a running health plan. This plan covers the medical expenses that may arise due to an illness/injury over and above the limit of the actual cover. A top-up health plan works by ‘single incidence hospitalization’, however, a super top-up plan looks at the aggregate claim. A super top-up health plan puts together several incidence of hospitalization to cover the medical bills. It covers a total/aggregate of the medical bills in a year, not just the single instance of hospitalization.

Surgical Expense Benefits Cover

In case the insured is hospitalized for undergoing surgery for a period of at least 24 hours, a lump sum benefit is paid subject to benefit limits and conditions mentioned under the rider. The benefit amount varies depending on the grade of the surgery and the plan opted, so it is advisable to read through the fine print.

Maternity & Newborn Baby Cover

It is one of the most important add-on covers for your family floater health insurance policy. This rider covers maternity expenses related to the delivery of a child and it also includes treatment of mother and child till the discharge from the hospital, provided the mother is an insured person under the plan. Expenses related to pre & post hospitalization and pre & post-natal care is also covered as applicable under the rider benefits.

Several health insurers cover the newborn right from the birth. The medical expenses incurred in the treatment of the new born baby of the insured for a maximum period of 90 days from the date of birth.

(Note: The rider benefit, conditions, and eligibility criteria may vary from insurer to insurer)

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What is NOT included in the Family Floater Health Plan?

Following are the conditions/exclusions that are not included in your Family Floater Health Plan.

• All pre-existing diseases (Any illness that had symptoms or received medical treatment within 4 years of commencement of the first policy).

• Any claim arising with-in the first 30 days from the commencement of the health policy is not covered, except accidental injury claims.

• During the first year of your policy, some specific illnesses such as Cataract, Hysterectomy for Menorrhagia/Fibromyoma, Hydrocele, Benign prostatic hypertrophy, Hernia, Congenital Internal diseases, Fistula in anus, piles, sinusitis and related disorders are not covered.

• Circumcision unless for treatment of a disease.

• Cost of hearing aids, specs, and contact lenses.

• Pregnancy or childbirth related treatments.

• Naturopathy treatment.

• Dental treatment/surgery.

• Convalescence, congenital external defects, the use of intoxicating drugs / alcohol, intentional self-injury, general debility, expenses for diagnostic tests related to the disease for which the insured has not been hospitalized.

(Exclusions may differ from one insurer to another and plan to plan.)