Tips To Keep In Mind Before Buying Family Floater Health Insurance

The coronavirus pandemic has reinforced the importance of health insurance policies among individuals. Healthcare expenses have been on the rise for a long time now, with the private sector contributing to approximately 74% of India’s total healthcare outlay. 

Any unforeseen financial liability due to a medical emergency can drain an individual’s entire life’s savings. Availing financial security like a mediclaim policy for family can help individuals avail effective treatment without compromising their planned investments. With a variety of healthcare covers available in the market, it is wise to compare different insurers before opting for one. 

Here are some important points to consider when choosing an insurance company.

  • Insurance amount

Understanding your requirement for financial coverage must be of utmost importance when choosing a health insurance plan for family. Although predicting the exact amount for future health emergencies might be impossible, opt for an amount adequate for all family members. 

Opting for a higher possible amount is more effective in this regard since it enhances future-proofing. Also, the insurance amount must be adjusted accordingly as and when more members are included in the plan. 

  • Costs covered

Every insurer has a list of inclusions or expenses covered under a particular policy. Make sure to thoroughly check this list and see if it covers the costs you are likely to incur. Coverage plans like Aditya Birla Capital Group Active health insurance offered by Bajaj Finserv provide financial aid with hospitalisation expenses, daycare treatment, and organ donation procedure charges, among others. Additionally, policyholders can avail coverage on pre and post hospitalisation costs, ICU, vaccination, and ambulance charges.  

  • Waiting period 

Several medical insurance providers specify a waiting period during which no claims are admissible. There can be different types of diseases with separate waiting periods. While a standard 30-90 day waiting period is mandated for any treatment, claims against pre-existing health conditions are only approved after a few years since policy commencement. 

The illnesses and their waiting period can vary across insurers. Also, there can be individual disease types with separate waiting periods. Individuals must be aware of the details on the same before choosing the best family health insurance policy in India.

  • Disease-specific coverage and co-payment

Each type of mediclaim policy for family comes with separate cost limitations on specific treatments. The residual charges must be covered by the insured with their out-of-pocket expenditure. 

Such policies also come with a pre-defined co-payment against selected healthcare services. To understand these requirements in detail, individuals need to scrutinise their insurer’s co-payment clause and other terms and conditions.

  • Cashless network

Health insurance providers allow filing a claim in two modes, reimbursement and cashless. A reimbursement claim requires a policyholder to make payment to the hospital and then avail compensation for the same from their insurer. 

On the other hand, cashless claims involve the insurer settling all expenses directly with the hospital, i.e., you enjoy treatment without paying a penny. While the latter might seem more convenient, insurance providers offer this benefit only in partner hospitals. Therefore, check your insurer’s hospital network to see if you can enjoy such a family medical insurance claim at your preferred institution.

  • Policy exclusions

Every health insurance plan, including a mediclaim policy for family, comes with its own list of disease exclusions. Several medical conditions, like STDs, self-inflicted injuries, specific cosmetic surgery, dental treatments, etc., are not covered by most plans. 

Individuals may also not get assistance with specific mental health conditions, although the Mental Healthcare Act 2017 mandates insurers to cover treatments for psychological disorders. It is important that you go through these specifications beforehand while conducting a health insurance comparison.

Plus, check for additional benefits like a no-claim bonus when you file zero claims in every subsequent year of your mediclaim policy for family. Also, check if your insurance cover offers free annual health check-ups for a comprehensive plan.

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