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Family Health Insurance

What is Family Health Insurance?

Family health insurance provides financial security against unforeseen medical emergencies and illnesses for your family.Under family health insurance plans, the policyholder can cover themselves,their parents, spouse, dependent children, and elders by paying a standard premium. The policy's sum insured is a pool of funds for everyone. Any insured family member can use the sum insured entirely or partly to pay hospitalisation expenses and other medical costs. That’s how health insurance for families offers a protective shield to all your loved ones under one financial umbrella.

You can also customise the coverage amount while adding optional benefits to meet the medical needs of covered members. Add-on benefits include cumulative bonus super, air ambulance cover, and wellness benefits. If you are worried that a family floater may compromise on every member’s medical needs, you can opt for separate health insurance policies to cover every member individually.

Select from the Best Family Health Insurance Plans

At  Health Insurance, we meet the diverse healthcare needs of every household with some of our best family health insurance plans in India. Here are some of our top-selling family mediclaim plans:

Man IllustrationLook for best health plan that suits your need!

 

 

How Does Family Medical Insurance Work?

Let’s understand the concept of health insurance for a family with the help of an example.

Family Floater Health Insurance

32-year-old Fatima Khan opts for a floater plan covering herself, her spouse, and two dependent children with a health plan of ₹10 lakh coverage. A few months after the policy purchase, Fatima had to undergo kidney stone removal surgery. She had to stay in the hospital for 5 days, and her medical bills reached ₹3 lakhs. The insurance company paid for these expenses. A few months later, her husband met with a car accident and hospitalised for 7 days. His hospital bill came around ₹5 lakhs, which was paid by the insurer.

In this case, the remaining ₹2 lakhs coverage can be utilised in case health emergency arises during the policy tenure.

Individual Health Insurance for Family

Suppose, Dhruv Sharma, a 27-year-old software engineer, opted for individual cover for himself and his spouse. Each has a sum insured of ₹5 lakhs, which cannot be shared with each other. After a few days of policy inception, Dhruv had covid and had to spend 8 days in the hospital, where the hospital bill was ₹4 lakhs. Four months later, his wife needed to be hospitalised due to covid and her hospital bill was ₹3 lakhs. Both the bills were paid by the insurance company.

Dhruv has a cover of ₹1 lakh left for the remaining policy year while his wife can utilise up to ₹2 lakh during this tenure.

Why Do You Need a Family Health Insurance Plan?

Securing your loved ones under a family health insurance plan can save you the stress of paying multiple premiums and choosing various policies. Here are a few things that a Family Health Insurance plan offers:

Shield Against Healthcare Inflation

Even a single hospital stay can cost lakhs and drain your household savings. A  health insurance for a family cover lowers the financial burden by covering medical treatment, doctor’s consultations, medications, etc.

Protection From Lifestyle Diseases

Lifestyle diseases are the new normal. However, benefits such as annual health check-ups can prevent the worsening of issues and keep you and your loved ones safe.

Affordable Healthcare & Financial Security

Getting a family floater at an early age saves you from hefty medical bills while lowering the premium rates. The EMI option makes premium payments more accessible and budget-friendly.

Facilitates Cashless Hospitalisation

In the face of a constant financial crunch, medical bills are best paid through a cashless facility. Especially when living with a family, cashless claims help you focus on recovery.

Relief Amid Chronic Illnesses

Over 20% of Indians suffer from chronic conditions like cancer, heart ailments, diabetes, etc. A Family health insurance coverage helps you bear the treatment cost of prolonged illnesses and treatments.

Difference between Individual and Family Health Insurance

The table below will guide you better on the differences between Individual and family health insurance:

Individual Health InsuranceFamily Health Insurance
It provides financial and medical coverage to a single individual against medical emergencies.It provides financial and medical coverage to the whole family against medical conditions.
The sum insured can only be used by a single insured individual.The sum insured is shared among all the insured members of the family.
The sum insured can range up to ₹1 crore depending on the chosen plan.Varied sum insured options are available up to 6 crore.
The premium charged depends majorly on the age of the individual.The premium depends majorly on the age of the oldest member of the family.
The minimum entry age is 18 years.The minimum entry age is 91 days (with at least 1 individual insured above the age of 18).

When you compare the premium of a family health plan you will find it more affordable as compared to an individual health plan. This is because of the higher coverage and sum insured offered by an individual plan. In you wish to opt for a family health insurance plan, you can still enhance the coverage by opting for add-ons and the lifelong renewability.

While choosing between a family health cover and individual plan, it is imperative to address the specific needs of your family and compare the available options. By having a thorough understanding of your requirements.

Features of Our Top Family Health Insurance Policies

When family security is on your mind, choose nothing but the widest coverage to keep financial worries at bay. We present you– Care Supreme and Care Advantage– the next-generation health insurance for family offering unrestricted coverage while helping you save more and maintain a healthy lifestyle. Here are the comprehensive benefits of the Care Supreme and Care Advantage family insurance:

KEY FEATURESCare Supreme Family PlanCare Advantage Family Plan
Sum Insured Options5*,7,10, 15L, 25 L, 50 L & 1 Cr25L, 50L, & 1Cr, 2Cr, 3Cr, 6Cr
In-Patient CareUp to SIUp to SI
Day Care TreatmentAll Day Care Procedures540+ Day Care Procedures
Advance Technology MethodsUp to SIUp to SI
Pre-Hospitalisation Medical Expenses60 days60 days
Post-Hospitalisation Medical Expenses180 days180 days
AYUSH TreatmentUp to SIUp to SI
Organ Donor CoverUp to SIUp to SI
Ambulance CoverUp to Rs 10,000 per year for SI < 15 Lakhs &
Up to SI for Policy SI >= 15 Lakhs
Up to the Sum Insured
Automatic Recharge of SIUnlimited automatic rechargeUp to SI (Once in a Policy Year)
Health Care Services

*Disclaimer: The sum insured option of 5 lakh is not available for Zone-1 cities.

Advantages of Buying a Family Health Insurance Plan

A family health insurance plan covers all the family members under one insurance plan. Apart from this, there are various other benefits of investing in a family health insurance, like:

Comprehensive Coverage

Our Family Health Insurance Plans offer wide coverage and benefits, including pre and post-hospitalisation, day-care treatment, and ambulance cover. The plans also provide benefits like cumulative bonuses, annual health check-ups, automatic recharge of the sum insured, and others.

Cashless Hospitalisation Facility

With our vast network of 24800+ cashless healthcare providers, we promise quality medical care at the best price. Our network hospitals ensure your family members can avail of timely healthcare services without draining the family’s savings.

Tax Benefits

By adding multiple family members, you can save more tax benefits and deductions up to ₹75,000. This way, your family gets double financial security while preparing for medical emergencies.

Unlimited Recharge of the Sum Insured

A growing family’s healthcare needs are diverse and never-ending. Thus, we offer you a family health policy that never runs out of coverage amount with the benefit of unlimited automatic recharge of the sum insured.

Customisable Health Benefits

With Care Family Health Insurance Policies, you can customise the policy features to match your family's healthcare needs. You can opt for adequate coverage amount and tenure while choosing the required set of additional benefits.

Freedom to Add Members

A family health cover provides you the flexibility to add new members to the existing plan. If you have recently welcomed a new born to the family, you can add the baby to the policy during the time of renewal. In order to add a new member, you only need to inform the insurer, and pay an additional premium.

benefits of securing family health insurance

What is Covered under Our Family Health Insurance Plans?

Comprehensive benefits and wider coverage help us serve you the best mediclaim policy for family.Our health insurance plans for family cover the following benefits and features:

Annual Health Check-up

We value your family’s health and thus, offer annual health check-ups for all insured family members. Health checks help track ailments & get treated early on.

Day Care Treatment

With family health insurance, you do not have to worry about daycare procedures such as cataract treatment, dialysis, etc., as they are already covered.

Pre and Post-Hospitalization

Family plans offer optimum security—from tests and doctor’s fees to post-treatment hospital visits—with up to 60 days of pre-hospitalisation coverage and 180 days of post-hospitalisation coverage.

Advance Treatment Methods

We enhance your coverage with robotic surgeries and therapies to treat critical illnesses at specialised healthcare centres. Get coverage up to the sum insured.

Up to 100% Cumulative Bonus

We reward your family for maintaining good health by offering a cumulative bonus of up to 100% of SI every year for raising no claims as per policy terms.

AYUSH Treatment

When modern medications fail, traditional treatments come in handy. Family floater plans offer coverage for alternative treatments up to the sum insured.

Domiciliary Hospitalization

When you need special care at home, we cover domiciliary hospitalisation expenses up to the SI as per policy terms.

Ambulance Cover

Family floater plans relieve you from medical expenses incurred in hiring an ambulance with adequate coverage, so you can immediately avail of treatment.

What are the add-ons in Family Health Insurance?

Add-ons are the extended coverage that you can purchase for your existing health insurance family plans by paying an extra premium. Here is the list of various add-ons that you can purchase with family health insurance:

  • Annual Health Check-up: With the Annual Health Check-up add-on benefit, you can ensure that all elderly insured members’ health is tracked timely. Under this benefit, you can avail yourself of a cashless health check-up for all adult-insured members at any of the Care Health Insurance network labs once a year as per the standard terms and conditions.
  • Cumulative Bonus Super: By choosing this add-on benefit under the Care Supreme Health Insurance, you can boost your coverage to a maximum of 500% of SI in five consecutive years. The benefit increases 100% of the Sum Insured annually for up to 5 years, and the accrued bonus remains unaffected by the claims made.
  • Wellness Benefit: We reward you for staying active! Thus, we offer up to 30% discounts on the renewal premium if you successfully achieve the healthy days’ target. (1 healthy day = 10,000 steps in a day). Based on the policy terms, if all the adult insured members achieve the healthy days target for 270 days, then you can avail of a 30% discount on the premium paid at the time of renewal.
  • Air Ambulance Cover: With the add-on benefit of air ambulance, you can get coverage for the expenses incurred towards shifting an insured patient from one hospital to another through an air ambulance. While Care Supreme offers road ambulance as an in-built benefit, the air ambulance add-on ensures you can get the proper treatment at the right time.
  • Claim Shield: With the claim shield, you can spare yourself from paying the cost of consumables! Opting for Claim Shield under the Care Supreme Health Insurance ensures you do not have to pay for the 68 non-payable items such as masks, sanitiser, gloves, PPE kit, etc.
  • Instant Cover: Lifestyle diseases such as Asthma, Hypertension, Hyperlipidemia, and Diabetes generally come with extensive waiting periods in the case of health insurance. However, with instant cover, you can waive the waiting period and get coverage for the ailments under set T&C after an initial waiting period of 30 days.
  • Reduction in PED Wait Period: Worrying about the long waiting period is the old story! With the Reduction in the PED Wait Period, you can now modify (or reduce) the waiting period for specified ailments from 36 to 24, or 12 months as per the policy terms & conditions.
  • Care OPD: Health insurance generally offers coverage in case of hospitalisation. However, with the add-on benefit of Care OPD, you can get specified reimbursement for OPD consultations taken from four general physicians and four specified specialists.
    The list of specified specialists includes- Paediatricians, Obstetrics and Gynecologists, Homoeopathic Physicians, Dieticians, Diabetologists, Dermatologists, Pulmonologist, Psychiatrist, Cardiologist, Neurologist, Orthopedic, Surgeon, Nephrologist, Gastroenterologist, ENT Specialist.
  • Be-fit: Staying active is the secret to staying healthy! Thus, with the Be-fit add-on benefit, we offer unlimited free access to network fitness centres to all insured members above the age of 12 years.

What is Not Covered under Family Health Insurance Plans?

Our family health insurance is a comprehensive plan designed to offer an exhaustive coverage for all the insured members. However, there are certain conditions that may be out of coverage for our plans. The standard exclusions are as mentioned here after:

  • Self-inflicted injuries resulting from suicide or attempted suicide.
  • Diseases, surgeries, or medical events, occurring within 30 days of the policy start date.
  • Expenses arising out of or attributable to alcohol or drug use/misuse/abuse.
  • Treatment arising from or traceable to pregnancy and childbirth, miscarriage, abortion, and its consequences.
  • Tests and treatments relating to infertility and in vitro fertilisation.
  • War, riot, strike, nuclear weapons-induced hospitalisation.
  • External Congenital Diseases

Please check out the policy terms and conditions to have a detailed idea on exclusions of a family health insurance plan.

Eligibility Criteria under the Family Mediclaim

Most of our medical insurance for family include the following set of standard eligibility conditions:

Minimum Entry AgeIndividual- 18 years
Floater- 91 days with at least 1 insured person of age 18 years or above
Maximum Entry AgeLifelong
Premium Payable on RenewalSubject to change with prior approval from IRDAI
Waiting Period30 days-36 months for illnesses, except injury based on policy t&x.
Grace Period30 days to renew your policy post expiry

How to Buy Family Medical Insurance Plans from Care Health Insurance?

Medical costs are always rising, so now is the best time to get healthcare insurance for your whole family. Signing up for our medical policy for family is easy through our digital portal.

Here's how:

Step 1: Select a suitable health plan from the official website of Care Health Insurance.

Step 2: Enter your phone number and proceed to calculate the premium.

Step 3: Select the members that you wish to insure and fill out their age. Finally, fill in your current residential address pincode to get the correct premium.

Step 4:Take your time to analyse the different plans and choose the plan that suits your needs.

Step 5: Customize your policy's tenure, sum insured, and add-ons.

Step 6: Get an instant quote for your chosen family health insurance.

Step 7: Proceed to purchase by filling in the proposer details, details of insured members, and your KYC details.

Step 8: Pay using a secured method such as a payment wallet, net banking, or a debit or credit card. You can also pay the insurance premium in EMI.

Your policy information, including your policy number and e-card, will be sent to your registered mobile number.You can always reach out to our representatives in case you need assistance during the policy purchase.

How to Renew Family Health Insurance?

To continue availing of the benefits or health insurance family plans, you must renew the plan before it expires. You can quickly find the expiry date of your health insurance plan on your policy documents. Care Health Insurance also reminds its customers about the renewal date of their health insurance policy through SMS.Here is how you can renew your family health insurance policy:

Online option

  • On the Care Health Insurance homepage, click on the ‘Renew the policy’ option.
  • Enter your policy number and verify the captcha to proceed.
  • Select the renew option available.
  • You can make changes in your policy like increasing the sum insured, changing the plan, customising the add-ons, etc.
  • Make sure to avail any ongoing offers, discounts, or accumulated bonuses (if any).
  • Submit the documents required.
  • Make the payment to complete the process.

Offline option

For renewing your family health insurance policy via the offline method, you need to visit a nearby Care Health Insurance office. Take the required documents with you, along with the policy documents. You can connect with an executive at the office and get the policy renewed by making the payment.

How to File a Claim Under Family Floater Insurance?

Our quick and efficient claim management team helps us serve our customers with the best claim settlement experience!

In the event of emergency hospitalisation, you must inform your insurer via call or mail within 24 hours of hospitalisation. Whereas, in the event of planned hospitalisation, you must inform your insurer at least 48 hours before getting hospitalised. Hereafter, you can file either for a cashless or reimbursement claim.

Cashless Claim ProcessReimbursement Claim Process
Step 1: Find a network hospital near you.Step 1: Find a hospital near you and get the treatment at the earliest.
Step 2: At the TPA desk of the hospital, fill out the pre-authorisation request form.Step 2: Upon discharge, you must pay the bill and collect the original receipts.
Step 3: Upon receiving the request from the network hospital, we will start the approval process and keep you informed on your claim status. 
Alternatively you can track your claim status on Care’s Mobile App.
Step 3: Login to www.careinsurance.com and fill in claim form and submit documents including bills, reports, etc.
Step 4: All the further documentation and coordination shall be done with the hospital TPA desk.Step 4: We will reach out to you in case we need any further documents/ information.
Step 5: We settle the bill directly with the hospital upon discharge.Step 5: We will release the approved claim amount to your bank account after completing the query.In case of claim rejection, we will inform you of the reason.

Documents Needed to File a Health Insurance Claim

In order to raise a claim for a family health insurance plan, you need to present a few documents as well. To avoid any back and forth while filing a claim, keep these documents handy at the time of filing a claim.


The documents required for a reimbursement claim include:

  • Duly filled claim form
  • The original discharge summary from the hospital
  • The original medicine bills, lab and diagnostic reports
  • The original hospital bill payment receipt

In case of an accidental hospitalisation, you need to submit the following documents as well:

  • MLC/ FIR copy (if applicable)
  • Alcohol history (if applicable)
  • Investigation reports (like X-Ray/MRI/CT Scan etc.)
  • Attested copy of indoor case papers
  • Invoice and the stickers required in case of implant surgery
  • In case the claim amount ranges above ₹1 lakh, you must provide a copy of any one of the following KYC documents:
  • Aadhaar Card, Passport, Driving Licence, and/or Voter ID

The address on the KYC documents must match the Policy address.

In case of a cashless claim, you need to present a few documents at the hospital desk, like:

  • A copy of the patient's medical ID card
  • A copy of the e-health card ( available at Care Health Customer Application)
  • Pre-authorisation letter
  • A valid government ID proof such as Aadhaar card.

Please note that your policy address must be same as the current residential address to avoid claim rejections.

Tips to Choose the Perfect Family Medical Insurance Policy

While choosing a family health insurance plan, you must look out for the following factors.

  • Age Eligibility: Many health policies have age restrictions. We provide coverage at three months of age with lifetime renewals on a floater basis.
  • Maximum Coverage: We cover expenses related to pre and post-hospitalisation as well. This includes tests, treatments, medication, and check-ups every year.
  • Affordable Premiums: Our premium calculator helps you figure out your cost for the features you need in advance.
  • Exclusions: Certain conditions can exclude claims. Look for a mediclaim policy for family that offers maximum coverage with the least exclusions.
  • Co-Payments: Co-pay in health insurance is when the policyholder needs to pay a certain part of the claim amount as per policy terms. The insurer bears the rest of the claim expense. Check the co-payment percentage before signing up for family medical insurance plans.
  • List Network of Hospitals: Easy access to our large group of in-network hospitals that provide cashless treatment in the least amount of time. Check the in-network hospital list to find the best hospitals in your area.

Factors Affecting Health Insurance Premium

You may have noticed that the premium charged for health insurance differs from one customer to another. This is because the premium for family health insurance is calculated based on various factors. These include:

Age of the Oldest Member

Age plays a crucial role in deciding the premium of a health insurance plan. In the case of family health insurance, the age of the oldest family member is taken into consideration. The older the member, the higher the premium will be. This is because as you grow old, the risk-appetite increases.

Pre-existing Diseases

The insurance premium is likely to go high in case any of the family members suffer from pre-existing diseases like diabetes, thyroid, hypertension, etc., Keep in mind that the waiting period for raising a claim against a pre-existing disease is typically 2 to 4 years.

Lifestyle Habits

The lifestyle habits of the family members are also determining factors. The premium charged is often high for a prolonged habit of smoking in the family. Again, the nature of occupation is also crucial since some professions with high health risk are likely to attract higher premiums.

Location

The location of your residence also plays a crucial role in determining the premium of a family health insurance plan. Locations with high calamity risks draw higher premiums, considering the chances of claiming the policy.

Type of Plan Chosen

The premium varies depending on the type of plan you choose. Although the premium goes up with more coverage and a higher sum insured, you get peace of mind that your finances will be protected even if multiple claims are registered in a policy year.

Add-ons

If you choose to increase the coverage of your plan, you may purchase various add-ons available. However, with each add-on, the premium also increases. So, pick only those add-ons that enhances the value for your coverage.

Co-pay/deductibles

Co-pay or deductibles are part of the claim that the policyholder has to pay. It may be in terms of a fixed amount or a percentage of the claim. If you choose a higher deductible/co-pay, you are charged a lower premium and vice-versa.

Duration of the Policy

The tenure of the family health cover plays a major role in determining the premium of the policy. If you opt for a longer policy duration, you will be charged a lower premium amount. Alternatively, shorter family health insurance plans have a higher premium amount.

Common Mistakes While Opting for Health Insurance

Are you opting the right health insurance for your family? This is one question that might pop up in your mind when you are planning a family mediclaim policy. Let's see what are the common mistakes that customers often make and how you can avoid them:

Low-sum Insured

When buying family health insurance, people often try to limit themselves to a low-sum insured in order to pay a low premium. This may help you with a lower premium now, but maybe in the long run, you will have to pay from your pocket in case of multiple health emergencies. The best mediclaim policy for a family is the one where you have sufficient coverage for all the family members.

The Right Approach

You need to assess the medical needs of your family and try to choose a plan with comprehensive coverage. A higher sum insured may charge you a slightly higher premium, but owing to the rising medical costs, it will definitely be worth it.

Limiting to Basic Coverage

The basic coverage of a family health insurance plan includes a range of benefits. A higher coverage means greater insurance benefits. However, sometimes it may be the reason for hike in premium, which is why people tend to limit the basic coverage, ignoring its long-term effect.

The Right Approach

The possibility of coverage amount being insufficient is considerably less if it is decided after analysing the family’s insurance needs only. Another way to increase the coverage amount is opting for add-on covers such as sum insured restoration, OPD cover etc. However, always be calculative while buying an add-on cover as it again draws an additional premium.

Communicating Wrong Information

In order to avail of insurance benefits, sometimes insurance seekers tend to furnish wrong information related to medical history. Little do they know that insurance companies do their verification for a proper background check. Thus, any miscommunication can lead to policy termination only.

The Right Approach

Maintaining transparency while dealing with your insurer is highly appreciated as hiding medical history or presenting wrong information can lead to health insurance policy cancellation.
You should be 100% truthful and honest with whatever information you are providing to your insurer. For instance, the smoking habit of any of the family members must be declared in the application. During the process, several tests are done at the insurers’ end to ensure genuine documentation.

Ignoring the Policy Fine-print

Reading the entire policy document may sound tedious, and many people tend to skip reading the policy documents while buying health insurance. Ideally, you shouldn’t skip it as it can affect your policy experience and may hinder you from availing the best of benefits.

The Right Approach

When you are done deciding on a health insurance policy for family, make sure you read the fine print before signing and making the payment. It gives you a complete idea of the plan you are purchasing. You may ask our executive for any doubts and clauses that you may not be able to understand. This way, you can make the most of a family health insurance policy.

Waiting for the Right Age

Certain diseases and health conditions develop with age. However, unforeseen medical emergencies can strike anyone. Hence, it is a mistake if you are waiting for the right time to secure your family, is a mistake.

The Right Approach

When planning to buy a health insurance plan for family, you need not wait for your youngest member to become old enough. The youngest member of as less as 91 days can join the family health insurance plan. Also, the premium increases with age. Make sure all your family members have access to the best medical facilities with a family health insurance policy.

Taxability on Health Insurance

A health insurance policy for family has dual benefits. On one hand, you get medical and financial coverage for all your family members under one plan, and on the other hand, you can enjoy tax benefits for premiums paid towards the health insurance plan. So, this way, you can enjoy dual benefits.

Under Section 80D of the Income Tax Act, 1961, the policyholder of a family health insurance can avail of tax benefits. Policyholders below the age of 60 can get tax deductions of up to ₹25,000 for premiums paid towards family health insurance plan. Those above 60 years of age can avail higher tax deductions. The following table will help you understand how can one make the most of the tax benefits:

CategoryAmount of premium paidDeductions available under Section 80D
Self, family, and childrenParents
Individuals and their parents who are below 60₹25,000₹25,000₹50,000
Individuals and their family who are below 60, but parents are above 60₹25,000₹50,000₹75,000

Why to Buy Health Insurance Plans for Family Online?

Below are the main benefits of buying a family health insurance policy online in India:

Secure Payment Modes

Secure payment options keep your bank data safe and help you complete the transaction in a few clicks from anywhere, any time.

Chat Option & Easy Policy Evaluation

We try to resolve all your queries instantly through our chat service. Also, policy evaluation is easy with our precisely spelt-out policy terms.

Instant Premium Quote Calculation

Make a calculated buying decision by estimating the premium of your policy online. It will help you plan finances and choose affordable coverage.

Convenient Policy Selection

The website lets you compare coverage, choose and pay anywhere at any time. Also, you can access policy documents online for quick verification.

Readily Available Value-Added Services

It's easy to add benefits such as OPD care, co-payment waivers, and pre-existing diseases while purchasing our health policy for your family online.

No Claim Bonus in Family Health Insurance

A no-claim bonus is a reward given to all those healthy members of Care Health Insurance who haven't raised any claims in a policy year. It is a way of appreciating the healthy lives of insured members for remaining healthy. In the case of family health insurance, if none of your insured family members raises any claim in a policy year, the no-claim bonus is accumulated.
The first year of the no-claim bonus gives you a 10% rise in the sum insured and a 20% rise in the next subsequent no-claim year. The maximum limit for no claim bonus accumulation is 50% of the original sum insured. In times of rising medical costs, it is a huge relief to see your sum insured getting increased by adding up the no-claim bonus.

Please note that at Care Health Insurance, we offer the benefit of No Claim Bonus on Care Advantage Health Insurance plan. Whereas, under Care Supreme, we offer Cumulative Bonus and Cumulative Bonus Super which work regardless of the claims made.

What is Family Health Insurance?

Family Health Insurance, also known as a Family Floater Plan, is a type of health insurance policy that provides medical coverage to all members of a family under a single sum insured. Instead of taking individual policies for each family member, this plan allows the entire family to share a common coverage limit, ensuring financial security during medical emergencies.

It is a cost-effective solution for families, offering comprehensive healthcare benefits while reducing the hassle of maintaining multiple policies.

Key Features of Family Health Insurance

Shared Sum Insured

  • A single sum insured is shared by all covered family members, which can be used by any member as needed during the policy term.

Coverage for All Family Members

  • Typically covers the policyholder, spouse, dependent children, and sometimes dependent parents.

Cashless Treatment

  • Provides cashless hospitalization at network hospitals, reducing out-of-pocket expenses during emergencies.

Wide Range of Sum Insured

  • Options typically range from ₹2 lakhs to ₹1 crore or more, based on the family's healthcare needs.

Affordable Premiums

  • Family floater plans are more economical than purchasing individual policies for each member.

Tax Benefits

  • Premiums paid are eligible for tax deductions under Section 80D of the Income Tax Act.

Lifelong Renewability

  • Many family health insurance plans offer the option to renew the policy for life, ensuring continued coverage.

Add-On Benefits

  • Additional benefits like maternity coverage, newborn cover, critical illness riders, and OPD (Outpatient Department) coverage can be added to the base policy.

What Does Family Health Insurance Cover?

Hospitalization Expenses

  • In-patient treatment costs, including room rent, ICU charges, doctor’s fees, and medicines.

Pre- and Post-Hospitalization

  • Covers medical expenses incurred before and after hospitalization, typically for 30–60 days prior and 60–90 days after treatment.

Daycare Treatments

  • Covers procedures that don’t require 24-hour hospitalization, such as cataract surgery or chemotherapy.

Ambulance Charges

  • Covers the cost of ambulance services for emergency transportation.

Domiciliary Treatment

  • Provides coverage for treatments taken at home if hospitalization is not possible.

Health Check-Ups

  • Some plans offer free annual or periodic health check-ups for all covered family members.

Newborn and Maternity Coverage (optional)

  • Covers maternity-related expenses and medical care for newborns.

Critical Illness Cover (optional)

  • Provides financial support in case of life-threatening illnesses like cancer, heart attack, or stroke.

What Does Family Health Insurance Not Cover?

Family health insurance plans typically exclude:

  1. Pre-existing illnesses (during the waiting period).
  2. Cosmetic or aesthetic treatments (e.g., plastic surgery).
  3. Injuries due to self-harm or substance abuse.
  4. Alternative treatments like Ayurveda or Homeopathy (unless specified).
  5. Maternity expenses (if not included in the plan).
  6. Treatments for non-allopathic medicine (in some cases).

Benefits of Family Health Insurance

Comprehensive Coverage

  • Protects the entire family against medical emergencies under one plan.

Cost-Effective

  • A single policy for the entire family is more affordable than multiple individual policies.

Hassle-Free Management

  • Easier to manage and renew a single policy compared to multiple policies.

Flexibility in Sum Insured Usage

  • Any family member can use the shared sum insured as needed.

Cashless Claims

  • Simplifies hospitalization payments with cashless services at network hospitals.

Customizable

  • Add-ons and riders can be included to enhance coverage as per the family’s requirements.

Tax Savings

  • Premiums paid for family health insurance are eligible for tax deductions under Section 80D.

Who Should Buy Family Health Insurance?

Young Couples

  • Ideal for newlyweds who plan to start a family and want to secure their medical future.

Families with Children

  • Covers hospitalization and healthcare costs for dependent children, ensuring financial stability.

People with Dependent Parents

  • Some plans include coverage for elderly parents under the same policy.

Joint Families

  • Provides a cost-effective solution for covering multiple family members under one plan.

Documents Required for Family Health Insurance

Identity Proof

  • Aadhaar Card, Passport, PAN Card, or Voter ID.

Address Proof

  • Aadhaar Card, Passport, Utility Bills, or Rent Agreement.

Age Proof (for all family members)

  • Birth Certificate, Aadhaar Card, or Passport.

Medical Records (if applicable)

  • Reports or history of pre-existing medical conditions.

Income Proof (for policies with higher sums insured)

  • Salary slips or bank statements (if required).

Recent Passport-Sized Photographs

  • For all members covered under the plan.

How to Choose the Best Family Health Insurance Plan?

Sum Insured

  • Opt for adequate coverage based on the number of family members and their medical history.

Coverage Benefits

  • Ensure the policy covers critical areas like pre- and post-hospitalization, daycare procedures, and maternity benefits (if required).

Network Hospitals

  • Check if the insurer has a wide network of cashless hospitals, especially near your location.

Waiting Period for Pre-Existing Diseases

  • Choose plans with a shorter waiting period for covering pre-existing conditions.

Add-Ons and Riders

  • Look for add-ons like critical illness cover, maternity benefits, or OPD coverage if needed.

Claim Settlement Ratio

  • Check the insurer's claim settlement ratio for hassle-free claims.

Top Family Health Insurance Plans in India

  1. HDFC ERGO Family Health Plan
  2. Star Family Health Optima
  3. ICICI Lombard Complete Health Insurance
  4. Care Health Insurance Family Plan
  5. Max Bupa Health Companion Family Floater

Conclusion

Family health insurance is an excellent way to ensure the financial protection of your loved ones during medical emergencies. With a shared sum insured, affordable premiums, and comprehensive coverage, it offers a reliable solution to manage healthcare costs effectively.

If you need assistance in comparing plans or finding the best family health insurance, feel free to

Documents Needed to File a Health Insurance Claim

In order to raise a claim for a family health insurance plan, you need to present a few documents as well. To avoid any back and forth while filing a claim, keep these documents handy at the time of filing a claim.


The documents required for a reimbursement claim include:

  • Duly filled claim form
  • The original discharge summary from the hospital
  • The original medicine bills, lab and diagnostic reports
  • The original hospital bill payment receipt

In case of an accidental hospitalisation, you need to submit the following documents as well:

  • MLC/ FIR copy (if applicable)
  • Alcohol history (if applicable)
  • Investigation reports (like X-Ray/MRI/CT Scan etc.)
  • Attested copy of indoor case papers
  • Invoice and the stickers required in case of implant surgery
  • In case the claim amount ranges above ₹1 lakh, you must provide a copy of any one of the following KYC documents:
  • Aadhaar Card, Passport, Driving Licence, and/or Voter ID

The address on the KYC documents must match the Policy address.

In case of a cashless claim, you need to present a few documents at the hospital desk, like:

  • A copy of the patient's medical ID card
  • A copy of the e-health card ( available at Care Health Customer Application)
  • Pre-authorisation letter
  • A valid government ID proof such as Aadhaar card.

Please note that your policy address must be same as the current residential address to avoid claim rejections.