Health Insurance Plans for Family

Family Health Insurance Plan is a health insurance policy that caters to the needs of the entire family. This means you can cover your loved ones under one plan. Such a plan offers insurance coverage for hospitalisation, preventive health check-ups, etc. Covering your family with this plan can lend peace of mind, as you can rest assured that major healthcare costs shall be taken care of in the case of unfortunate incidents.

Family Health Insurance Statistics in India by State. Delving into the 2019-20 reports, reveals a concerning truth—less than 40% of families in 11 states possess the vital safeguard of health insurance coverage. Explore the nuanced distribution and implications of family health insurance across the diverse landscape of Indian states.

The National Family Health Survey-5 (2019-20) data reveals some concerning statistics. In Jammu and Kashmir, only 12.7% of households have at least one member covered by general insurance. Similarly, Bihar and Manipur lag behind, with percentages of 14.5% and 14.2%, respectively.

Maharashtra shows slightly better figures at 20%, while Nagaland records 20.5%.

States like Sikkim (25.7%), Karnataka (28.1%), and West Bengal (29.3%) are still below the ideal coverage rates.

Tripura (33%), Himachal Pradesh (34.5%), and Gujarat (39%) make modest progress.

Mizoram (46.4%) and Kerala (51.5%) fare better but have room for improvement.

Assam (60%), Telangana (60.8%), Meghalaya (63.5%), and Goa (66%) exhibit encouraging growth.

However, amidst these figures, it's crucial to underscore the importance of health insurance for your family's well-being. As Andhra Pradesh takes the lead with an impressive 70.2% coverage, it's evident that securing your family's health should be a top priority. Don't leave their health to chance; consider investing in a ACKO family health insurance plan today.

ACKO offers three types of Family Health Insurance plans — ACKO Platinum Plan, ACKO Standard Health Plan, and ACKO Platinum Super Top-up Plan. You can get coverage for yourself, spouse, parents, parents-in-law, and your children under one plan resulting in comprehensive coverage for your entire family. The starting price for this plan is approximately INR 150/month*.

Key Features of ACKO's Family Health Insurance Plan are listed in the table given below.

Here’s a list of things you need to be conscious of while going through the best health insurance plans for family. Note that this is a generic informational section and not specific to ACKO. 

This is the maximum amount of money that the insurer will cover for the medical expenses of all the family members covered under the policy. You should choose a sum insured that is adequate to meet the potential medical expenses of your family. Here are some factors to consider when choosing a sum insured for your health insurance plans for family.

The premium amount will increase with the sum insured. In a family health plan, the premium also depends on the age of the eldest family member. If you choose to add on additional coverages, such as critical illness or accidental death and dismemberment, the premium will increase further.

Here is an example.

A wider network of hospitals is better as it gives you more options and makes it easier to get cashless treatment. Cashless treatment means that you do not have to pay the hospital upfront. Instead, your insurer will directly settle the bill with the hospital. 

You do not have to worry about paying the hospital upfront, which can be a financial burden in case of a medical emergency. The process of getting cashless treatment is usually faster and more convenient than reimbursement. You should also consider the location of the hospitals in relation to your home or workplace.

Health insurance plans for family should cover both pre and post-hospitalisation expenses. This is because medical expenses can occur before and after hospitalisation, such as doctor's visits, diagnostic tests, and medications.

Here are some of the pre-hospitalisation expenses that may be covered by a health insurance plan.

Here are some of the post-hospitalisation expenses that may be covered by health insurance plans for family.

Most health insurance plans only cover hospitalisations that last for more than 24 hours. However, there are some medical procedures that require only a few hours of hospitalisation, such as dialysis. These procedures are known as daycare procedures. It is important to check whether your health insurance plan covers daycare procedures. If it does not, you may have to pay for the procedure out of pocket.

Here are some of the daycare procedures that may be covered by a health insurance plan.

Ambulance expenses can be expensive, especially for emergency services. Some plans cover the cost of ambulance transportation, while others do not. It is important to check with your insurer to see if ambulance expenses are covered under your plan.

If ambulance expenses are covered under your plan, you may still have to pay a deductible or copayment. The amount of the deductible or copayment will vary depending on your plan. If you are not sure whether your health insurance plan covers ambulance expenses, you should contact your insurer to find out.

Here are some additional things to keep in mind when considering ambulance coverage.

Alternative therapies, such as Ayurveda and homoeopathy, are gaining popularity as people look for ways to complement traditional medical treatments. Some health insurance plans cover the costs associated with inpatient care for alternative treatments, while others do not. It is important to check with your insurer to see if alternative therapies are covered under your plan.

You should also check whether your plan covers the cost of alternative therapies that are not provided in a hospital setting. For example, some plans may cover the cost of homoeopathy consultations, but not the cost of acupuncture treatments.

Here are some additional things to keep in mind when considering alternative therapy coverage.

Policy exclusions can affect your out-of-pocket expenses. You can go through the exclusions mentioned in the plan’s policy wordings. If you have any doubts, get them clarified with the insurer’s customer care team before purchasing the policy.

The most important phase for a policyholder comes when they must raise a claim. Thus, the claim settlement process needs to be smooth and straightforward. For instance, you can raise a reimbursement claim via the ACKO app. If you want to raise a hospitalisation claim, you simply have to upload the relevant documents, such as the discharge summary and your claim application will be submitted.

Go through the online reviews to understand the insurer’s customer service. Speak to friends and family who have purchased the policy from the insurer before to understand how their experience was. 

While buying health insurance, you might ponder over buying an individual health insurance plan or opting for a health insurance plan for family. Here’s a table that will help you make that decision.

Follow the three simple steps mentioned below to choose the best health insurance plans for family in India in 2024.

It is important to understand your needs before searching for a health insurance policy that can cover them. You should be clear about the number of family members you want to include in the family health insurance policy. You also need to understand the medical history, lifestyle, and medical costs in your city to determine the sum insured.

Here are some specific things to consider when determining the sum insured for a family health insurance plan:

In today’s digital era, a single search for ‘family health insurance plans’ will give you a long list of results. You can select a suitable insurer from that list or opt for a known brand and check out their health insurance offerings. Also, you can reach out to your friends and family regarding their health insurance provider and then check out that insurer’s health insurance family plan.

Here are some specific steps you can take to find health insurance plans for family:

Now that you have a good understanding of your health insurance needs and the options available to you, it is time to make an informed purchase decision. Compare the available options and choose the policy that best meets your needs in terms of coverage, premium, and services.

It is important to be realistic about your expectations. Not all of your requirements may be met by a single insurer. In this case, it is best to choose the insurer that meets most of your requirements. For example, a family health insurance plan should be cost-effective. Look for a policy that offers adequate coverage and services at a relatively lower premium. Ultimately, the decision of whether to compromise on features and services in exchange for a lower premium is up to you.

Here are some things to keep in mind when making your purchase decision.

Discover convenient and hassle-free healthcare access with our extensive network of 14,300+ cashless hospitals and healthcare providers nearby - click here

Here is the eligibility for buying health insurance at ACKO.

Digital-first insurers do not need a bunch of documents from you to buy health insurance plans for family. However, some documents are crucial. 

Follow these steps to insure your family with ACKO.

To file a claim against ACKO Platinum Plan, follow these steps. Note that this is an overview, exact details can vary.

Cashless claim

Visit the hospital’s billing department and approach the TPA desk.

Reimbursement claim

Here are the features of ACKO Family health insurance plan (Platinum Health Plans)

Choose ACKO for hassle-free, comprehensive insurance that truly cares about your well-being. Get started today and experience the peace of mind you deserve. 

Pre-existing diseases are medical conditions that you already have when you buy a health insurance policy. Insurers will generally look into your medical history to understand if you have any such pre-existing diseases when you apply for the policy. Then, the insurer might cover these conditions but may apply a waiting period. 

The waiting period may differ from one health insurance company to another. The time may also defer based on the type of plan you choose or the condition you or a family member suffers from. During this time, you must bear the cost of treatment for the condition where the waiting period is applicable. Other medical events like injuries from an accident or diseases diagnosed after purchasing the policy will be covered.

When selecting a health insurance plan, it is vital to be aware of the terms and conditions of pre-existing disease coverage. Some policies can have more extended waiting periods or may not cover certain pre-existing conditions. Hence, people should read through the policy documents and compare different health insurance plans to settle for a plan that offers coverage for their specific health needs.

As a policyholder, it is necessary to consider both ICR and CSR factors when choosing an insurance provider for health care. A company that maintains a balance between these ratios is more likely to offer a better service and to ensure a seamless claim experience. 

Network Hospitals are hospitals or healthcare facilities in your insurance company's network. Simply put, your insurer will have a tie-up with hospitals to allow timely treatment and a smooth claims experience. For policyholders, accessing healthcare services at network hospitals means access to cashless treatment. This eliminates the need for heavy out-of-pocket payments, as the insurance company settles the bills directly with the hospital.

Network hospitals are selected according to the criteria, such as the quality of care and the range of services provided. This ensures that people can get quick access to reliable medical care within their coverage.

Sum Insured: Sum insured is the limit up to which the health insurance company will pay for your medical expenses that are covered under the policy. This is the upper limit or the maximum coverage the insurer will offer for the selected health plan, if your claim is approved.

Maternity coverage: Maternity coverage in health insurance plans includes expenses associated with pregnancy and giving birth. This usually covers care, the delivery process, and aftercare. It provides support during this time, assisting families in handling the expenses related to maternity services.

Critical Illness Coverage: Critical illness insurance offers security in case of a medical condition. It covers diseases like cancer, heart attack, or stroke. This type of coverage provides a one-time payment when diagnosed, which assists individuals in managing the treatments and adjustments to their lifestyle.

Renewability and Lifetime Coverage: The ability of health insurance coverage to be renewed yearly is referred to as renewability. No matter how old they get or what kind of health issues they have, lifetime coverage guarantees that people can keep their health insurance. It provides long-term security, especially considering that healthcare requirements often rise with ageing.

Telemedicine Services: Digital platforms make it easy to have remote medical consultations, part of telemedicine services. Health insurance plans can now include telehealth benefits, letting policyholders talk to medical professionals online. This not only increases healthcare accessibility but also reduces the need for in-person visits, making it simpler to get timely medical advice.

Waiting period: The time in which you cannot raise a claim is called a waiting period in health insurance. There are roughly three types of waiting period: 1. Initial waiting period, 2. Pre-existing diseases waiting period, 3. Specific diseases waiting period

Disclaimer: The plans, services, features, processes, and other details mentioned on this page are subject to availability and changes. Please check the applicable policy wordings before making any insurance-related decisions. Feel free to reach out to us at [email protected] for any queries.