Children Health Insurance
Health insurance plans for children offer coverage to children for various healthcare expenses arising due to the child getting ill, sick, or contracting any disease. The coverage can be availed as per the sum insured chosen and the premium paid.
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Health insurance plans for children are one of the most preferred ways to meet the healthcare costs in case the child gets ill, sick, contracts a disease. These plans cover the child against several expenses including roaming ambulance expenses, in-patient hospitalization expenses, pre-hospitalization expenses, post-hospitalization expenses, etc. at the time of all health-related contingencies. In India, health insurance plans for children are individual health insurance plans, and family floater health insurance plans, etc. These plans cover the insured for several healthcare expenses, as well as other benefits such as tax benefits under Section 80D of the Income Tax Act, 1961, discounts, add-in covers, etc.
Need For Health Insurance Plans For Children
Children have weaker immune systems that are not fully developed that limit their ability to fight several diseases. Also, young children have slower reflexes as compared to adults. Their reflexes grow as they age and until then they may be accident-prone. Thirdly, children are more exposed to illnesses than adults. Considering their eating habits that involve unhealthy food, they are more prone to illnesses. So, it is imperative to purchase health insurance that provides children the adequate coverage they need. Dependent children can be covered on a family floater basis along with either of their parents.
Benefits of Buying Health Insurance for Children
Health insurance plans for children generally cover a wide range of illnesses and offer the following benefits.
1. Lower Premium: Children can be covered along with their parents at a lower cost.
2. Comprehensive Coverage: Usually, there is no restriction in the coverage features for children as they are offered comprehensive coverage.
3. Additional Perks: Children are offered added perks like a consultation with experts, information on nutrition and diet, etc.
4. No Claim Bonus: Some health insurance plans for children offer No Claim Bonus. This bonus increases the sum insured amount for greater coverage or gives concession on health insurance premium if no claim is made during the policy period.
Types of Health Insurance Plans For Children
You can get your children covered under two types of health insurance plans. These are:
1. Family Floater Plans: These plans cover the entire family. Apart from self, these plans can include a spouse, up to 4 dependent children, and parents of the policyholder. Many health insurance plans have limitations on the age of children, teenagers, newborn babies, toddlers, etc. The plans allow dependent children to be covered only till the age of 25 years, but this may vary from plan to plan. These plans come at lower premiums and cover the entire family under a single sum insured.
Benefits of Family Floater Health Insurance Policy
The benefits highlighted below are offered under the Family Floater Health Insurance policy:
- Special Discounts: The policyholder is offered special discounts related to including members to an insurance plan, and the less is the age of the member added to the plan, the lower would be the amount of premium payable.
- No-Hassle: As all the family members get covered under a single health insurance plan, it is much simpler to maintain track of the plan and the coverage related to it. Moreover, registering for a claim is also easy as the entire procedure can be streamlined.
- Fixed Premium: There are fixed premium amounts for a policy duration. The premiums payable are freezed for that entire duration of the policy.
- Tax Benefits: You can avail tax benefits on family floater health insurance plans under section 80 D of the Income Tax Act.
- Add-On Covers: There are various health insurance add-on covers that you include with your family floater health insurance plan as and when you require it.
2. Individual Child Health Plans: These are standalone plans that are especially designed to cover children. Unlike family floater plans, the sum insured here is entirely dedicated to your child. Coverage benefits under these plans include hospitalisation expenses, ancillary services like lab tests, ambulance expenses, etc. Another benefit that these plans offer you is cashless treatment in network hospitals.
Benefits of Individual Child Health Insurance Policy
The following benefits are offered under Individual Child Health Insurance Plans:
- No Claim Bonus: A few child health insurance plans offer NCB or No Claim Bonus benefit, wherein the premium payable towards the insurance plan gets reduced or there is an increase in sum insured without extra charges. This is done to reward the policyholder for taking care of their health and not raising any claims in the previous policy duration.
- Lower Premiums: The premiums charged against Individual child health insurance plans is low as there is minimum risk involved with the insured. Therefore, the parents can have the much needed peace of mind by getting their child protected and at a very affordable cost.
- Additional Perks: Individual Child Health Insurance Plans generally included various other perks like cashless hospitalisation. With a cashless hospitalisation facility, an insured can easily get themselves treated at any tie-up hospitals without requiring to pay anything from their pocket as the insurance provider would directly settle the bill with the hospital.
Purchasing a health insurance plan for your children is an ideal way to get that much needed peace of mind and also to ensure financial safety in times of unforeseen medical emergencies. Moreover, buying a health plan for kids at a young age comes with an additional advantage of paying a lower premium amount, and allows you to protect the health of your children without drilling a hole in your pocket.
How Many Members Can Be Covered Under Health Insurance Plans For Children?
Children can be covered on a family floater basis along with either of their parents. Usually, these plans cover Self, Spouse, and up to 4 children. But the number of members who can be included under the health insurance may vary from insurer to insurer and from plan to plan.
Factors to Consider When Buying Health Insurance For Children
To make an informed decision when buying a health insurance plan for children, one must consider the following parameters:
1. Coverage Features: Checking the plan coverage features is important in order to choose a plan that offers an adequate cover so that it is useful at the time of need. Make sure to choose a plan that covers OPD treatment, in-patient hospitalisation expenses, pre-hospitalisation and post-hospitalisation expenses, etc.
2. Additional Benefits: Several health insurance plans offer added benefits to the policyholders. So, it is better to go for a health insurance policy for children that offers added benefits like cover for consultation with experts, no co-payment clause, no limit on room rent capping, etc.
3. Network Hospitals: Network hospitals are the hospitals that insurance companies have tie-ups with and where the policyholders can avail cashless treatment. So, it is recommended to choose a health insurance policy for children that has a good number of hospitals and preferably nearby the place of residence, so that they can transfer the child to the nearest hospital without wasting any time at the time of emergency.
4. Critical Illness Cover: Not all health insurance plans for children offer critical illness cover, and those that do, offer it for specified illnesses. So, make sure when choosing a health insurance policy, to opt for a plan that offers cover for the maximum number of critical illnesses.
5. Sum Insured Options: Choosing a sufficient sum insured amount is a must as it provides the insured sufficient coverage without having to worry at the time of claim. So, one must opt for a sum insured amount that suits best their requirements and falls within the budget.
Choosing the Right Health Insurance Policy For Children
Family floater health insurance plans offer comprehensive coverage to the insured, by providing them cover for several healthcare expenses for your child’s health. Under these policies, you can find value-added benefits such as health risk assessment, primary consultation with qualified experts and physicians, and health-related counseling. But certain coverage benefits such as pre-existing illnesses generally come with a waiting period, during which no claim can be made. So, when choosing a family floater health insurance policy, you must look for certain criteria. This is given below:
- Check if the policy offers coverage for children aged 5 years and above.
- Children aged less than 5 years can seek cover under the policy from the 91st day if both the parents are covered already.
- See if the policy offers maximum renewal ceasing age that should ideally be a lifetime renewability policy.
- Check if the policy offers the highest amount of coverage for your child, both in terms of co-payment and treatment.
- Although not in terms of children, you must opt for plans that cover them for pre-existing diseases.
But the most important thing before you select any children’s health insurance policy is to thoroughly read the brochure. It helps a lot to find out how useful a children’s health insurance plan is, what are the inclusions and exclusions under it, and other policy features.
What is Covered Under Health Insurance Plans For Children?
Most health insurance plans for children cover you for healthcare expenses listed below. But note that the coverage benefits of one health insurance plan may differ from another.
- In-Patient Hospitalisation Expenses: Most health insurance plans cover your child for in-patient hospitalisation expenses. These are the expenses that incur due to hospitalisation of at least 24 hours. These expenses include room rent, nursing, boarding expenses, ICU/ICCU expenses, etc.
- Pre-Hospitalisation And Post-Hospitalisation Expenses: Individual or family health insurance plans for children cover you for expenses arising before and after hospitalisation, known as pre-hospitalisation and post-hospitalisation expenses, for a specific number of days. These include doctor’s consultation fee, x-rays, tests etc. Some health insurance companies cover these expenses for up to 60 and 90 days respectively, while others cover them for 90 and 180 days respectively.
- Daycare Treatments: Daycare treatments are the ones that do not require hospitalisation for at least 24 hours and can be done before that, due to technological advancements. For instance, balloon sinuplasty, chemotherapy, radiotherapy, sinusitis, dialysis, etc. Most health insurance plans for children cover a specific number of daycare procedures, which can be found in the policy document.
- Ambulance Expenses: Road ambulance expenses are the expenses that incur due to transportation of the patient to the nearest hospital in case of a medical emergency. Health insurance plans for children cover these expenses for up to a specific limit.
- Domiciliary Hospitalisation Expenses: Children’s health insurance policies cover your child for treatments taken at home due to the unavailability of beds in the hospital, or on doctor’s advice. The hospitalisation should continue for at least 3 consecutive days, only then the insurance company will reimburse you for the medical expenses incurred from the first day.
There can be some exceptions to the list of inclusions under different health insurance plans for children. So, to check them, you should refer to the policy document.
What is Not Covered Under Health Insurance Plans For Children?
Common exclusions under health insurance plans for children are as follows:
- Pre-Existing Conditions: Individual or family floater health insurance plans cover you for pre-existing illnesses after a specific waiting period. During this period, you will not be covered for pre-existing diseases.
Dental, Hearing, And Vision: Children’s health insurance plans do not cover you for any expenses related to dental, hearing, or vision. These include hearing aid, the cost of spectacles, lenses, etc.
- Cosmetic Surgery: Cosmetic surgery, for the improvement of one’s appearance, is not covered under individual or family floater health insurance policy. But in case the surgery is required due to an accident or injury, then it will be covered under the policies.
- Participation In Adventure Sports: Health insurance plans for children do not cover you for any injury, illness, or treatment required due to participation in adventure sports. For instance, rock climbing, parasailing, etc.
- Self-Harm: Health insurance plans for children do not cover you for any treatment required due to any act of self-harm like suicide, etc.
There can be some exceptions for exclusions under different health insurance plans for children. So, to check the list of exclusions, you should refer to the policy document.
How to Buy Health Insurance Plans For Children Online At InsuranceDekho?
InsuranceDekho has a simplified process when it comes to buying health insurance plans for children online. The steps given below need to be followed:
1. Visit www.insurancedekho.com, and click on the ‘health’ tab.
2. Select gender, enter your name and then enter your mobile number. You will receive a One Time Password (OTP) on the provided number. Please enter the same.
3. Tell us when you can purchase the health insurance policy for children. Then click on the ‘View Instant Quotes’ button to proceed.
4. If you want to add family members along with yourself in the policy too, then select them and their age. Click on ‘Continue’.
5. Enter your Email ID. Then enter your city and click on the ‘Submit and View Quotes’ button.
6. You will see many health insurance quotes for children. Choose the most suitable one out of them considering your requirement and budget.
7. Select the policy term. Then enter the required details. Pay the premium online via any flexible mode of payment offered.
Health insurance for children can also be purchased offline at InsuranceDekho by contacting the experts on the toll-free number 7551196989. In case of any further query or doubt, you can even write an email to us at customersupport [at] insurancedekho.com.
Mistakes to Avoid When Buying Children Health Insurance Plans
In order to make the right decision when buying health insurance plans for children, the following are the mistakes that you must avoid:
- Not Getting Enough Coverage for Children: When buying children’s health insurance plans, you check the premium to be paid for the same. And for a lot of people, the premium is the sole deciding factor to buy a health insurance policy. But this should not be the case. Choosing a policy with a nominal premium may cost you more later. So, in a way, you can understand that the higher the premium you pay for a health insurance policy for children, the higher returns you may be able to avail. So, you should not just choose it on the basis of premium, but also on the basis of other factors such as sum insured, coverage benefits, waiting period, renewability benefits, etc.
- Missing The Co-Payment Clause: The last thing to miss when buying a health insurance policy for children is the co-payment clause. Co-payment is when the insured and the insurance company pay partially for a health insurance claim. The percentage of the amount of partial payment is pre-decided and depends on the type of policy. So, you must choose a children’s health insurance policy with minimum co-payment.
- Hiding Relevant Medical History: When buying health insurance policies for children, you must avoid hiding any health-related history with the insurance company. This is because even if you get the required policy, you may not be able to avail of the claim made under it, in case of a health emergency. Because you may not be able to hide the medical emergency in the future in case you require treatment and make a claim for the same. You may even face charges of insurance fraud, also the outcome may not be good for your health.
- Relying on Single Insurance Policy: Another mistake people make when buying health insurance plans for children is relying on insurance cover offered by an employer or a single insurance policy. In the case of employer’s insurance, you may lose coverage for your child when you leave the organisation. Also, with multiple health insurance policies, you can avail greater coverage.
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*Tax benefits are subject to changes in Income Tax Act.
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FAQ About Children Health Insurance
What is health insurance for children and how does it work?
Children health insurance offers healthcare protection to children if one or both parents are covered under the same health insurance policy. The conditions, however, may vary with different plans.
Who all can be covered under a child health insurance policy?
If you have purchased an individual child health insurance plan, then children till the age of 25 years can be covered under the plan. However, if you have bought the health plan on a family floater basis, then members that can be covered include self, spouse and up to four dependent children.
What is covered under health insurance for children?
Under health insurance plans for children, the children are covered for several healthcare expenses such as ambulance expenses, pre-hospitalisation and post-hospitalisation expenses, daycare procedures, and so on.
What is the waiting period for health insurance for children?
Waiting period for health insurance for children varies from plan to plan. However, the initial waiting period is 30 days and the waiting period for pre-existing diseases is 2 years.
What are the eligibility criteria for health insurance for children?
The minimum and maximum eligibility criteria for health insurance for children are 3 months and 18 years respectively. However, the eligibility criteria vary from plan to plan.
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