What Is A Family Health Insurance Plan?
Family Health Insurance is a type of medical insurance that covers all your family members under a single health insurance policy. In this type of insurance, a fixed sum insured is shared by all the family members with a common assumption that not everyone will get sick at the same time.
Paying a premium for different family members under different health insurance policies can be exhausting or very confusing. Instead of that, buying one Family Health Insurance policy that includes all your family members and paying a single premium on the same will be more promising and convenient. It also makes the expenses more affordable to spend on a health insurance plan.
List of 20 Best Family Health Insurance Plans in India
Finding the right family health insurance plan isn’t just about ticking boxes—it’s about securing peace of mind for you and your loved ones. To make your decision easier, we’ve put together a comparison table of 18 popular family health insurance plans. Take a look and find the one that best fits your needs!
| Plan Name | Sum Insured (₹) | Key Benefits |
| Max Bupa Health Companion | 3L – 1 Cr | Cashless hospitalization, No claim bonus, Maternity cover |
| HDFC ERGO Optima Restore | 3L – 50L | Restore benefit, Lifelong renewability, 100% sum insured restoration |
| ICICI Lombard Complete Health Insurance | 2L – 50L | No sub-limits on room rent, Wellness benefits, OPD coverage |
| Star Family Health Optima | 3L – 25L | Auto-recharge of sum insured, Maternity cover, Ambulance cover |
| Care Health Insurance Family Floater | 5L – 75L | No claim bonus up to 150%, Annual health check-up, International second opinion |
| Niva Bupa ReAssure | 5L – 1 Cr | Unlimited sum restore, Booster benefit, Organ donor cover |
| Tata AIG Medicare Premier | 5L – 50L | Global cover, High maternity limit, No room rent cap |
| ManipalCigna ProHealth Protect | 2.5L – 1 Cr | Critical illness add-on, Worldwide emergency cover, OPD cover |
| Aditya Birla Activ Health Platinum | 3L – 1 Cr | Reload benefit, Wellness rewards, Chronic disease management |
| SBI Arogya Supreme | 3L – 50L | 20+ coverage benefits, Alternative treatments, Daily hospital cash |
| Religare Health Care Plus | 4L – 25L | No sub-limits on room rent, Wellness benefits, and OPD coverage |
| Future Generali Health Total | 3L – 50L | AYUSH cover, Free health check-up, Maternity benefits |
| IFFCO Tokio Family Health Protector | 2L – 30L | No sub-limits, Ambulance cover, Critical illness add-on |
| New India Assurance Family Floater Mediclaim | 2L – 10L | Government-backed, Lifetime renewability, OPD cover |
| Kotak Mahindra Health Care | 2L – 50L | Maternity & newborn cover, Free annual health check-up |
| Bharti AXA Smart Super Health | 3L – 50L | Critical illness cover, No co-payment, Cashless hospitalization |
| Royal Sundaram Lifeline Supreme | 4L – 50L | Worldwide coverage, No-claim bonus, Annual preventive check-up |
| United India Family Medicare | 3L – 25L | No room rent cap, pre- & post-hospitalization, Ambulance cover |
Why You Need A Family Health Insurance Plan
Before buying a family health insurance plan, let’s know why we have to buy it.
Here are the benefits if you take a family health insurance plan:
- Hospitalization covers expenses smoothly
- Parents get covered under the same Insurance plan
- Premiums are much more affordable than taking individual policies
- Any newborn can be accommodated easily under the existing family policy
- Cover for COVID for the whole family
- Tax benefits
- Add-ons can be easily availed according to the family’s needs.
Who is Eligible for a Family Health Insurance Plan?
Wondering if you qualify for a family health insurance plan? Here’s a quick breakdown of the eligibility criteria, including who can be covered and the age limits for enrollment.
| Eligibility Criteria | Details |
| Minimum Entry Age | 18 years (Adult), 90 days (Children) |
| Maximum Entry Age | 65 years (Adult), 25 years (Children) |
| Who Can Be Covered? | Self, Spouse, Dependent Children, Parents, Parents-in-law |
| Renewability | Lifetime Renewability Available |
Individual Health Insurance vs Family Health Insurance Plans
When deciding between individual and family health insurance plans, it’s essential to understand their key differences to select the coverage that best suits your needs. Here’s a comparative overview:
| Aspect | Individual Health Insurance | Family Health Insurance |
| Coverage | Provides medical coverage for a single person. Each family member requires a separate policy. | Covers the entire family under a single policy. The sum insured is shared among all members. |
| Sum Insured | The entire sum insured is dedicated to one person, ensuring full coverage for that individual. | The sum insured is shared among all insured family members, which can be utilized by any member as needed. |
| Premium Calculation | Premiums are based on the age, health condition, and coverage needs of the individual insured. | Premiums are determined based on the age of the eldest family member and the number of members covered. Typically, it is more cost-effective than multiple individual policies. |
| Cost-Effectiveness | Can be more expensive for families since each member needs a separate policy. | More economical for families as a single policy covers multiple members. |
| Claim Process | Only the insured individual can claim the benefits. | Any insured family member can claim benefits, subject to the available sum insured. |
| Suitable For | Individuals seeking personalized coverage tailored to their specific health needs. | Families looking for comprehensive coverage under one policy, especially when members are unlikely to require simultaneous high-cost treatments. |
What You Must Know About Family Health Insurance
What Does Family Health Insurance Cover?
Some important inclusions of coverage under a Family Health Insurance Plan are mentioned below :
- Day Care Procedures: This covers the expenses of daycare procedures that might require hospitalization of fewer than 24 hours.
- Pre/Post Hospitalization Charges: The expenses incurred before hospitalizing a family member, which include tests, medical investigation, etc and the charges incurred after discharge, which include follow-up tests or consultations, etc, are covered up to a limited number of days.
- Ambulance Charges: This includes the charges spent on an ambulance service to the hospital during any medical emergency for a family member covered under the health insurance policy.
- Inpatient Hospitalization Charges: This includes any medical expenses incurred for an inpatient hospitalization for more than 24 hours resulting from an illness or accidental injury.
- Home Care: The policy will pay for domiciliary treatment on the advice of the doctor.
- AYUSH Treatment: The AYUSH includes Ayurveda, Homoeopathy, Yoga, Siddha, and Unani,i and any hospitalisation expenses incurred to take these treatments also will be covered under your family health insurance plan.
- Maternity Cover: Almost all family health insurance plans come with a maternity cover too, which includes pregnancy-related expenses as well as newborn baby expenses.
- Organ Donor Expenses: This includes the charges incurred in cases of organ transplant surgeries, which cover the cost of getting an organ and donor-related charges.
- Mental Illness Cover: Most family health care plans provide coverage for mental illnesses like depression, anxiety, schizophrenia, etc.
Health Insurance Plans offer a Daily Cash Allowance for their policyholders to cover day-to-day expenses during hospitalization.
Exclusions Of A Family Health Insurance Plan
Although the insured gets a lot of benefits from his family health insurance plan, there are certain things to note that are not normally covered under the same. For this reading through the policy documents are very crucial to understand the exclusions too in detail.
Some exclusions are mentioned below:
- Expenses incurred in routine medical checkups or OPD treatments.
- Expenses incurred on plastic surgeries or any beauty-related treatments.
- Charges incurred on life-support machines.
- Overseas treatment is not included in the plan.
- Treatments for illnesses or injuries resulting from acts of war, foreign enemies, etc.
- Illness due to involvement in unethical/ criminal activities.
- Pregnancy/ childbirth-related complications, unless mentioned as per the insurance plan, voluntary termination of pregnancy, etc.
- Any type of pre-existing medical conditions until the completion of the waiting period.
What Are The Family Health Insurance Benefits?
The members of your family can avail of a huge number of benefits under the family health insurance policy. For instance, all the family members can get coverage under a single policy, irrespective of their age, financial status, etc.
Some major benefits are mentioned as follows:
- Low Cost / Affordable Premium – The family health insurance plan provides coverage for you, your spouse, child, and parents all under a single insurance policy. This allows you to pay a one-time affordable premium instead of paying individual premiums for all your family members. But senior citizens are advised to take a separate insurance plan for more benefits on their health-related coverage.
- Adding a new family member to your family plan – Instead of buying a fresh policy for a new family member, you can add a new family member easily to your existing health insurance policy with an extra premium. However, if your parents are being added later to the policy, make sure you increase the sum insured considering their age-related health issues.
- Stress-free Hospitalization Expenses – The family member of the insured can avail of cashless treatment in a network hospital of the particular insurance company in case of emergency hospitalization. This makes it easy to get treatment and medical attention without delay.
- Family Plan for COVID-19. – Ever since the pandemic arrived, almost all insurance companies have offered COVID-related treatments under their basic health insurance plans. But here you can get specialised plans exclusively for COVID to cover hospitalisation costs spent on the treatment of COVID alone on a family floater plan, which covers all family members included in the policy.
- Avail additional benefits – There are a lot of Add-on benefits or Rider benefits that are available under your existing family health plans. This includes critical illness cover, etc. The add-ons can be bought according to the needs of the family members under the insurance policy, and with an additional premium being paid.
- Income Tax Benefits – You can avail of a tax exemption in your health insurance premium under Section 80D of the Income Tax Act if you are paying the health insurance premium for the whole family, including your parents.
What Does The Term-No Claim Bonus Mean?
No Claim Bonus is a common term used in an insurance policy, also known as NCB, and is usually a financial benefit offered to the insured by the health insurance provider. The insurance company rewards the policyholder if they continue with the insurer with a claim-free year. NCB applies to both individuals as well as family health insurance plans, depending on the type of cover bought by the family, and depending on the insurance company’s terms that provide the same.
A monetary benefit is provided to the insured as well as their family if no claims are raised in the previous year of the policy. Usually, the benefits are applicable as premium discounts during renewals or an increase in the sum insured of the health insurance policy.
NCB makes sure you or your family gets better financial protection at the time of any medical emergencies by reducing the cost of renewing the health insurance policy and offering more coverage at a much lower premium. This ensures the insured keeps the policy claim free by staying fit and healthy because of self-health care which is very much needed for a person.
How To Use Family Health Insurance Premium Calculator
A person can calculate the Family health insurance premium using an online calculator where you provide all the details like the age of the family members, the number of persons in the family to be insured, sum insured, policy tenure and such and get a quote for the premium you have to pay each year for the policy.
Family Health Insurance premium calculator is a time-saving and effective online tool that avoids any confusion for the person who is planning to buy an insurance policy. Sometimes people might end up buying just one type of insurance policy to avoid researching the many benefits available in other policies, too. The online premium calculator comes in handy under these circumstances.
It helps you to calculate the average premium that you have to pay before even purchasing the policy. You will be able to compare premiums for different insurance companies and choose the one that suits you. You can find the available discounts offered by different insurance companies when you use the premium calculator.
Factors to Consider Before Buying a Family Health Insurance
When selecting a family health insurance plan, it’s crucial to consider several key factors to ensure comprehensive coverage and financial security. Here’s a concise checklist to guide your decision:
- Adequate Sum Insured: Ensure the policy offers a sum insured that can sufficiently cover potential medical expenses for all family members, considering factors like age, health conditions, and rising healthcare costs.
- Scope of Coverage: Opt for a plan that includes inpatient hospitalization, pre- and post-hospitalization expenses, daycare procedures, maternity benefits, and coverage for pre-existing diseases after a minimal waiting period.
- Waiting Period for Pre-existing Diseases (PED): Choose a policy with the shortest waiting period for pre-existing conditions to ensure timely coverage when needed.
- Co-payment and Sub-limits: Select plans without co-payment clauses or sub-limits to avoid out-of-pocket expenses during claims.
- Network Hospitals: Verify that the insurer has a wide network of hospitals, including those near your residence, offering cashless treatment facilities for hassle-free medical care.
- Restoration Benefit: Look for policies that offer restoration benefits. These replenish the sum insured upon exhaustion during a policy year, ensuring continuous coverage.
- Lifetime Renewability: Ensure the policy offers lifetime renewability, allowing continuous coverage without age restrictions.
- Claim Settlement Ratio: Research the insurer’s claim settlement ratio to assess their reliability and efficiency in processing claims.
- Additional Benefits: Consider policies that offer value-added services, such as annual health check-ups, wellness programs, and premium discounts, to help you maintain a healthy lifestyle.
By meticulously evaluating these factors, you can select a family health insurance plan that aligns with your family’s healthcare needs and financial considerations.
Common FAQs
- What are the major things covered in the Family Health Insurance Plan?
Normally, all the family insurance plans cover the pre- and post-hospitalization, inpatient hospitalization expenses, ambulance charges, medicines, and day-care treatment costs for all the family members insured under the single policy.
- For how many years can we take the Family Health Insurance Plan?
Normally, you may get a cover for a period of one, two, or three years, but with a lifelong renewability option.
- How many family members can be covered under one Family Health Insurance policy?
Normally, it’s provided for about 6 members in a family, which usually includes yourself, your spouse, and up to four of your dependent children. The plans provided by each insurance company differ in their eligibility criteria and the number of members who can be added.
- When I own a family health insurance policy, what is the procedure to follow once I or my family members get hospitalized?
The most important thing you need to do is inform the TPA about the hospitalization, along with the details of the policy that you own and the treatment you or your family member needs to undergo. Fill in a claim form and submit it with all required documents.
- How do I add my family members to my existing family health insurance policy?
You may add your family members to your existing family health insurance at the time of renewal. Only a newborn baby can be added in the middle of the policy tenure. You might have to pay an additional premium for the new members.
- How long can my child stay in my family’s health insurance policy?
Dependent children are allowed to stay in a family health insurance policy till they turn 25 years of age. However, if the child gets married or starts earning before 25 years of age, the exit will be done earlier than provided by the insurance company.
Nowadays you may always choose from the best family health insurance policies available in a wide range. Just make sure you choose the insurance according to your own family needs and avail the maximum benefits with an affordable premium.