How to choose health insurance for your family
Sum insured, floater or individual plans, waiting periods, room rent limits and cashless hospitals: what to check before you buy family health cover.
By TommyAndFurry advisory teamReviewed by [REVIEWER NAME, QUALIFICATION]Updated 4 min read
In short
- Choose a sum insured that would cover a major hospital stay in the city where you would be treated, for everyone the policy covers.
- A family floater shares one sum insured across members and often costs less for young families; older parents are often better on separate plans.
- Check the waiting periods, room rent limits, co-payment and sub-limits in the policy wording, because they decide how much of a bill is actually paid.
- Cashless claims work only at the insurer's network hospitals, so check that hospitals near you are on the list.
1. Decide how much cover you need
The sum insured is the most the insurer pays in a policy year. Think about the cost of a major hospital stay in the city where your family would be treated, how many people the policy covers, and any conditions that could need treatment. Medical costs tend to rise over time, so leave headroom.
Many plans also offer a restore benefit that tops the sum insured back up after it is used, and a cumulative bonus that increases it for claim-free years. Both help, but read how they work in the policy wording.
2. Family floater or individual plans
A family floater covers everyone under one shared sum insured. It is often cheaper for a young couple with children, because a claim by all members in the same year is unlikely. The premium is usually based on the eldest member's age.
Individual plans give each person their own sum insured. They can suit parents or older members, whose claims could use up a shared floater and whose age would push up the floater premium for everyone.
3. Read the waiting periods
Health policies do not pay for everything from day one. The policy wording states each waiting period:
- Initial waiting period: a short period after you first buy, when only accident claims are paid.
- Pre-existing diseases: conditions you had before buying are covered only after a longer waiting period.
- Specific illnesses and procedures: some treatments, listed in the policy, have their own waiting period.
4. Check the limits that reduce a claim
- Room rent limit: if you choose a room above the limit, other charges linked to it may be paid only in proportion.
- Co-payment: a share of every claim that you pay yourself, common in plans for senior citizens.
- Sub-limits: caps on specific treatments, such as cataract surgery, even when the sum insured is higher.
- Deductible: an amount you pay before the policy starts paying, which lowers the premium.
5. Look at network hospitals and claims
With a cashless claim, the insurer or its TPA settles approved bills directly with a network hospital. At other hospitals you pay first and claim a reimbursement. Check that hospitals near your home are in the insurer's network, and ask how claims are handled before you buy.
6. Tax benefit
Premiums for yourself, your family and your parents may qualify for a deduction under Section 80D of the Income Tax Act, depending on the tax regime you choose and the limits in force. Check with your tax adviser.
Compare before you buy
Put two or three plans side by side and compare the same things: sum insured, waiting periods, room rent limits, co-payment and the hospital network. You can compare health insurance plans from our partner insurers, or estimate a premium with the health insurance premium calculator.
Questions readers ask
Can I add a newborn to my family floater?
Many insurers allow you to add a newborn at renewal, and some plans cover newborns from birth. The rules are in the policy wording, so ask your insurer or advisor.
Should my parents be on the same floater as my children?
Often not. Parents' age raises the floater premium for everyone, and their claims can use up the shared sum insured. Separate plans for parents are worth comparing.
Is the health cover from my employer enough?
Group cover usually ends when you leave the job and may have a limited sum insured. A personal policy keeps you covered and builds up waiting-period credit over time.
This guide is general information, not advice for your situation. Cover, exclusions and claim terms differ by insurer and plan, so always read the policy wording before you buy. Insurance is the subject matter of solicitation. For more details on risk factors, terms and conditions, please read the sales brochure carefully before concluding a sale.
