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Discover the Differences: Family Health Insurance vs Family Floater Plan

TeamAckoJun 13, 2024

Health insurance is an essential part of most individual’s lives since it acts as a saviour during medical emergencies, ensuring the financial protection of your family. Health insurance plans like family health plans and floater plans are often considered the same, however, they are not so.

Therefore, here we will be discussing family health insurance vs family floater plan, understanding their points of difference and other essential details related to it.

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What Does a Family Health Insurance Plan Mean?

A family health plan is a type of insurance that covers medical expenses of all the family members under one insurance policy. This plan includes pre and post-hospitalisation along with maternity benefits, and cashless hospitalisation facilities.

With affordable premiums, family health insurance is a great way to cover the expenses of all the family members in the same fixed sum. You can also get tax benefits in health insurance if you pay the insurance amount for your family.

However, you must choose the insurance plan according to your budget, which would ensure your convenience in paying the premiums on time.

What is a Family Floater Insurance Plan?

A family floater health insurance is another kind of medical insurance for your family. In this case, it covers the medical expenses of your immediate family members, including spouse and children.

In a family floater health plan, the fixed sum you get would be applicable only to your immediate family members. Hence, the premium you pay for this plan may not be as affordable as the former one.

However, under section 80D, you can get tax benefit in health insurance in a floater health plan as well.

Family Health Insurance v/s Family Floater Plan?

While both family health insurance plans and family floater health insurance come with their distinctive benefits and policies, they differ in certain matters. 

Below is a table regarding family health insurance v/s family floater plan, helping you to understand their differences accurately.

Points of DifferenceFamily Health InsuranceFamily Floater Insurance
MeaningIt covers the medical expenses of all the insured members of a family.It covers the medical expenses of immediate family members like spouses and children.
BenefitsIt is an affordable option since it covers the medical expenses of all family members under one plan.Easier to add new family members in a floater. For example, spouses and newborns.
CoverageAll members of your family.Your immediate family members.
Ideal ChoiceIt is ideal for bigger families, where you can cover all their medical expenses under one sum insured.It is ideal for nuclear families or couples, since the sum insured may not be sufficient to cover the medical expenses of more family members.
DrawbacksPremiums can be costly in the cases of higher coverages.The coverages cannot be increased with the addition of new family members to the floater.

How to Choose the Right Plan for Your Family among Family Health Insurance vs Family Floater Plan?

Choosing between a family health insurance plan and a family floater plan can feel like navigating a maze. Here are the factors to consider:

  • Assess Your Family's Health Needs: Start clearly understanding your family's overall health condition. If you have elderly parents or members with existing health issues, a family health insurance plan might offer more comprehensive coverage for each individual.

  • Consider the Family Size: A family floater plan could be more cost-effective for a small family, such as a couple or a family with one child. It allows you to share a large pool of funds among fewer people, potentially reducing your premiums.

  • Look at Your Budget: Understandably, your budget plays a crucial role. While a family health insurance plan might offer more tailored coverage for each member, it can also be more expensive. Compare the costs and benefits of each option to see what fits your financial situation best.

  • Understand the Coverage Limits: Floater plans generally offer a large sum insured that is shared among all family members. However, if one member uses a significant portion of the insured amount, it might leave less coverage for others. Ensure the sum insured is adequate for your family's needs.

  • Evaluate the Flexibility to Add Members: If you plan to expand your family or have aging parents to consider, consider how easy it is to add new members to the policy. Floater plans can be more accommodating for new additions like newborns.

  • Check for Age Renewability: Some plans have age limits for renewability. It's crucial to choose a plan that offers lifelong renewability to avoid complications as you or your family members get older.

  • Review the Claim Process: A straightforward claim process can alleviate stress during emergencies. Look for plans with a reputation for hassle-free claims, quick settlements, and cashless options at a vast network of hospitals.

  • Understand the Exclusions and Waiting Periods: Every plan lists exclusions and specific waiting periods for pre-existing conditions or treatments. Make sure these terms are something you can comfortably live with.

We would recommend you go for a high sum insured in the case of a family insurance plan. It helps to ensure that the coverage is sufficient for all family members. Nonetheless, creating a budget and sticking to it while selecting a health insurance plan would help you make the right choices and decisions.

Tips for Managing Your Family’s Health Insurance Costs

Here are some tips for managing family health insurance costs:

Compare Plans Carefully

Don't just renew your current health plan automatically every year. Review multiple providers' plan options to find optimal coverage, balancing premiums, deductibles, and copays aligned with your expected healthcare usage.

Max Out Health Savings Accounts (HSAs)

Contribute up to the IRS limit in an HSA. These tax-advantaged accounts grow interest tax-free, and withdrawals for medical bills are tax-free, too. This effectively reduces insurance costs long-term.

Snag Wellness Incentives

Many employer and personal policies feature premium discounts for partaking in various wellness programs. Simple participation in health assessments, preventative screenings, or activities like virtual workout classes earns tangible savings.

Purchase Gap Coverage Plans

Pairing robust core insurance with supplemental gap plans to offset out-of-pocket expenses like deductibles or copays saves total costs for those expecting elective surgeries or chronic care management.

The key lies in diligently evaluating your particular circumstances before insurance decisions. Optimised policies bring peace of mind against catastrophes without routine overspending.

Final Takeaway

Overall, when opting for a family insurance plan, the cost of premium cannot be the only crucial point for you to consider. Be it a family insurance plan or the floater one, you must aim to get the maximum benefit of the policies. Do your research well to get the best insurance policy that matches your preferences.

Therefore, we hope to have cleared your doubts regarding family health insurance v/s family floater plan. So, you must buy a health insurance plan for your family to ensure a stress-free life for you, providing you with financial support for your medical emergencies.

Hence, sort out your preferences and budget, and wisely select the kind of medical insurance that would earn you maximum benefits.

Frequently Asked Questions (FAQs)

Given below are some of the common queries on family health insurance v/s family floater plan.

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What would happen if the sum of insurance gets exhausted?

In the case of most family health insurance plans, if the insurance sum gets exhausted before the stipulated time period, you will not get any further funds within the policy period.

What are the factors that can affect the premiums of a floater family health insurance?

Some of the factors that can affect the premiums of a floater family health insurance include:

  • The type of health insurance plan you are opting for.

  • Number of family members included in the insurance plan.

  • Age of each of your family members included in the health plan.

  • Medical histories of each family member who is included in your health insurance plan.

  • Any other add-ons in your insurance plan.

Do family health plans cover pre-existing diseases of the insured family members?

Yes, family health plans cover pre-existing diseases of the insured family members. However, they are often covered after 2-4 years of waiting period.

Is it possible to buy more than one family floater health plan?

Yes, you can go ahead and opt for more than one family floater health plan. Nonetheless, an insurance company would settle your claims in rateable proportions. 

What are the documents required to reimburse the family health insurance claim?

Given below are the documents that are required to reimburse your family health insurance claim:

  • Policy document

  • Medical/ hospital bills

  • Payment receipts of medical bills

  • Discharge summary from the hospital

  • Duly filled health insurance claim form

  • Consultation and diagnostic reports

Please note, that there can be more/ fewer documents required based on the type of insurance plan or company.

Is a family floater health insurance plan better than individual health plans for each member?

A family floater health insurance plan is an affordable option since it covers the medical expenses of your family members under a single premium.

Whereas, opting for individual health plans for each member of your family can be costly since you will pay multiple premiums.

For how long will my children be in the family floater health insurance plan?

Though it varies among companies, most insurance providers allow children in the family floater health insurance plan up to 25 years of age. If they start earning or get married before 25 years, they would no longer be eligible for the plan.

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