FAMILY FLOATER HEALTH INSURANCE PLANS
What is Family Floater Plan ?
Family Floater is one single policy that takes care of the hospitalisation expenses of entire family. The policy has one single sum insured, which can be utilised by any/all insured persons in any proportion or amount subject to maximum of overall limit of the policy sum insured. Family floater plans are better than buying separate individual policies as it will be cost effective . The family floater plans normally come with different sets of people in a family covered under the policy .
1. Covering Husband and wife only
2. Covering husband and wife with two minor children .
3. Covering husband , wife , two minor children along with parents of either husband or wife
Premium for each policy varies according to the ages of the people to be covered ,
WHO ISSUES FAMILY FLOATER POLICIES IN INDIA ?
There are 5 insurance companies that issue health insurance policies exclusively . Other than these five companies , most of the Life Insurance companies and General insurance companies also issue health insurance policies including Family Floater Plans . To go the website of any of the health insurance companies or insurance companies issuing health plan , CLICK HERE
To help our readers to understand the basic conditions for issue of health insurance plans , we have selected ten different plans from array of insurance companies plans and you may go through the table . The terms & conditions vary from plan to plan . One can chose most appropriate plan useful to their family among hundreds of plans available . Before going through the table , one may go through the basics below to understand the terms & conditions .
What expenses health insurance policy normally covers ?
A Health Insurance Policy would normally cover expenses incurred under the following heads in respect of each insured person subject to overall ceiling of sum insured
a. Room, Boarding expenses
b. Nursing expenses
c. Fees of surgeon, anesthetist, physician, consultants, specialists
d. Anesthesia, blood, oxygen, operation theatre charges, surgical appliances, medicines, drugs, diagnostic materials, X-ray, Dialysis, chemotherapy, Radio therapy, cost of pace maker, Artificial limbs, cost or organs and similar expenses.
Sum Insured
The Sum Insured may have a maximum amount for each of the insured under the policy or cumulative for all the insured or a fixed amount to be paid out on particular type of disease or surgery needed or affixed amount per day for the period of hospitalization.
Pre and post hospitalization expenses
Expenses incurred during a certain number of days prior to hospitalization and post hospitalization expenses for a specified period from the date of discharge may be considered as part of the claim provided the expenses relate to the disease / sickness.
Cashless Facility
Insurance companies have tie-up arrangements with a network of hospitals in the country. If policyholder takes treatment in any of the net work hospitals, there is no need for the insured person to pay hospital bills. The Insurance Company, through its Third Party Administrator (TPA) will arrange direct payment to the Hospital. Expenses beyond sub limits prescribed by the policy or items not covered under the policy have to be settled by the insured direct to the Hospital. The insured can take treatment in a non-listed hospital in which case he has to pay the bills first and then seek reimbursement from Insurance Co. There will be no cashless facility applicable here.
CO-PAY CLAUSE
If there is co-pay clause , insured have to pay a portion the expenses incurred himself / herself either as a percentage of claim or a fixed amount . In such a policy , insured will not get reimbursement of 100 % of expenses incurred .
DOMICILIARY EXPENSE REIMBURSEMENT
Many health policies will provide reimbursement of expenses incurred at home for health conditions which would normally require hospitalization . General conditions are
1. The condition of patient is such that he cannot be removed to an hospital .
2. The patient takes treatment at home on account of non-availability of a room in a hospital .
Some policies would put a maximum number of days of home treatments allowed and some would have clause that reimbursement would be provided only after certain initial number of days borne by the insured .
Hence one has to go through the policy document to know exact term of the policy .
PRE-MEDICAL TEST
Some insurance companies require a health check up to be conducted for the persons to be covered under a health insurance policy . Some companies may not insist for people aged up to specific year or if they don't have any adverse medical conditions . Normally insurance companies pay for such medical exam . Please check with the insurance company about the condition before applying .
PRE-EXISTING MEDICAL CONDITION
While conducting medical exam before issuing a health policy or by declaration from the applicant , any adverse medical conditions of the insured may surface to the knowledge of insurance company . Insurance companies normally deny any reimbursement for a specified period for any hospitalization taken place on account of such pre-existing medical conditions .