The data on healthcare in India is quite straightforward. The numbers speak for themselves. Today, 75% of medical costs are still paid out of pocket, leaving families at risk of financial crises during emergencies. Even with over 2 dozen health insurance providers in the country and various types of health insurance plans in place, 68% of people state that they do not have enough funds to afford the costs. Although cashless treatment is still preferable, with 89% of the population wanting it, 79% opt for reimbursements.

Amidst all this, imagine if your loved one is struck with sudden sickness, and instead of your attention being on their recovery, you are frantically trying to come up with the funds to cover their hospital costs. This is a situation no family should face, and yet, it's all too common.

This is exactly where family health insurance plans become super essential. Yet again, it's unfortunate to note how 400 million Indians still lack access to health insurance.

However, the true question is not whether you need one, but rather how to choose the best plan that fits your family's unique requirements. Let’s look closer at health insurance for your family, why you need one, and how to choose once you know what you want!

What are Family Health Insurance Plans?

A family health insurance plan can be perfectly described as coverage for all of your loved ones including parents and children under a single policy.

Usually, it covers all the basic needs like hospitalization, pre- and post-hospitalization costs, daycare services, etc.

One of the biggest advantages of these plans is the flexibility that they offer. The sum insured can be shared by the entire family.

Plus, several family plans also come with value-added benefits like newborn cover, maternity cover, free health check-ups, and even wellness programs, which are particularly designed to help keep your entire family in the best health possible.

Why Do You Need a Family Health Insurance Plan?

When it comes to protecting your family, a hundred reasons will fall short. Nevertheless, below are a few reasons why family health insurance plans are the best bet and why you should invest in one!

Rising Medical Costs

The cost of healthcare is sky-high and is not expected to go down anytime soon. Having a family health insurance plan eases your financial burden and prepares you for a health emergency or a planned surgery.

Did you know that in 2023, India’s medical inflation reached 14%, which was the highest in Asia?

Financial Security

No one plans for emergencies. However, they are bound to happen. The issue arises when the hospitalization expenses start mounting up rapidly, eventually depleting your funds when you least expect it. A family health insurance plan lowers this financial impact by paying for the medical costs and freeing you up to concentrate on getting healthier.

Preventive Care Benefits

Most family plans offer free preventive health check-ups. Yet again, these are more than just a bonus. Instead, they allow you to stay ahead of the uncertainties regarding your family's health. By early detection, diagnosis, and treatment, you can ward off deadly illnesses and health problems.

All-inclusive Coverage

These plans provide comprehensive coverage. Starting from in-patient hospitalization coverage to domiciliary hospitalization facility, from daycare to yearly health check-ups, these plans offer a safety net for your family’s well-being.

Tax Benefits

Here comes the best part. The financial relief does not stop at medical bills. Section 80D of the Income Tax Act allows you to deduct the premiums you pay for the family health plan, which will eventually increase your savings even further.

Did you know that you can claim up to ?1,00,000 as tax benefits when you have a health insurance policy for your family?

Peace of Mind

This is probably the most underappreciated and underrated advantage. When medical emergencies arise, knowing that your family is protected frees you from the financial burden, stress, anxiety, and hassle. With health insurance in place, you become mentally prepared, knowing your family’s medical needs will be taken care of appropriately without draining your bank.

How to Select the Best Family Health Insurance Plan?

The first thing you must be looking at at the time of buying a plan is the rates or premiums. However, there is more to it. Here are some things to consider while choosing the best family health insurance plan:

1. Understand the Needs of Your Family

Do you have aging parents who may require regular medical attention? Do you intend to have kids shortly? Do you have any chronic conditions? Try assessing all these factors before choosing a plan. Evaluate your family's present and future health needs. This will help you come up with the best sum insured package.

2. Pay Attention to the Coverage along with the Premium Although it may be tempting to choose the plan with the lowest premiums, remember that you need comprehensive coverage. And coverage with cheaper premiums may not be sufficient. Seek plans that come with extensive benefits including wellness programs, maternity benefits, AYUSH treatment, daycare treatment cover, etc.

3. Go for Cashless Hospitalisation

A decent family health insurance plan should provide cashless treatment facilities at networked hospitals. It eliminates the need to pay the medical bills from your pocket. Make sure your nearby hospitals are included in the insurer’s list of network hospitals and you have the complete list of network hospitals.

Update: In January 2024, the concept of ‘Cashless Everywhere’ was introduced by the Insurance Regulatory and Development Authority of India(IRDAI). This also states that you can get cashless treatment in a non-network hospital. 

4. Check the CSR (Claim Settlement Ratio): 

You would never want to be stuck in a situation where your claims are endlessly delayed or rejected. Hence, choose insurers with high claim settlement ratios, preferably over 90%. The higher, the better. A strong CSR also indicates that the insurer is reliable and efficient in processing claims when time is of the essence!

5. Select Enough Sum Insured

Considering the growing expense of medical care today, make sure that the health insurance amount you opt for is sufficient for the size of your family. A minimum of ?10 lakh to ?15 lakh would possibly be appropriate coverage for a family of four living in a metro city.

Tip: A common thumb rule is that your policy sum insured should be at least 50% of your annual income.

6. Look for Sub-Limits

This is one of the most important areas to check while opting for a family health insurance plan. Be aware of plans that have sub-limits on doctor fees, room rent, or specific treatments. Despite having insurance, these restrictions may reduce the amount you may claim and require you to make out-of-pocket payments.

7. Add-ons/Extra Benefits

To provide comprehensive care to your family, look for add-ons like OPD coverage, maternity coverage, or mental health coverage. While these may come at an extra cost, they are worth it.

Tip: Use an online health insurance premium calculator to know how the coverage can affect your premium. An estimate of the annual cost will help you make a well-informed decision. 

8. Inclusions and Exclusions of the Policy

This is the most crucial part of health insurance plans that most people skip. Don’t forget to read the fine print. Generally, it is easy to get drawn in by the advantages of the plan. Yet again, it is extremely important to know what is excluded to prevent unpleasant bills and surprises when filing claims. Unless you don’t want hefty surprise bills, give a thorough read to the policy documents.

Wrap Up

To conclude, with the correct health insurance plan, you are not just investing in a better today but a healthier tomorrow. Health insurance plans ensure that no matter what health problems life throws your way, your family will have the ultimate access to quality care without compromising your hard-earned savings. Just choose wisely and stay safe!