A family health insurance plan is designed to cover all the members of a family. In other words, in this type of insurance, the entire sum insured is divided among the family members. Also known as a floater plan, it is a cost-effective way to ensure that every member of the family remains guarded in case of a medical emergency.

As there are several family health insurance plans available, choosing the right one can be a daunting task. In this article, we list several parameters that you must look into before zeroing in on the best plan. Let’s get started.

• Sum insured

Sum insured refers to the amount of coverage offered by a plan. Simply put, it’s the maximum amount which your insurer would reimburse in case of a medical claim. While availing a family floater plan, it’s essential to opt for a policy that offers adequate coverage.

Several factors go into choosing the right health insurance plan. Location, number of dependents, family history of diseases, etc., are some crucial elements which you must consider before choosing the sum insured. Medical costs in a tier I city are higher than tier II and tier III cities. Also, treatment in a private hospital is usually more expensive than a government one. 

• Network of hospitals covered

Availing the best health insurance for family warrants a close look at the network of hospitals covered. Every insurer has a network of hospitals which might be spread across several cities to the entire country. These network hospitals also allow you to use the cashless treatment facility. Before opting for a family plan, go through the list of hospitals in the insurer’s network. 

Make sure that your chosen insurer has collaboration with the leading hospitals in your location. Also, inquire about the reimbursement procedure(s) in case you are treated in a non-network hospital. 

• Co-pay and sub-limit clauses 

Co-pay and sub-limit are two essential clauses of any health insurance plan. Co-pay refers to the amount which you need to pay from your pocket against the claim amount. For example, in case your health plan has a co-pay clause of 30% and the bill amounts to Rs. 1 lakh, then you need to pay Rs. 30,000 from your savings. The insurer will pay the remaining Rs. 70,000.

Sub-limit refers to the cap on expenses such as room rent, doctor’s fees, etc. For instance, if your plan has a sub-limit of Rs. 2,000 per day for room rent, and your treatment requires you stay in a room whose daily rent is Rs. 4,000, you need to pay the remaining Rs. 2,000 from your own pocket. It’s in your best interest to avail a family health insurance with a low co-pay and high sub-limit, though it may increase the premium a little.

• Waiting period for pre-existing diseases

Most health insurance plans have a waiting period for pre-existing diseases such as arthritis, diabetes, etc. These refer to ailments which you have while buying a health plan. In case of hospitalisation due to them, you aren’t offered any coverage. Coverage starts only after a certain number of years. 

While choosing a family health insurance policy, do find out about the waiting period for pre-existing ailments. The lesser it is, the better it is for you and your family members. Additionally, do find out about the No Claims Bonus (NCB) on offer.  It’s a feature that rewards for a claim-free year. The sum insured is increased at no additional cost.

Note that premium for a family health insurance plan depends on the age of the eldest member of a family. Compare quotes from multiple insurers before making a choice. Bajaj Finserv offers a rage of health insurance plans that offer comprehensive health coverage for your family members. While purchasing a health insurance policy, one should always go through the policy document that includes the inclusions and exclusions of the policy. Understanding of the policy terms and conditions can be instrumental at the time of making claims.