PERSONAL FINANCE FINANCIAL PLANNING
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No one should have to choose between medicine and other necessities. No one should have to use the emergency room every time a child gets sick. And no one should have to live in constant fear that a medical problem will become a financial crisis.
- Brad Henry
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 ,
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READ OUR NEW ARTICLE ON GROUP HEALTH INSURANCE PLANS
READ OUR NEW ARTICLE ON GROUP HEALTH INSURANCE PLANS
WHO ISSUES FAMILY FLOATER POLICIES IN INDIA ?
There are 5 insurance companies that issue health insurance policies exclusively . Other than these five compnies , most of the Life Insurance compnies 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 undestand 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 .
To help our readers to undestand 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 .
FAMILY FLOATER PLANS
SELECT BEST FLOATER POLICY THAT SUITS YOU
Insurance company / plan |
Maximum Entry age |
Maximum exit age |
Insurance amount range ( Rs in Lakhs ) |
Premium Range |
Pre Medical test |
Waiting Period pre existing (months ) |
CO -PAY |
Domi -ciliary |
Special conditions |
Religare care |
No limit |
Lifelong |
4 to 600 |
You can calculate on the website |
Required only for age > 50 cover > 25 lakhs |
48 |
Nil for age below 60 years 20% for others |
10 % of SI |
12 CRITICAL GLOBALLY COVERED |
Apollo Munich Easy Health |
No Limit |
Lifelong |
5 to 65 |
Refer the Premium Card |
Required |
36 |
Not specified |
covered |
6 critical illness |
HDFC Ergo Suraksha |
No Limit |
Lifelong |
2 to 50 |
Refer the Premium Chart |
Required |
up to 48 |
10 % to 20 % |
covered |
- |
ICICI Lombard |
No Limit |
Lifelong |
3 to 50 |
Check with the company |
Required |
24 |
Not specified |
Covered |
- |
No Limit |
Lifelong |
2 to 150 |
Check with the company |
Required |
36 |
Not specified |
Covered |
- |
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Future Generali |
No Limit |
Lifelong |
3 to 100 |
Rs 4,418 to 4, 78,455 |
Required |
24 |
up to 40 % |
covered |
- |
Star Family Health Optima |
65 |
Lifelong |
3 to 25 |
Refer the Premium Chart |
Not specified |
48 |
20% for above 60 years |
covered |
- |
IOB Easy Health |
69 |
Lifelong |
3 to 10 |
Refer the Premium Chart |
NO |
36 |
Not specified |
Covered |
- |
LIC's Jeevan Arogya |
65 |
80 |
1 to 4 |
Check with LIC |
NA |
No claim allowed |
NA |
NO |
Fixed payment per day / per surgery . special conditiona apply |
Bajaj Allianz |
65 |
Lifelong |
1.5 to 50 |
Check websitr |
Required above 45 |
36 |
Optional |
Covered |
- |
To go to the individual Insurance companies listed above , click on the name of the insurance company / plan below
1. Religare Care
2.Apollo Munich Easy health PLAN and PREMIUM CARD
3.HDFC Ergo Suraksha
4.ICICI Lombard
5.Royal Sundaram
6.Future Generali
7. Star Family Health optima
8.IOB Easy Health
9. LIC'S Jeevan Arogya
10.Bajaj Allianz Family Health Guard
1. Religare Care
2.Apollo Munich Easy health PLAN and PREMIUM CARD
3.HDFC Ergo Suraksha
4.ICICI Lombard
5.Royal Sundaram
6.Future Generali
7. Star Family Health optima
8.IOB Easy Health
9. LIC'S Jeevan Arogya
10.Bajaj Allianz Family Health Guard
OUR ARTICLES ON HEALTH INSURANCE
Senior Health Insurance Mashak Rakshak Policy Arogya Sanjivani plan
Corona Kavach Policy Corona Rakshak policy
Critical illness Policy Hospital cash Policy
Senior Health Insurance Mashak Rakshak Policy Arogya Sanjivani plan
Corona Kavach Policy Corona Rakshak policy
Critical illness Policy Hospital cash Policy
NEW BLOG ARTICLE ON
HEALTH INSURANCE OPTIONS FOR RETIRED BANKERS
The article explores the alternative avenues for existing health insurance group policy for Retired Bankers
TO READ THE ARTICLE CLICK HERE
HEALTH INSURANCE OPTIONS FOR RETIRED BANKERS
The article explores the alternative avenues for existing health insurance group policy for Retired Bankers
TO READ THE ARTICLE CLICK HERE
TITBITS : From a recent report of Sample Survey Office , it is revealed that 80 percent of Indians , who mainly rely up on private health care , do not have any medical insurance . The government has brought only about 12 % of population under health protection schemes like Rashtriya Swasthya Bima Yojana . In the absence of health insurance , 75 % of Indians use their hard earned savings while 18% have to borrow . In order to escape from financial gloom in the events of medical emergencies , one has to definitely require some form of Health insurance .
KNOW ABOUT TAX ON RETIREMENT BENEFITS , CLICK HERE
FOR INCOME TAX NEWS , CLICK HERE NEWS ON INTEREST RATES CLICK HERE
ARTICLE ON INVESTMENT OPTIONS FOR RETIREES , CLICK HERE WHAT IS SYSTEMATIC INVESTMENT PLAN ? CLICK HERE
NEW ARTICLES ON
SMALL FINANCE BANKS PAYMENT BANKS
UNIFIED PAYMENT INTERFACE BHARAT BILL PAYMENT SYSTEM
BHIM APP AADHAR
e-INSURANCE Account ( eIA )
FOR INCOME TAX NEWS , CLICK HERE NEWS ON INTEREST RATES CLICK HERE
ARTICLE ON INVESTMENT OPTIONS FOR RETIREES , CLICK HERE WHAT IS SYSTEMATIC INVESTMENT PLAN ? CLICK HERE
NEW ARTICLES ON
SMALL FINANCE BANKS PAYMENT BANKS
UNIFIED PAYMENT INTERFACE BHARAT BILL PAYMENT SYSTEM
BHIM APP AADHAR
e-INSURANCE Account ( eIA )
OTHER TERMS & CONDITIONS IN A HEALTH POLICY
Additional Benefits and other Riders
Insurance companies offer various other benefits like “ Health Checkup “. There are also policies that give benefits like “Hospital Cash”, “Critical Illness Benefits”, “Surgical Expense Benefits” etc. These policies can either be taken separately or in addition to the hospitalization policy. A few companies have come out with products in the nature of Top Up policies to meet the actual expenses over and above the limit available in the basic health policy.
Exclusions
The following are generally excluded under health policies:
a. All pre-existing diseases or with waiting period typically from 12 to 48 months .
b. Under first year policy, any claim during the first 30 days from date of cover, for sickness / disease. This is not applicable for accidental injury claims.
c. During first year of cover – cataract, Benign prostatic hypertrophy, Hysterectomy for Menorrhagia or Fibromyoma, Hernia, Hydrocele, Congenital Internal diseases, Fistula in anus, piles, sinusitis and related disorders.
d. Circumcision unless for treatment of a disease
e. Cost of specs, contact lenses, hearing aids
f. Dental treatment / surgery unless requiring hospitalization
g. Convalescence, general debility, congenital external defects, V.D., intentional self-injury, use of intoxicating drugs / alcohol, AIDS, Expenses for Diagnosis, X-ray or lab tests not consistent with the disease requiring hospitalization.
h. Treatment relating to pregnancy or child birth including cesarean section
i. Naturopathy treatment.
The actual exclusions may vary on each policy terms .
TAX BENEFIT UNDER HEALTH INSURANCE
In India, as per Section 80D of the Income Tax Act, a deduction is allowed in respect of the health insurance premium paid for up to Rs. 25,000 p.a when you buy health insurance in India for your family. For a senior citizen , deduction allowed is up to Rs 50,000 from the financial year 2018-19
Insurance companies offer various other benefits like “ Health Checkup “. There are also policies that give benefits like “Hospital Cash”, “Critical Illness Benefits”, “Surgical Expense Benefits” etc. These policies can either be taken separately or in addition to the hospitalization policy. A few companies have come out with products in the nature of Top Up policies to meet the actual expenses over and above the limit available in the basic health policy.
Exclusions
The following are generally excluded under health policies:
a. All pre-existing diseases or with waiting period typically from 12 to 48 months .
b. Under first year policy, any claim during the first 30 days from date of cover, for sickness / disease. This is not applicable for accidental injury claims.
c. During first year of cover – cataract, Benign prostatic hypertrophy, Hysterectomy for Menorrhagia or Fibromyoma, Hernia, Hydrocele, Congenital Internal diseases, Fistula in anus, piles, sinusitis and related disorders.
d. Circumcision unless for treatment of a disease
e. Cost of specs, contact lenses, hearing aids
f. Dental treatment / surgery unless requiring hospitalization
g. Convalescence, general debility, congenital external defects, V.D., intentional self-injury, use of intoxicating drugs / alcohol, AIDS, Expenses for Diagnosis, X-ray or lab tests not consistent with the disease requiring hospitalization.
h. Treatment relating to pregnancy or child birth including cesarean section
i. Naturopathy treatment.
The actual exclusions may vary on each policy terms .
TAX BENEFIT UNDER HEALTH INSURANCE
In India, as per Section 80D of the Income Tax Act, a deduction is allowed in respect of the health insurance premium paid for up to Rs. 25,000 p.a when you buy health insurance in India for your family. For a senior citizen , deduction allowed is up to Rs 50,000 from the financial year 2018-19
TIPS FOR BUYING HEALTH INSURANCE FOR SENIOR CITIZENS
1. Various Insurance companies offer health Insurance Policies . But the terms , diseases covered and premiums vary . Hence first write down your needs and Medical history of your spouse / children to be covered , and the amount of coverage you may require . Please remember the medical costs are increasing year after year and what looks like suffice today may not cover fraction of your requirement after 5 years . Hence keep cushion while having the amount fixed .
2. You check the hospitals in your city , especially which are convenient to you , are covered under cashless facility by TPA .
3. Compare the premiums from three or four insurance companies for the least and you can find huge variation from company to company and chose the one which suits your budget and requirements .
4. Floaters policies covering all the members of your family are cheaper than taking individual policies and hence get a policy which can cover your family members .
5. Check whether premiums are kept at the same level as offered for at least for few years . Otherwise every year you will have to pay higher demanded premiums .
6. Check up to what your age the policy will cover . There are policies which cover till lifelong . Otherwise at the ripe age when you require insurance , umbrella of insurance would be removed .
7. Check towards the conditions on pre -existing diseases . Lesser period will be better .
8. Even if pre-existing conditions are covered after a lapse of waiting period , some insurance company will charge as much as
50 % after the waiting period is lifted . Hence check
9. If you have already covered by a health insurance policy taken by yourself or your employer or any of your family members and if you feel the amount covered is not sufficient , you may go in for a Top up Health Insurance or Super top up health insurance which will cover you beyond the amount covered by your initial policy .
10. Health Insurance policies get income tax rebates under SEC 80D . For details , CLICK HERE
PLEASE NOTE WE HAVE NO COMMERCIAL INTEREST WITH ANY OF THE INSURANCE COMPANIES
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BHIM APP AADHAR
