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Family Floater Health Insurance

Family floater health insurance provides health coverage for the entire family under a single policy, offering cost savings and convenience.

  • 3,302 Views | Updated on: Aug 07, 2024

Exploring different health insurance plans can be exhausting, especially when considering the well-being of your entire family. Especially individual policies that require separate premiums and provide coverage for one person, maintaining these plans become a hassle. To reduce this extra burden, family floater plans come to your rescue. Let us understand the benefits, and considerations of family floater health insurance to help you make an informed decision for your family’s health and financial security.

What is Family Floater Health Insurance?

Family floater health insurance is a type of health insurance policy that covers multiple family members under a single plan. Unlike individual health insurance policies that require separate premiums and provide coverage for one person, a family floater policy extends its benefits to the entire family, ensuring everyone is protected under one umbrella. It makes managing health insurance simpler and often more cost-effective.

How Family Floater Health Insurance Works?

When you purchase a family floater health insurance policy, you choose a sum insured amount to be shared among all the family members covered under the plan. In a medical emergency or health issue, any family member can utilize the insurance coverage up to the total sum insured. For example, if you have a family floater policy with a sum insured of ₹10 lakhs, and one family member incurs medical expenses of ₹3 lakhs, the remaining ₹7 lakhs can still be used by any other covered member within the policy period.

Who Must Consider Buying Family Floater Health Insurance?

Having a family floater cover is ideal for families with young and middle-aged members, particularly those with children. It is also beneficial for small families with a relatively low likelihood of multiple members falling ill simultaneously. This type of policy can be a smart choice for those who seek comprehensive coverage without the hassle of managing multiple individual policies.

Advantages of Family Floater Health Insurance

Family floater plan is a medical insurance for family that offers assistance during medical emergencies. Let us take a look at other benefits of this plan:

1. Covers the Whole Family Under One Plan, Making it Easier to Manage

One of the primary advantages of family floater health insurance is the convenience of having a single policy for the entire family. You only need to remember one renewal date and manage one premium payment, simplifying the process significantly.

2. The Sum Insured is Shared by Covered Family Members

The sum insured in a family floater policy is available to all covered members. It means that if one member uses a portion of the coverage, the remaining amount is still available for others, providing flexibility and comprehensive protection.

3. Lower Premiums than Individual Policies for Each Member

Family floater health insurance often comes with lower premiums than purchasing individual policies for each family member. It makes it a cost-effective solution for families balancing good coverage with affordability.

4. Tax Benefits

Premiums paid towards family floater health insurance are eligible for tax deductions under Section 80D of the Income Tax Act. It can reduce your taxable income and provide financial relief.

5. Annual Health Check-up for Each Family Member

Many family floater policies include free annual health check-ups for all covered members. Regular health check-ups can help in early detection and treatment of health issues, promoting better overall health.

6. Teleconsultations

With technological advancements, many insurance providers offer teleconsultation services as part of their family floater plans. These plans allow you to consult doctors and specialists from the comfort of your home, saving time and providing easy access to medical advice.

7. AYUSH Treatment Coverage

AYUSH (Ayurveda, Yoga and Naturopathy, Unani, Siddha, and Homeopathy) treatments are becoming increasingly popular. Many family floater policies now cover these alternative treatments, providing more options for healthcare.

8. Daycare Treatment Coverage

Modern medical procedures often do not require prolonged hospital stays. Family floater health insurance covers daycare treatments, which include surgeries and procedures that do not necessitate an overnight hospital stay.

9. Pre and Post Hospitalization Coverage

Family floater health insurance typically covers expenses incurred before and after hospitalization. It includes diagnostic tests, medications, and follow-up consultations, ensuring comprehensive coverage for the entire treatment cycle.

10. Cashless Claims

Most family floater, health insurance policies, offer cashless claim facilities at network hospitals. It means you don’t have to pay out of pocket for hospital expenses; the insurer settles the bill directly with the hospital.

How is the Premium for Family Floater Health Insurance Calculated?

The premium for a family floater health policy is determined based on several factors, including the age of the eldest family member, the number of members covered, the sum insured, and the family's health history. The age of the eldest member is a significant factor because it increases the risk for the insurer, leading to higher premiums. Other factors, such as the city of residence and pre-existing medical conditions, also influence the premium amount.

What Does Family Floater Health Insurance Cover?

Family floater health insurance is designed to provide comprehensive coverage for multiple family members under a single policy. Here’s a detailed look at what it typically covers:

  • Hospitalization Expenses: Costs for room rent, nursing, ICU, and treatment
  • Pre and Post Hospitalization Costs: Medical expenses incurred before and after hospitalization
  • Daycare Procedures: Surgeries and procedures do not require overnight hospital stay
  • Ambulance Charges: Expenses for emergency transportation to the hospital
  • Annual Health Check-ups: Regular health check-ups for all covered members
  • AYUSH Treatments: Coverage for alternative treatments like Ayurveda, Yoga, Unani, Siddha, and Homeopathy
  • Teleconsultations: Remote medical consultations with doctors
  • Maternity and Newborn Cover: Costs related to childbirth and newborn care (in some policies)
  • Cashless Treatment at Network Hospitals: Direct settlement of hospital bills by the insurer

What Does Family Floater Health Insurance Not Cover?

Despite its extensive coverage, family floater health insurance has specific exclusions:

  • Pre-existing Conditions: Illnesses or conditions diagnosed before policy purchase for a specified waiting period
  • Certain Illnesses During Initial Years: Specific diseases and conditions during the first few years of the policy
  • Cosmetic or Aesthetic Treatments: Procedures for beautification or appearance enhancement
  • Dental Procedures: Dental treatments unless required due to an accident
  • Injuries from Hazardous Activities: Injuries or illnesses resulting from risky sports or activities
  • Treatments Outside India: Medical expenses incurred outside the country unless specified
  • Experimental or Unproven Treatments: Procedures and treatments that are not scientifically validated

Wrapping it Up

Family floater health insurance is a practical and economical option for families seeking comprehensive health coverage. It offers the convenience of managing a single policy, cost savings through shared coverage, and numerous benefits like annual health check-ups and cashless claims. However, it is essential to understand your policy's specific coverage and exclusions to ensure it meets your family’s healthcare needs.

FAQs on Family Floater Health Insurance

1

How many members can I cover under a family floater health insurance plan?

Typically, you can cover 2 to 6 family members, including yourself, your spouse, children, and sometimes your parents.

2

What are the eligibility criteria for buying a family floater health insurance plan?

Eligibility criteria usually include the age of the members, relationship to the policyholder, and medical history. The primary policyholder must be an adult.

3

Are family floater plans cost-effective compared to individual health insurance policies?

Family floater plans are often more cost-effective because they provide a higher sum insured shared among all members at a lower premium than separate individual policies.

4

What is the significance of a shared sum insured in family floater plans?

A shared sum insured means the total coverage amount is available to any family member, providing flexibility and potentially higher benefits compared to individual limits.

5

Can senior citizens be included in a family floater health insurance plan?

Yes, senior citizens can be included, but this might increase the premium due to higher risk factors associated with their age.

6

Is there a limit on the number of claims that can be made in a year under family floater health insurance?

There is generally no limit on the number of claims, but the total claim amount should not exceed the sum insured for the policy year.

7

Are maternity and newborn baby expenses covered under family floater health insurance?

Many family floater plans include maternity and newborn baby coverage, which often comes with a waiting period and specific sub-limits.

Amit Raje
Written By :
Amit Raje

Amit Raje is an experienced marketer who has worked in various Fintechs and leading Financial companies in India. With focused experience in Digital, Amit has pioneered multiple digital commerce in India. Now, close to two decades later, he is the vice president and head of the D2C business department. He masters the skill of strategic management, also being certified in it from IIMA. He has challenged his challenges and contributed his efforts in this journey of digital transformation.

Amit Raje
Reviewed By :
Prasad Pimple

Prasad Pimple has a decade-long experience in the Life insurance sector and as EVP, Kotak Life heads Digital Business. He is responsible for developing user friendly product journeys, creating consumer awareness and helping consumers in identifying need for life insurance solutions. He has 20+ years of experience in creating and building business verticals across Insurance, Telecom and Banking sectors

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