"Spending a whole day looking for insurance is fun," said nobody, EVER!
"Spending a whole day looking for insurance is fun," said nobody, EVER!
  • Family Floater Health Insurance

    Health Insurance
    • Premiums as low as Rs12/day for coverage of Rs.4 Lakhs*
    • 10,000+ hospitals for cashless treatment
    • Claim up to Rs. 55,000 deduction under section 80D**

    Health insurance policies are a smart way to reduce or eliminate expenses arising due to hospitalisation or other medical reasons. Health insurance plans can be purchased for a single individual or for the entire family. In case it is purchased to provide health cover for the entire family, the plan will be called a Family Floater Health Insurance Plan.

    These plans offer a larger sum insured and they can be used in varying amounts by different members of the family. Family floater health insurance plans are usually much cheaper than buying individual insurance plans for each member of the family. They are also much easier to manage since there is only one master policy and only a single premium needs to be paid towards it.

    What is Family Floater Health Insurance?

    A family floater health insurance policy can be utilised to cover all members of the family under a single insurance policy. It will reduce the hassle of managing multiple insurance documents and paying premiums for each of them. The benefits offered by the policy is similar to an individual health insurance policy wherein protection for in-patient care, day care, and pre and post-hospitalisation is provided. The benefits will differ from insurer to insurer.

    A family floater will prove to be beneficial when parents cannot be covered under any other individual policy. The family floater will allow members to use the sum insured amount collectively. So, if a member uses a part of the money for his/her expenses, another member can use the rest of the sum insured at any time during the same policy year.

    How do Family Floater Health Insurance Plans work?

    To demonstrate how a family floater health insurance plan will work, let’s make use of an example. Mr. Raheja has just purchased a family floater health insurance plan for his family of four, for a sum insured of Rs.15 lakh. A few months after he purchases this plan, his wife has to undergo a planned hospitalisation in a network hospital. The total cost of the hospitalisation comes up to Rs.3 lakh. All medical expenses related to her hospitalisation are covered by the family floater health insurance plan. Mr. Raheja and his family still have a total sum insured of Rs.12 lakh left for the rest of the policy term.

    In case, this entire sum insured is exhausted by any one member of the family, Mr. Raheja cannot claim for any more hospitalisation expenses that may arise during the policy term. However, each member of the family can use varying amounts of the sum insured.

    Why should you buy a Family Floater Health Insurance Plan?

    Family floater health insurance plans offer several benefits to the proposer and his/her family, such as:

    • Larger Sum Insured: If you were to take up individual health insurance policies for each family member, the sum insured for each member would be quite low. If the hospitalisation expenses were to exceed this sum insured, you will have to pay for these expenses, out of your pocket. If this sum is not used at all, then it goes to waste. With a family floater health insurance plan, the sum insured is available to all family members, and is also much higher than what is offered in individual plans.
    • Single Policy: Managing individual policies and premium payments for each policy is sure to take up a significant amount of time and energy. With family floater health insurance plans, you only need to manage a single policy for all the members of your family.
    • Tax benefits: Premiums paid towards family floater plans are eligible for tax benefits under Section 80 D of the Income Tax Act, 1961.
    • Option to extend the Policy Cover: Most family floater health insurance plans only cover the immediate family – the proposer, spouse and two children. However, these days, several insurers allow members to extend the policy cover to include their parents, in-laws, grandparents, and grandchildren for a nominal cost.
    • Cashless hospitalisation: While you can always seek medical treatment/hospitalisation at any hospital of your choice and claim for a reimbursement later, family floater health insurance plans give you the added benefit of availing cashless treatment at a network hospital.

    Features of Family Floater Health Insurance Plans

    Family floater plans are a cost-effective way to avail a comprehensive health insurance cover for all members of the family. The key features of these plans are listed below:

    • Option to choose your Sum Insured: Family floater health insurance plans usually allow you to choose your preferred sum insured, provided it falls within the insurer’s maximum sum insured amount. If the age of the family members is relatively advanced, you would benefit from choosing a higher sum insured. Likewise, you can also choose a lower sum insured and pay a lower premium.
    • Customizable with Riders: You can choose to customize your plan by purchasing additional riders, in order to give you and your family members additional protection.
    • Co-payment option: Many plans will give you the added benefit of choosing a co-pay option, while purchasing the plan. Under this, your insurer will pay a certain amount of your hospitalisation expenses, while a portion of your hospitalisation expenses will have to be borne by you. Opting for co-pay is a smart way to lower your premiums. It is best if you choose this option if there are several young family members being covered under the policy.
    • Varying Plan Options: Many insurers will offer you family floater health insurance policies with various plan options to choose from. Hence, you have the additional benefit of choosing a plan option that best suits your needs.
    • Medical Examinations: For most family floater health insurance plans, members will have to undergo a medical exam or test to prove their insurability. This is especially so in the case of older family members. Ensure you check your insurer’s eligibility criteria to make sure you qualify for the product.

    Family Floater Health Insurance Plans available in India

    Insurer Name Plan Name Age Range Basis Coverage/Sum Insured Co-Payment Waiting Period
    Oriental Insurance Happy Family Floater Policy 2015 18 – 65 years Family Floater Plan Silver Plan: up to Rs.5 lakh Gold Plan: up to Rs.10 lakh Diamond Plan: up to Rs.20 lakh Silver Plan: 10% co-pay Pre-existing diseases: 48 months
    Max Bupa Insurance Heartbeat Family Floater Health Insurance Plan 18 – 65 years Family Floater Plan Platinum Plan: up to Rs.1 crore Gold Plan: Up to Rs.50 lakh Co-pay options: 10% or 20% General medical treatment: 30 days Specific diseases: 24 months
    Apollo Munich Insurance Easy Health Family Floater Plan 18 – 65 years Family Floater Plan Standard Plan: up to Rs.15 lakh Exclusive Plan: up to Rs.50 lakh Premium Plan: up to Rs.50 lakh   Pre-existing conditions: 3 years Specific diseases: 2 years Maternity: 3 or 4 years, based on plan option chosen
    Apollo Munich Insurance Optima Restore Family Plan 5 – 65 years Children over the age of 91 days can be covered Family Floater Plan Up to Rs.50 lakh   General medical treatment: 30 days Pre-existing conditions: 3 years Specific diseases: 2 years
    Apollo Munich Insurance Optima Super Family Floater Plan Adult members: 18 – 65 years Children over the age of 91 days can be covered Family Floater Plan Up to Rs.10 lakh   General medical treatment: 30 days Specific diseases: 24 months Pre-existing conditions: 48 months
    Max Bupa Insurance Health Companion Family Floater Plan 18 – 65 years Family Floater Plan Up to Rs.1 crore   Medical treatment: 30 days Specific waiting period: 24 months
    Bajaj Allianz Insurance Family Floater Health Guard Policy Adult members: 18 – 65 years Dependent children: 3 months – 30 years Family Floater Plan Silver Plan: up to Rs.2 lakh Gold Plan: up to Rs.50 lakh Co-pay of 20% if members residing in Zone B avail treatment in Zone A Specific diseases: 2 years Bariatric Surgery: 36 months Pre-existing diseases: 3 years PIVD/ Joint replacement: 3 years Maternity expenses: 6 years
    New India Assurance Co. Ltd. Family Floater Mediclaim Policy 18 – 60 years Family Floater Plan Up to Rs.5 lakh Co-pay percentage will be based on which zone the member avails treatment in General Illnesses: 30 days Specific illnesses/diseases: 2 years or 4 years

    Oriental Insurance Happy Family Floater Policy 2015

    The Happy Family Floater Policy 2015 from Oriental Insurance offers health insurance cover for the proposer, the spouse, children, dependent parents and parents-in-law. Anybody between the ages of 18 to 65 years can purchase this plan. Policy buyers can also purchase additional riders, such as the Personal Accident cover and the Life Hardship Survival Benefit to customize their plan. There are three plan options to choose from – the Silver Plan, Gold Plan, and Diamond Plan. The benefits and sum insured for each plan will vary accordingly.

    Max Bupa Heartbeat Family Floater Health Insurance Plan

    The Max Bupa Heartbeat Family Floater Health Insurance Plan comes with two plan options – the Gold Plan option and the Platinum Plan option. The minimum sum insured for the Gold Plan is Rs.5 lakh and the maximum sum insured is Rs.50 lakh. The minimum and maximum sum insured for the Platinum Plan are Rs.15 lakh and Rs.1 crore, respectively. This plan offers policy buyers a one-year or two-year policy tenure option. Anybody between 18 years and 65 years of age can purchase this plan.

    Apollo Munich Easy Health Family Floater Plan

    The Easy Health Family Floater Plan from Apollo Munich comes with three plan options – Standard, Exclusive, and Premium plans. This policy can be purchased by anyone who is over the age of 18 years and under the age of 65 years. Policy buyers can also purchase an additional rider to protect themselves and their families from critical illnesses. You can choose a policy term of 1 year or 2 years, as per your needs. A maximum of 2 adults and 5 children can be included, under this policy.

    Apollo Munich Optima Restore Family Plan

    The key benefit of the Optima Restore Family Plan from Apollo Munich is that the sum insured gets automatically reinstated, even if the whole sum insured amount is exhausted during the policy year. Policyholders are also offered a Critical Advantage Rider, if they opt for a Sum Insured of Rs.10 lakh or higher. Policy buyers can choose a policy term of 1 or 2 years. Anybody between 91 days and 65 years can be covered under this policy.

    Apollo Munich Optima Super Family Floater Plan

    The Optima Super Family Floater Plan from Apollo Munich can be purchased by any adult who is over 18 years of age and under 65 years of age. Also, children over 91 days can be included under this policy. The premiums for this plan are linked to the age of the eldest family member. The primary benefit of this policy is that even if your total hospitalisation expenses were to cross the threshold limit, you can still claim for expenses over and above the said limit. You can choose a policy term of 1 year or 2 years.

    Max Bupa Health Companion Family Floater Plan

    The Health Companion Family Floater Plan from Max Bupa Insurance comes with 3 plan options. All three plan variants have top-up options. The minimum entry age for this plan is 18 and the maximum entry age is 65 years. You can choose a policy tenure of 1 year or 2 years, under this plan. The key benefits of purchasing this plan include guaranteed plan renewal for the proposer’s lifetime, direct settlement of claims, cashless facility, etc.

    Bajaj Allianz Family Floater Health Guard Plan

    The Family Floater Health Guard Plan from Bajaj Allianz offers members many benefits, including cover for pre-hospitalisation and post-hospitalisation expenses, reinstatement of the sum insured, a 1-year, 2-year, or 3-year policy term option, cover for day-care procedures, etc. Prospective policy buyers under the age of 45 years don’t have to undergo any medical tests. This plan also provides cover for maternity expenses and new born baby care expenses, after the due waiting period has been completed. The proposer needs to be a minimum of 18 years and a maximum of 65 years in order to purchase this policy. Dependent children between the ages of 3 months to 30 years can be enrolled under the policy. The floater policy can be used to provide health cover for the proposer himself/herself, the spouse, and any dependent children.

    New India Assurance Family Floater Mediclaim Policy

    The Family Floater Mediclaim Policy from New India Assurance will cover health-related expenses of the proposer, the spouse, and a maximum of 2 children. The premiums for this plan will be based on the entry age of the proposer. This policy offers many benefits such as cover for pre- and post-hospitalisation expenses for a 30-day and 60-day period, respectively, cover for day-care procedures, a good-health discount, and a loyalty discount, among others. The policy can be purchased by anyone over the age of 18 years and under the age of 60 years. Those over the age of 60 years can be enrolled if they were insured under this policy in the past, continuously, without any breaks. The floater cover can be used by the proposer, the spouse, and a maximum of 2 children.

    Exclusions for Family Floater Health Insurance Plans

    Listed below are a few general exclusions under which the insurer will not be liable to pay your claim for hospitalisation expenses:

    • Non-medical expenses
    • Diseases/medical conditions that are treated during the waiting period
    • Cosmetic surgery or enhancements
    • Experimental treatments
    • AYUSH procedures/treatments are not covered by many insurers
    • Psychiatric treatment
    • hospitalisation caused due to any criminal/unlawful acts
    • HIV/AIDS treatment
    • hospitalisation caused due to attempted suicide
    • hospitalisation caused due to drug abuse, alcohol abuse, and other addictive disorders
    • Medical treatment outside the country
    • Medical treatment by a non-registered doctor

    Each insurer’s exclusion criteria may vary, and hence you must ensure you read your policy document for plan-specific exclusions.

    FAQs about Family Floater Health Insurance Plans

    1. Should I undergo a health check-up in order to purchase a family floater health insurance plan?

      The proposer might be required to undergo a medical examination, based on his/her age, at the time of purchasing the policy. Some insurers will pay for the medical examination, provided it is deemed satisfactory, while in some cases, you might have to bear the costs of the medical examination in part or full. Medical examinations are usually not required if you renew your policy every year.

    2. What are the tax benefits that I am entitled to if I buy a family floater health insurance plan?

      Policyholders can claim for tax benefits under Section 80D of the Income Tax Act, 1961, for all premiums that they pay. Individuals below the age of 60 years can avail tax benefits for up to Rs.25,000 of their taxable income, and senior citizens can avail tax benefits for up to Rs.30,000 of their taxable income.

    3. What are network hospitals? How do I know if my chosen hospital is a network hospital?

      Each insurer will have a list of network hospitals, in which you can avail cashless hospitalisation facility. However, even if you choose to have your treatment at a non-network hospital, you can file for reimbursement, and the insurer will compensate you for your expenses. Most insurers will have the network hospital list on their official website.

    4. Is the insurer liable to pay my entire hospitalisation expense?

      In most cases, the insurer will pay the entire hospitalisation expense, excluding the non-medical expenses. If you have opted for co-pay, you will have to pay a percentage of the medical bills on your own. Further, if your treatment falls under the insurer’s exclusion criteria or if the claim happens while you are still on your waiting list, you will have to pay the hospitalisation charges out of your pocket. Also, if your treatment exceeds the sum insured, you will have to pay the difference amount.

    5. What is the difference between medical and non-medical expenses?

      Medical expenses are actual, valid expenses that the insured has incurred due to hospitalisation. Examples of medical expenses include procedure charges, post-hospitalisation expenses, pre-hospitalisation expenses, etc. Non-medical expenses are usually not paid for by the insurance company. Expenses such as registration desk charges, charges for toiletries, etc. fall under this category.

    6. How many family members can be covered under family floater health insurance policies?

      Most family floater health insurance policies will cover the proposer, the spouse and 2 children. However, some plans will also allow the proposer to include more children, parents, parents-in-law, grandparents, etc., under the policy, for an additional fee.

    7. How will my premium be calculated?

      Your insurer will calculate your premium based on a few factors, such as:

      • Age of the proposer
      • Pre-existing ailments or medical conditions
      • Your city of residence
      • The Sum Insured
      • Percentage of co-pay
    8. What is a waiting period?

      Almost all individual health insurance policies come with a waiting period, during which the insured cannot make a claim. The waiting period may differ from insurer to insurer, but the waiting period for general medical treatment is usually 30 days. Waiting period for specific illnesses and pre-existing diseases will usually be anywhere between 2-4 years, or more.

    9. What is co-pay? Do all insurance policies come with a co-pay percentage?

      Co-pay is a certain percentage of your hospitalisation bill that you will have to bear, out of your pocket. Co-pay percentages vary and not all insurers offer this option to members. However, opting for co-pay is one way to reduce your premiums.

    10. How do I renew my policy?

      Nowadays, many insurers have made a provision for you to renew your policy online, through the insurer’s website, by providing a few details like your name, policy number, etc. However, in case your insurer doesn’t offer online renewal of policies, you can also renew them at the nearest company branch.

    11. Will my family and I be covered under this policy even if I move to a different city within India?

      In most cases, you can avail medical treatment even in different cities within India. However, some insurers categorize different cities into different zones, and if you avail medical treatment at a zone that’s different from the one that you live in, you might be liable to pay a certain percentage of the bill, out of your pocket. Also, you will have to check your insurer’s list of network hospitals in the new city, if you want to avail cashless treatment.

    12. Is it necessary to buy a Critical Illness Cover along with my Family Floater Plan?

      Not all insurers provide a Critical Illness Rider. However, if your insurer does, you can choose to purchase this additional cover/rider since it will offer additional protection for you and your family members.

    13. What are pre-existing conditions?

      A pre-existing condition is any condition or disease for which the symptoms were observed, diagnosed or treated, in the past, before your family floater health insurance policy was issued by the company. In order to raise a claim for hospitalisation expenses related to a pre-existing condition or disease, you will need to have completed the waiting period specified by your insurer.

    14. I already have a corporate health insurance cover. Is an additional Family Floater Plan required?

      Your corporate health cover will only be valid as long as you work for your employer. Further corporate health covers may or may not cover certain ailments or diseases, and the Sum Insured may also be quite low. In order to get comprehensive coverage that perfectly matches your needs, for your entire family, it is recommended that you purchase a Family Floater Health Insurance Policy.

    15. What are pre- and post-hospitalisation expenses?

      If you have raised a claim for hospitalisation due to a certain ailment, any medical expense that you may have incurred a few weeks before and after the actual hospitalisation will be covered by your insurer. You will have to read your policy document in order to ascertain how many days pre and post your hospitalisation you can claim medical expenses for.