Points to Keep in Mind While Buying Family Health Insurance Plans


Family health insurance plans are an absolute must for everyone these days because healthcare costs are going up continually. Many people had to bear exorbitant hospital bills during the pandemic. Not many people can afford to pay such high hospital bills right out of their pocket. The best bet is for everyone to have a comprehensive family health insurance plan that provides wide coverage at an affordable price.

Here is a list of factors that you should keep in mind while buying a health insurance plan for your family.

  1. Wide Coverage: This is understandably the most important and first thing that you should always consider for choosing family health insurance. You want to make sure that the policy covers as many diseases, ailments, injuries, accidents, etc. No one wants to be in a situation where they pay to buy a health insurance policy only to find out that the medical problem they developed is simply not covered in the plan. Compare plans from different companies and thoroughly go through the inclusions and exclusions to buy a health policy that suits your needs.
  2. Wide Network of Cashless Hospitals: In cashless hospitalization, if you get treatment in a network hospital, health clinic, diagnostic labs, etc, all you have to do is visit them and present your health insurance documents. They will file paperwork and you can get your treatment started without actually having to pay any money at the hospital. The treatment bill will be settled between the hospital and your health insurance provider. You should choose an insurance company that has an extensive network so that you can have easy access to a network hospital of the insurer, anywhere in India.
  3. Check Claims Settlement Ratio: Claim settlement ratio is the ratio between the number of claims settled by the insurance company against the total number of medical claims received by the health insurance company. A higher claim settlement ratio is an indicator of higher claim settlements. It is very important to choose an insurance company that has a high claim acceptance ratio. No one wants to have their claims rejected when they need this money the most.
  4. Pre and Post-Hospitalisation Coverage: The pre and post-hospitalisation expenses can add up to become a significant amount, which can burn a hole in your pocket. It may so happen that multiple members of your family need the coverage of your family floater plan in the same year. If pre and post-hospitalisation charges are not covered under your family health insurance plan, you may run out of your savings.
  5. Wide Variety of Add-ons: While the basic family health insurance plan does bring in a good number of features in and of itself, it still may have some areas where cover can be improved. You should look at the number of add-ons that the company allows you to choose from. At the very least, the critical illness cover add-on and value restoration add-ons must be offered by the company.
  6. Services in digital mode: Another very important factor that you should consider While choosing your health insurance plan is to opt for a health insurance provider which offers the maximum number of services in the digital mode. Of these, along with cashless claims, the filing of claims for out-of-network hospital treatment should be online. During a medical emergency, visiting the insurer’s office would be the last thing on your mind. Subsequently, you would want to file your claim and receive assistance online.
  7. Buy a Critical Illness Health Plan: While your regular insurance does provide some protection in case a critical illness of any kind arises, getting either a stand-alone critical illness health insurance plan or an add-on to your regular health insurance plan. This is to ensure that the high expenses arising out of a life-threatening illness do not actually bite into the protection of your family health insurance that other family members also are relying upon. 
  8. Calculate Your Health Insurance Needs: Before you shell out the premium amount for a family health insurance, run a check if the sum insured is enough to cover all your family members. If you have elderly parents, check with your insurance company, if the policy covers them as well, or not. Also, check if any of the family members have any pre-existing conditions, and what is the possible associated medical cost. Accordingly, choose a health insurance plan that covers the potential medical costs comprehensively.
  9. Planning funds for your health insurance: One thing many people fail to do is plan for getting health insurance. In absence of such a plan, they either have to take the policy on credit or have to drop their health insurance altogether. You should do financial planning which is inclusive of your health insurance plans. Ideally, take the amount you have paid this year as the premium and divide it by 11. Every month save an equivalent amount in a bank account. Saving for 11 months will give you the amount for your premium. Now your 12th month saving of the same amount will cover the increase in premium arising out of inflation or regular price revision by the insurance company.

It is very important to realise that the best family health insurance plans are those which provide you cover when you need it. A robust family health insurance plan is one where the sum insured is enough to cover the medical emergencies of multiple members of the family. Furthermore, they should not come with too long a waiting period. Always remember that insurance is also only good when you keep on renewing it in time. If you create unnecessary gaps in policy renewals, it may come back to bite you. Also, try to stick with an insurance company for some time instead of frequently doing insurer hopping. And last but not least, it is of utmost importance to read the policy outline thoroughly and be well aware of all the exclusions and inclusions.

Disclaimer: The above information is for illustrative purpose only. For more details, please refer to policy wordings and prospectus before concluding the sales.

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