5 Elements You Should Not Ignore While Finalising A Family Health Plan

A sharp surge in consumer awareness has bolstered the demand and sales of health insurance plans for family. In fact, compared to the country’s general insurance market, which has declined by 9%, medical insurance has witnessed a surge in market share. 

Experts suggest that factors like increasing medical cost, lifestyle disease, and pandemic-like situations are more likely to push the demand for health insurance policies even further.

Nonetheless, as an individual who wishes to avail a comprehensive health plan for his/her entire family, it is essential to pay close attention to policy terms. Gaining insight into the intricate terms and elements of a medical insurance plan will help make an informed decision and allow policyholders to account for emergencies better.

Elements to keep in mind while availing a family medical insurance

To choose the best medical insurance in India for family, individuals should keep these 5 elements in mind –

  • Extent of coverage

Instead of selecting a health insurance plan based on its policy premium, individuals should make it a point to assess the scope of coverage. To make the most of the health insurance, they should find out details related to sum assured, cashless facility, and hospitalisation coverage. Additionally, they should look for enhanced offerings, including maternity cover, convalescence benefit, etc. 

  • Network hospitals

Cashless hospitalisation is the most important USP of the best family health insurance plans. However, it must be noted that policyholders can avail such a facility only from selected hospitals that come under the insurance providers’ network. This makes it imperative for individuals to find out which hospitals come under the network beforehand. 

By doing so, policy buyers will have an exact idea about whether the insurance provider has a wide network of hospitals or not. Also, it will help to streamline the process of availing the cashless hospitalisation facility with greater convenience. 

  • An upper limit on room rent

Leading insurance policies also account for the hospital room rent. However, one must note that most health insurance plans for family come with an upper cap on room rent. 

Policy buyers should make it a point to compare the room rent of hospitals near them with the cap under their insurance plan. This will help them understand whether the selected medical policy will prove effective in covering the rent or not. Furthermore, it will allow policyholders to take necessary steps if there is a gap between the prevailing charges and rent covered. 

  • Co-payment percentage

Notably, co-payment is the amount that policyholders need to pay from their own pocket regarding medical policy. In most cases, this component is represented as a percentage. One must note that by choosing a high co-payment policy, buyers can lower their premium of health insurance plans for family.

In case an insurance policy provider or aggregator is not upfront about the co-payment percentage, individuals must take it on themselves to find out about the clause to keep the process transparent. Generally, health insurance aggregators like Bajaj Finserv are quite transparent about the co-payment clause and help individuals make an effective comparison. 

  • Claim settlement and record management

To make an effective health insurance comparison, intending policy buyers must check the conditions related to claim settlement beforehand. This also includes the exclusions and other related conditions that will help to make a successful claim.

Keeping up with the process will allow policyholders to understand the extent of coverage and will help them to streamline the process with greater convenience. Additionally, keeping track of their settlement record will ensure that the share of claims and reimbursements are accounted for accurately. 

Bonus: Besides these pointers, individuals looking to purchase best medical insurance in India for family should factor in the flexibility to add a family member to an existing plan. This will help them include or exclude family members from the plan when required and ensure maximum protection for their loved ones. Furthermore, they should also determine whether there is an upper limit on the number of individuals who can be included in a family medical insurance policy.

Other than these, to make the most of the health insurance plans for family, individuals should find out about the applicable tax benefits in due time. Also, they may check out whether their choice of medical plans provides any long-term benefits or not. Having insight into these aspects will help make an informed decision and allow individuals to avail comprehensive medical coverage for their loved ones. 


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