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Important Points to be Considered While Buying Family Health Plan

Buying family health insurance is no more a matter of choice, but a compulsory investment for most Indian families in the face of rising medical expenses. While there are many plans available in the market, it is necessary that one looks at the benefits they provide and their inherent limitations before zeroing in on their choice.

Certain deciding factors must not be overlooked while paying for your family’s health insurance. Some of them are:

  • Amount of Sum Insured: Sum insured by any family health insurance plan is the amount of financial security promised to the family buying the policy. While choosing the amount of sum insured you are looking for, it is important to understand that any billing amount charged over and above the sum insured by the hospital will not be paid by the insurer. Applying for adequate cover under a health insurance plan is deemed better if taken early in life as it may incur added expenses to increase the sum insured at a later stage or after making the first claim.


  • Choosing Between Individual/Floater Policies: Most people feel lost when they have to decide between individual and family floater policies. Individual policies are expensive though they secure the insured against any medical emergency. However, paying for the family floater health insurance allows flexibility to use the insurance cover among the family members included under the policy. It is advisable to opt for a higher sum insured to cover the expenses of hospitalisation in case more than one family member needs to be admitted in a hospital for treatment during the policy period.

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  • Quantum of Insurance Coverage: Do not choose a family health insurance policy just for its price. It is necessary to be careful about the amount of coverage that the insurance policy allows. Check if the policy you are paying for allows benefits like pre and post-hospitalisation expenses, costs incurred on day care procedure, amount of OPD cover, ambulance expenses, etc.

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In many cases, hospitals tend to inflate bills on room rent charges or certain specified procedures for patients having health insurance cover. To tackle this menace, some insurers have added limits on room rent charges and expenses on certain procedures. Check the sub-limits on room rents and other procedures before opting for a health insurance policy to avoid unwarranted surprises later. Choose plans that do not have such restrictive options or require the insured to make co-payments for room rent charges and expenditures on specific procedures.

  • Inclusions and Exclusions in Your Policy: You may have paid for a plan without reading in details the list of ailments that would not be covered by the insurer and, hence, would not be paid for. Ignorance about the “List of diseases not covered” mentioned in the policy may impede emergency treatment due to unwarranted expenditures. Also, it is necessary to know what the policy covers to avoid paying from your own pocket for services that the policy covers.


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  • Does Your Hospital Fall in Your Insurer’s Network: Check if the hospital you family seeks treatment from falls within your insurer’s network. While opting for insurance, check if the network hospital is within reach of your office or place of residence. Choose that insurance company that has more network hospitals in locations where you are more likely to seek medical treatment.

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