Family Floater vs Individual Health Insurance: Know pros and cons to decide which one to opt for

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Published: September 18, 2019 7:19:48 PM

With ever increasing cost of healthcare, taking a health insurance cover has become a must for everyone to eliminate the uncertainty of paying exorbitant bills – especially of private hospitals if get admitted.

health insurance, healthcare costs, hospital bills, family floater vs individual health insurance, fixed sum insured, floating sum insured, health insurance premium, discount on health insurance premiumAll health insurance companies offer individual and family floater options under every basic health insurance plan.

With ever increasing cost of healthcare, taking a health insurance cover has become a must for everyone to eliminate the uncertainty of paying exorbitant bills – especially of private hospitals if get admitted – by paying health insurance premium, which is known and may be managed financially. So, along with life insurance, health insurance has become an integral part of financial planning to minimise the financial uncertainty before starting investments to fulfill life goals.

While the features and benefits of health insurance differ from company to company and plan to plan, but every health insurance company offers individual and family floater options under every basic health insurance plan.

As the names suggest, individual options are meant for single persons and family floater options are meant for persons with family. However, individual plans may be taken jointly for more than one persons and insurance companies also offer discounts on join individual policies.

So, if you also want to take health cover for other members of your family, you may either opt for a joint individual policy or a family floater policy, depending on for which members you want to take cover.

Generally, the features and benefits remain same for individual and family floater options under same health insurance plan of a health insurer. So, let’s discuss differences in term of eligibility to include members and cost of having either of the plans.

Eligible members

Under individual option, a person may include his/her spouse, children as well as parents and other family members, while in family floater, an individual may add his/her sopuse and dependent family members, including dependent children. So, more members may be added in a joint individual policy than a family floater policy. A person may add either of his/her parent in family floater as the second adult, but premium will become higher.

Insurance cover

In case of individual policy, each member has separate sum insured (SI), which may not be equal for every member, but SI of other members can’t exceed the SI of the proposer. For example, there are four members in a joint individual policy. If the SI of the proposer is 2 lakh, the SI of other members may be less than or equal to Rs 2 lakh. However, in case of family floater policy, the SI per member is not fixed, but the entire SI floats. So, any member singly or more than one member jointly may use the SI in a policy year.

Flexibility in claim

In case of joint individual policy, SI per individual is predefined and in case of any claim, the insurance company will pay up to the much to the member. So, if in a joint individual policy, if four members have SI of Rs 2 lakh each, out of claim of Rs 4 lakh for treatment of a member, the company will pay only Rs 2 lakh. Whereas, in case of a family floater policy of SI Rs 5 lakh, ideally any member may use the entire SI of Rs 5 lakh in a policy year or more than one member may jointly use the SI of Rs 5 lakh. So, a family floater policy has more flexibility in terms of using the amount of SI. However, some companies curtail the floating capacity of SI by putting restriction in term of percentage of SI the proposer, spouse and children may use.

Amount of premium

If an individual wants to take a certain amount of cover for his/her spouse and children, taking a family floater would be cheaper than taking same amount of cover separately under a joint individual health insurance policy. However, if an individual wants to add his/her parent as second member, joint individual policy may come cheaper than a family floater plan, as the premium is calculated on the age of the eldest member.

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