What is a Family Health Insurance Plan?


A family health plan or family mediclaim policy is designed to offer health cover to families. It works like the individual health plan/mediclaim policy with the only difference being that it coversthe entire family.

The mediclaim policy for family proves critical in safeguarding the health of the family. Without it, family members are exposed to ailments and critical illnesses and can suffer acute financial loss in treating the illnesses given the inflation in medical treatment costs.

To understand how the family health plan works vis-à-vis the individual health plan, let us consider this illustration revolving around the Shah family.

  1. How individual health plan works

    The Shah family has four members with individual covers of Rs 1 lakh each, which means that each member can claim reimbursement for up to a maximum of Rs 1 lakh. If the medical expense towards an individual’s treatment exceeds Rs 1 lakh, for instance let us say its Rs 1.5 lakhs, he can only claim Rs 1 lakh from the health policy and must pay the balance (Rs 50,000) out of his pocket.

  2. How the family health planworks

    To overcome the limitations of the individual mediclaim plan, the Shah family can opt for the family health plan, also known as the family floater plan.

    The Shah family can start with a family health plan of Rs 4 lakhs. This allows any family member to claim medical benefit for more than Rs 1 lakh so long as it is within the overall sum assured of Rs 4 lakhs. This way if two family members need medical treatment in a year amounting to Rs 4 lakhs, the family health plan with Rs 4 lakhs sum assured proves adequate.

    The family health insurance policy usually covers the individual, spouse and children. Some insurance companies also offer family health plans that cover dependent parents, siblings and parents-in-law.

    Make sure you understand the features and benefits of the family health plan and thouroughly compare health insurance plans for family, before selecting one.

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Category : Family Health Insurance

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