Complete Guide To Mediclaim Policy for Family In India

Your family is incredibly important to you. When it comes to securing and safeguarding their lives, money should not be a constraint. That’s why ensuring their well-being and providing them with financial security from the astronomical costs of medical crises is crucial and so is choosing the best mediclaim policy for family that covers your healthcare and that of your family.

What are mediclaim policies?

Mediclaim policies come under the umbrella of health insurance in India. An agreed amount is paid by the policyholder as premium to the insurance provider, for the agreed plan within a regular interval of time (as agreed). And in return, the insurance company covers any future or already-incurred medical care costs. Through mediclaim policies, if you go for the treatment in a network hospital, you can avail of the services and treatment cashless. In case you could not go to a network hospital, no worries, you can still reimburse it by filing it later by submitting all your bills.

Types of Mediclaim policies

There are two types of mediclaim policies

Individual mediclaim policies that provide coverage to each member of the family separately
Family floater mediclaim policy, where all the members of the family are covered under a single sum insured.

Please note that your family can also be included in an individual policy. In this case, each member of the family has a distinct sum insured which cannot be distributed or transferred.

What is a mediclaim policy for a family?

A mediclaim policy or a family floater health insurance is a plan which covers your entire family under a single policy. With a single payment, these policies cover your partner, dependent children, parents and parents-in-law. Some health insurance policies offer expanded coverage for your siblings, your grandparents, and any other relatives that you may want to cover. It provides coverage for in-patient expenses, pre and post-hospitalisation costs, acute illnesses, tests, etc.

Who all are covered under the family health insurance?

The insured person, partner, and their children (dependent – both natural and adopted), are covered under mediclaim policy for the family.

How does the mediclaim policy for family work?

All the family members are covered under a single health insurance plan and can utilise the same fixed insurance coverage. This money can ‌ pay your and your family’s health-related bills.

Let’s suppose, you bought a policy with a sum insured of INR 20 lakh per year for you and your family. Your father has utilised INR 5 lakh for his knee operation. Now you and your family have left with INR 15 lakh rupees for the remaining days of the year. Now imagine a different case wherein your father undergoes a more expensive surgery and eventually ends up using the whole INR 20 lakh insurance benefit. Now, the remaining family members won’t be able to submit any additional claims throughout the year.

Benefits of a mediclaim policy for family

The advantages listed below are available to you once you enrol in the most suitable mediclaim policy for your family:

Family coverage under a single plan

You can secure your family, ensuring that everyone receives the finest quality care. The current mediclaim policy can easily accommodate the inclusion of a new person. This will save you from paying several premiums for various plans.

Cashless hospitalisation

Every member of the family who is covered by the mediclaim policy is eligible for cashless treatment in the network hospital.

Economical

When you buy policies individually for each of your family members, you end up paying more compared to a single policy that covers your entire family.

Tax Benefit

Under section 80D of the Income Tax Act. There is an exemption where you can claim tax benefits against the premium you paid for your family’s health insurance.

Restore Coverage

A number of companies provide a unique health insurance benefit known as restoration coverage. Health care policies for families can benefit greatly from this. Based on this, in case the whole sum insured has been used up by a single family member, then the complete sum insured can be reinstated to ensure that the rest of the family under the plan is still covered. However, only for a different treatment, the restored coverage can be used by the same person in the family.

How to choose the best mediclaim policy for your family?

To choose the mediclaim policy for family, one must be attentive to the necessities of the family, such as,

Sum insured

The sum insured must be properly calculated to ensure sufficient coverage for all. Even if one person covered under the plan uses a significant portion, there should still be sufficient for the other insured members.

Age of the family members

When an old age group person is covered by the insurance, the premiums will go up. Additionally, there is a probability that an older person will utilise a large portion of the plan’s benefits. In that case, choosing an individual mediclaim for the senior member would be beneficial.

Co-payment percentage

Verify the co-payment options the insurer provides. When the insured person pays a portion of the entire claim from his/her pocket, it is a co-payment.

Understand the deductible

Deductibles are the sum that a person must pay on their own in the event of a claim. The insurance provider will cover the remaining balance. While a high deductible can decrease the premium, it also means that at the time of a claim, you would have to pay a significant amount.

Understand the sub-limits/capping amount

Every health plan comes with some sub-limits. This limit is the maximum amount covered under your mediclaim for paying your and your family’s medical expenses in the event of hospitalisation. Make sure you are well aware of all these limits.

Conclusion

Today, having a mediclaim policy is an essential financial instrument. Lifestyles diseases, covid-19 and the sharp increase in healthcare inflation have further strengthened the significance of health insurance. However, you need to be cautious and choose a policy that provides full coverage if you want to guarantee your family’s total financial security.