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  • Family Floater Health Insurance

    Overview

    A family floater policy is one where several members of a single family can be covered for a sum assured by paying a single premium in a year. In case of multiple illnesses in the family, the sum assured can be distributed between family members and multiple claims entertained. It works out to be more cost-effective than taking individual policies separately in the name of family members. Most health insurance companies in India offer family floater policies.

    Key Features:

    • One of the key features of a family floater is that the sum assured can be extended to cover several members of the same family if the need arises. Depending on the healthcare risk appetite and the location, the primary policyholder may zero in on a higher or lower sum assured and it reflects in the premium accordingly.

    • The covered members of a family floater may go in for cashless hospitalization if they intimate their insurer within 24 hours of their hospitalization and get admitted in a network hospital. In some cases like emergency hospitalization or accidents or admission in non-network hospitals, insurers may allow treatment first and reimbursement later.

    • The policy may include room rent up to a certain amount per day, for every day of hospitalization.

    • Some family floaters work on the co-pay basis, where the insurers pays a percentage of the cost incurred and the insurer the rest. This usually has lower premium as the insured shares part of the hospitalization costs.

    • Most companies seek a medical examination if a higher sum assured is involved, any of the covered members are in the higher age groups or have a medical history. Some insurers also offer their policies online, where barring exceptions, a declaration of good health by the insured does not require any medical check-ups.

    Top Insurers Providing ‘Family Floater Insurance’:

    There are several family floater plans from leading insurers with a variety of benefits. Some of the plans are:

    • Oriental General Insurance - Happy Family Floater:

      The key features of this Happy Family Floater plan:

      • The Happy family Floater from Oriental General Insurance, is for the entire family it includes cover for Self, Spouse, Children, Parents, and Parents in Laws.
      • They have 2 variants for the Happy Family Floater, and are available in Gold and Silver.
      • The policy will provide daily hospital cash benefit, as per the Gold variant and will have a limit of 0.1% of the sum assured or maximum of 10 days.
      • An attendant allowance will be provided under the gold scheme, if the child below 10 years is admitted. Rs. 500 per day will be paid to a maximum of 10 days.
      • Ambulance services are also covered under both variants, Silver - Rs. 1000/- or 1% of the sum insured; Gold - Rs. 2000/- or 1% of the sum insured.
    • Max Bupa - Heartbeat Family First (Gold):

      The key features of this Heartbeat Family First (Gold) are:

      • The costs of medical treatment while any of the insured individuals are admitted in the in-patient care.
      • Both pre and post hospitalization will be covered under this policy, the pre-hospitalization will be covered for 30 days prior to you getting admitted, and post hospitalization will be covered up to 60 days after discharge.
      • Maternity Benefits will be covered under this plan as well as the new-born. The new-born will be covered as an insured member of the family without the need of extra premium.
      • Vaccination expenses for the new-born is also covered under this plan.
      • This plan doesn’t have an age limit, all family members will be insured irrespective of age.
      • Cashless facility will be provided within 4 hours at any of the network hospitals.
    • ICICI Lombard - Complete Health Insurance:

      The key features of this Complete Health Insurance are:

      • There’s not maximum entry age for this plan, and the insured will not require to go through medical tests if they are below the age of 46 years.
      • This policy will be for the whole family from children to parents. At least 1 proposer should be over the age of 18 years when purchasing this policy.
      • The policy covers expenses like in patient hospitalization for 24 hours and above including medicine and drugs costs, surgeon fees, room charges etc.
      • Both pre and post hospitalization will be covered under this policy, the pre-hospitalization will be covered for 30 days prior and post hospitalization will be covered up to 60 days.
      • Cashless facility is available in over 4000 partner hospitals.
    • Apollo Munich - Optima Restore:

      The key features of this Optima Restore policy are:

      • With this policy, pre and post hospitalization will be covered under this policy, the pre-hospitalization will be covered for 60 days prior and post hospitalization will be covered up to 180 days.
      • In-patient care is provided for 24 hours and above, this also provide cover for medical expenses for all day care processes which is less than 24 hours.
      • The policy covers treatment of organ transplant for the donor, in the time an organ transplant is needed.
      • Up to Rs. 2000/- is covered for ambulance charges in case of emergencies.
      • A lump sum amount is provided for choosing shared accommodation, in network hospitals.
    • Bajaj Allianz - Family Health Guard:

      The key features of this Family Health Guard are:

      • With this policy Family Health Guard, both pre and post hospitalization will be covered under this policy, the pre-hospitalization will be covered for 60 days prior and post hospitalization will be covered up to 90 days.
      • All expenses will be paid for at the time of being admitted in the in-patient care, will include room rates, all medical consumable products, medical procedures, etc.
      • Up to Rs. 1000/- is covered for ambulance charges in case of emergencies.
      • Medical Check-up for a continuous 4 years for the whole family.

    Understanding Family Floater Health Insurance

    What is family floater insurance?

    Family floater is a health insurance policy that covers multiple members of the same family under a single premium. Thus many individuals belonging to the same family can be covered for health exigencies at a reasonable cost.

    How many members of a family can be covered?

    Most of the health insurance companies limit the family member to the primary insured, his spouse and children. However, there are some insurers who even allow coverage for parents, siblings and other relatives under the same policy.

    What happens if the sum assured is reached in treatment of a member?

    Some companies cap the limit on hospitalization strictly on the sum assured being reached in a calendar year. Yet, some insurers offer an automatic restore/top-up facility on the sum assured being reached.

    Is there a no-claim discount on premium?

    Yes, no claim discounts up to a certain amount are available from certain insurers. If there is no claim on a family floater policy, the premium reduces the next year as per policy wording on the same.

    Advantages of Plan

    Family floater insurance offers the following benefits:

    Cost-effective insurance

    Family floater policies offer the benefit of a sum assured which can be shared across members of a family and can come in handy because the chances of all members falling sick in a calendar year are rare. If there are multiple illnesses in family, then the sum assured can be distributed among the family members. But the premium has to be paid once and is cheaper than availing individual policies for each of the family members.

    Tax benefits

    Premiums paid for Family Floater can benefit from tax deductions under section 80D of the Income Tax Act. Amounts up to Rs. 15,000 are allowed for deduction on health insurance premium for self, spouse and children. This gives additional exemption of Rs. 20,000 if senior citizens are covered. This means if someone takes family floater insurance covering his immediate family and parents who are senior citizens, he can save up to Rs. 35,000 in taxes.

    Sum Assured can be restored

    In case you are worrying about what happens if due to a hospitalization of one family member, the sum assured gets exhausted, some insurers offer automatic restore/top-up of sum assured by 100%. This takes care of worries about recurring hospitalization in the same year.

    Cashless treatment

    Family floater also allows the insured to be treated cashless at any network hospital. Policyholders need not pay expensive consultation fees, diagnosis tests, room rent and so on. All these expenses, up to the sum assured, are automatically covered by the policy.

    Who should buy this plan?

    Family floater is ideal for someone who is married and has children. This is also good for those who wish to cover their parents who are senior citizens. Overall, this offers a good option for insurance which is cost-effective and inclusive.

    Exclusion – What is not covered under Family Floater Insurance?

    • Pre-existing diseases are not covered up to a certain exclusion period under family floater plans
    • Admission of senior citizens beyond 60 may be a problem and may increase the premium substantially, as their risk is perceived to be higher. However senior citizens covered prior to attaining 60 can enjoy continued coverage when policy is regularly renewed.
    • Childbirths are not usually covered. But now insurers have started offering coverage for birth as well as cover for the new-born starting with birth.
      • Most insurers don’t cover treatments arising out of attempted suicide, nuclear attacks and so on.
      • Most insurers also do not allow experimental treatment, treatment for HIV/AIDS, congenital disease, non-medical expenses under their policies.

    An Example

    Let’s take an example. Suppose Rajiv an IT executive aged 38 years, took a family floater cover for his wife and two kids below 12 years for Rs. 16,000, with a sum assured for Rs. 5 lakh. Next year, his parents aged 60 and 58, arrived from his village to stay with him and he extended the family floater to include them under the same sum assured. His new premium now comes to Rs. 30,000. Rajiv can claim tax deduction of upto Rs. 35,000 for his family floater policy per year.

    If Rajiv had taken separate policy for Rs. 5 lakh for his parents, it would have cost him around Rs. 25,000. The total cost in addition to his nuclear family’s coverage would have come to Rs. 16,000+25,000=Rs. 41,000. Hence a family floater saves him Rs. 11,000 every year.

    You may also be interested about:

    Health Insurance Plans for Individuals
    Health Insurance Plans for Senior Citizens
    Critical Illness Insurance Policies
    Group/Employer Health Insurance
    Cashless Health Insurance Policies
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