Buying a family floater health plan? Keep these important things in mind

By: |
June 01, 2021 11:42 AM

Health insurance policies are usually available in two variants when it comes to covered individuals -- individual health policy and family floater health policy.

A family floater health insurance plan usually covers husband, wife, and dependent children up to the age of 23 to 25 years or until they get married, whichever is earlier.

People are increasingly getting concerned about hospitalization expenses in the prevailing second wave of the Covid-19 pandemic. Several states across the country have already clamped lockdowns and curfews to stop the spread of the deadly virus while vaccinations are still in their early phases. Many self-employed people are facing income losses while salaried are worried about salary cuts or job losses. The new strain of coronavirus has proved to be highly contagious, and there is a high risk of more than one family member getting infected. In such a situation, it’s critical to have a health insurance policy that can adequately cover all the family members if any or all of them require hospital treatment.

Health insurance policies are usually available in two variants when it comes to covered individuals, i.e., individual health policy and family floater health policy. As the name suggests, individual policies cover only one individual while a family floater would typically cover the entire family out of a single policy. Premiums for all health insurance policies are determined according to the age and medical condition of the insured (or the age and medical condition of the eldest member in case of a family floater) and they are cheaper when the policy is started at a young age. However, the premiums for a family floater plan could cost you less compared to the combined premium for separate individual policies for all the family members.

There are different types of family floater policies available in the market and you should choose one that best meets your requirements. So, if you’re planning to purchase a family floater plan, you’ll be well-advised to keep a few important things in mind.

Who all are covered in a family floater health insurance policy?

A family floater health insurance plan usually covers husband, wife, and dependent children up to the age of 23 to 25 years or until they get married, whichever is earlier. Some insurers extend coverage to other family members like mother, father, daughter-in-law, father-in-law, mother-in-law, grandfather, grandmother, grandson/granddaughter, etc. The sum insured of a family floater plan is shared by all the eligible members of the policy.

That being said, if you have senior citizens in your family, you might want to purchase individual policies for them instead of including them in a family floater plan. Senior citizens are usually at higher hospitalization risk and it’s better for them to have separate coverage aligned with their medical requirements. The health insurance premium is calculated on the basis of the individual with the highest age in the policy, so the family floater policy could be expensive if you include family members in a higher age bracket. Instead, you can buy a separate health policy for the senior citizen/aged family members and get a family floater policy (which is likely to cost you less in premiums) for eligible younger members so that there’s ample coverage available for all family members in case of multiple claims in a year.

How much health cover would you need?

With rising medical inflation, it’s crucial to take a health insurance cover of adequate size. While deciding the ideal size of your health cover, you should consider factors like the age, health condition and lifestyles of the family members, chances of getting hereditary illnesses in the future, etc. while factoring in your budget. You should also check out the features of the policy at different cover sizes. Some insurance companies allow better coverage and features in the policies with higher coverage than those with a lower sum insured. You should also prefer such a policy size that you’ll be able to renew easily without a break in the future. That being said, the cover size of your family floater plan should be at least Rs 7 lakh-Rs 10 lakh if you live in an urban area.

What are the important features that you should look for in a floater policy?

Features of health insurance policies may vary from company to company and depending on the variant you are planning to buy. Most insurers offer different health policy variants to serve different customer requirements. While purchasing a family floater policy, you should look for features like a large number of networked hospitals, low waiting periods for pre-existing conditions, a minimum number of exclusions, a no claim bonus structure, auto restoration of sum assured facility, air ambulance coverage, lifetime renewal facility, coverage to alternative treatment, no capping on room rent and treatment, no or low co-pay clause, quick settlement record, etc. Some of the features could be available on an add-on basis that might require additional charges. And while affordability of premiums should be a crucial consideration, you should also check out your chosen insurer’s claim settlement track-record. That being said, health insurance premiums can be claimed for tax-deductions under Section 80D of the I-T Act, subject to predefined limits.

Health insurance companies usually don’t require a pre-health check-up if the age of the eldest member in a policy is below 45 years. So, you should try to increase the health cover before 45 years of age. That being said, there are other options available in the market like top-up and super top-up health plans that could increase the health insurance coverage level in a cost-effective manner. You can also consider going for them according to your requirements keeping in mind the riders about deductibles – that should ideally be equal to or less than the sum insured of your family floater plan.

(The writer is CEO, BankBazaar.com)

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