How Many Members Can I Include in a Health Insurance Plan?
Updated On Nov 23, 2022
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One of the most popular types of health insurance plans in India is for families. Known as a family health insurance plan, this type of health cover offers coverage to you, your spouse, your children, parents, and even parents in laws. Under the family health plan, all the members of the family are covered with a single sum insured. However, when purchasing this type of plan, many times, one of the commonly asked questions is ‘how many people can I cover under family health insurance’. Read on to know more.
How Many People can be Covered by Health Insurance?
Different insurance companies have different rules about how many members a family health insurance policy covers in total.
In general, family floater plans provide coverage for individuals, spouses and kids. Some plans also allow ward guardians to be taken into account. There are also family health insurance plans that cover the individual, their spouse, their dependent children and parents, as well as their siblings, parents-in-law, grandparents, great-grandparents, grandchildren, son-in-law, daughter-in-law, sister-in-law, brother-in-law, nephew, and niece.
What Family Floater Health Insurance Plans Cover?
Family floater health insurance plans usually cover the following medical costs:
- In-Patient Hospitalisation Costs: are the costs that come up when someone stays in the hospital for at least 24 hours straight.
- Pre and Post-Hospitalisation Costs: include things like x-rays, doctor visits, etc. that happen before and after a stay in the hospital.
- Costs for Daycare: Daycare procedures are those that don't require at least 24 hours in the hospital. For example, radiotherapy, chemotherapy, balloon sinuplasty, etc.
- Ambulance Costs: These are the costs that an ambulance on the road has to pay to get a patient to the nearest hospital.
- Expenses For Organ Donors: Many family health insurance plans also cover the costs of organ harvesting.
Exclusions Under Family Floater Health Insurance Plans
Most family floater health insurance plans don't pay for the following medical costs:
- Waiting Period: Every plan to protect families' access to medical care has a basic waiting period during which no cases will be helped. Other waiting periods are for pre-existing illnesses, specific illnesses, etc., for which the insured is not covered for a certain amount of time.
- Expenses From Adventure Sports: Family health insurance plans do not cover expenses you have to pay because you do things like rock climbing, parasailing, etc.
- HIV/AIDS: Most family health insurance plans do not cover the costs of HIV/AIDS or treatments related to it.
- Tobacco Use or Abuse: Any illness or injury caused by using tobacco, drugs that make you drunk, or hallucinogens is not covered by these plans.
- Self-Inflicted Injuries: These plans don't pay for any costs caused by things like self-harm or suicide.
Who Can Buy Health Insurance Plans for Their Families?
Anyone who wants a financial back-up in case of medical emergencies for themselves and their family members can buy a family health insurance policy. The majority of insurance companies have set the age at which you can buy a policy at 18. But the terms of the insurance plan say that the dependents can be as young as 91 days old and as old as 65–75 years old.
What Documents Are Needed to Buy Family Health Insurance Plans?
Some of the documents you need to buy health insurance for your family are:
- Proof of Age: This is a very important document that you need when you buy health insurance, since most plans have a set age to join. One copy of each of the following can be sent in:
- Proof of Address: The health insurance company would need to send several letters to the policyholder's mailing address. The policyholder can send in any of the following documents:
A driver's licence, a ration card, a PAN card, an Aadhar card, and any utility bills, such as a phone bill or an electric bill, are all examples.
- Proof Of Who You Are: For records, you need proof of who you are. These records help the insurance company figure out what kind of coverage they want to offer the policyholder. The policyholder can send in any of the following documents:
Passport, ID card for voting, driver's licence, Aadhar card, and medical reports (in case asked by the insurance company)
Along with the above-mentioned documents, you must also submit a passport-sized photo, proposal form that has been filled out and signed
Conclusion
Before you buy a health insurance plan, you should make sure you know what it covers and how many people it covers. Almost all health plans cover day care costs, hospital stays, ambulance fees, costs before and after a hospital stay, and other costs. Choose a plan that fits your budget and meets the health needs of you and your family members.
Also Read: Comparison Between Health Insurance and Term Insurance
