Family Health Insurance

Secure your Family with a single Health Insurance Plan
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Health Insurance Plans for Family | Medical Cover up to Rs. 50 lakh

In today’s world, where the cost of medical expenses is on the rise, a family health insurance plan can be your way to financially secure your family against medical inflation.

However, with so many insurance policies available on the market, choosing the best health insurance plan for your family can get confusing. Hence, we at Tata AIG are here to help you navigate the world of health insurance plans for families so you can find your perfect plan.

What is Family Health Insurance?

Family health insurance is a type of health insurance policy that covers the medical expenses of individuals and their insured family members under one plan.

Health insurance plans for families function just like individual health policies, except in a family floater type of policy, the sum assured is shared among all the insured family members under one plan.

This sum assured can be availed of as often as needed or until exhaustion during the policy year.

How Does Family Health Insurance Work?

Let us understand this using an example.

Suppose a person X buys a family floater medical insurance for himself, his spouse and dependent children with health coverage of ₹12 lakhs.

After a few months of policy purchase, Person X has to go for minor surgery. The medical bill during that time was ₹4 lakhs, which the insurance company has covered.

A few months after that, an emergency medical emergency occurred where Person X's child needed treatment. The hospital bill, in that case, was ₹4 lakhs – which was also covered by the insurer for their family floater plan.

Now, as per the family floater health insurance policy condition, Person X has medical coverage left of ₹4 lakhs for the remaining policy tenure.

Importance of Buying a Family Health Insurance

Below are some reasons to buy the best insurance policy for your family:

Quality Medical Care - Many people tend to compromise on healthcare due to hefty medical expenses. However, with family health insurance, this is no longer an issue as most, if not all, of your family’s medical expenses will be covered by your insurer.

Preventive Health Check-ups - Many family health plans also come with free preventive health check-up benefits. With this benefit, you can keep track of and maintain your family's health by getting regular check-ups in the network hospitals.

Tax Benefits - A family health insurance plan makes you eligible for health insurance tax benefits under Section 80D of the Income Tax Law. You can claim deductions of up to ₹25,000/₹50,000 per year on your policy premiums.

Peace Of Mind - Knowing that your family's medical expenses are covered can allow you to lead a stress-free life. In fact, medical inflation is often the primary reason why most opt for family health insurance.

It is a cost-effective way to secure your family's health and ensure your peace of mind.

Hospitalisation Expenses - A single hospitalisation for a major accident can quickly leave you and your family bereft of your savings. Hence, securing your family members with family health insurance against these perils should be your number one priority.

It will cover most, if not all, of your hospitalisation expenses and mitigate any out-of-pocket costs on your end.

Difference Between Individual Vs Family Health Insurance Comparison

Parameters  Individual Health Insurance Family Health Insurance
Definition  A health insurance plan where only one person is insured under the policy.  A health insurance plan that offers coverage for all your family members that are insured under the plan. 
Coverage/Sum Insured  The sum insured covers only the individual covered under the plan. The sum insured is shared among all the family members.
Benefits  More extensive coverage and the sum insured is offered fully to the insured individual.  It is more affordable as the premium payment for all family members is done through a single payment rather than individual payments for each family member. 
Drawbacks  These plans can sometimes be more expensive.  The sum insured may not be enough to cover all family members. 
Ideal For Recommended for bigger families with senior citizen parents (over 60 years) as a family floater plan may not be able to cover all medical costs. Recommended for smaller/nuclear families or a young couple.

Eligibility Criteria for Health Insurance Plans for Family

A health insurance plan for a family comes with some eligibility criteria. However, the criteria may differ from insurance company to company. Below are the general criteria for a health insurance plan for a family.

Categories Specifications
Minimum Age  Children - 90 days Adults - 18 Years
Maximum Age Children - 25 years Adult - 65 Years
Members Covered Self, Spouse, children, parents, and parents-in-law
Waiting Period 30 days for Basic Cover 90 days for Critical Illness
Premium Paid Based on the Policy's Inclusion and Add–ons
Renewability Lifetime

Standard Exclusions of a Family Health Insurance Plan

If you sustain an injury while committing a crime, your health insurance plan will not cover it. Any criminal activity or breaches of law requires an investigation and is out of the scope of your insurance coverage.

  • Rehabilitation treatments for alcoholism or drug abuse, rehab costs and other kinds of treatment for alcoholism are not included in a family health insurance plan and, hence, not covered.

  • Cosmetic or plastic surgery expenses purely for aesthetic reasons and not medically necessary reconstructive surgery after an accident, for burns, or cancer are not covered.

  • Treatment, services, and supplies that lack significant medical documentation to support their effectiveness should be covered.

  • Medication or treatments for sterility or infertility, like contraceptives, assisted reproduction services (IVF, ZIFT, GIFT, ICSI), surrogacy, and sterilisation reversal, are not covered under a family health insurance plan.

Best Mediclaim Policy For Families Offered By Tata AIG

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Key Features Of Family Health Insurance  Details 
Plans Available at Tata AIGMedicare Medicare Premier Medicare Protect Criti Medicare
Waiting PeriodsBase Covers: 30 days from policy inception Accidents/Emergencies: Day 1 coverage Critical Illness: 90 days for Criti Medicare Pre-Existing Illness: Covered after 36 months
Insured Members Self, Spouse, up to 3 dependant children and up to 2 parents/parents-in-law
Age Limits 91 days to 65 years
Pre and Post-Hospitalisation Cover Available up to the sum insured
Ambulance Cover  Available for registered ambulances of network hospitals  
Hearing Aid 50% of actual cost or ₹10,000 per policy (covered every third year)
Health Check-up 1% of the previous sum insured or a maximum of ₹10,000 per policy
Ayush Benefits  Available at AYUSH hospitals 
Global Cover  Available for planned hospitalisations
Accidental Death Benefit  Available as an add-on 
Cashless Facilities  Available at network hospitals 
Sum InsuredMediCare: Up to ₹20 lakhs MediCare Premier: Up to ₹3 Crores MediCare Protect: Up to ₹5 lakhs Criti MediCare: ₹5 lakhs - ₹2 Crores
Cumulative Bonus Starting at 10% - 50% for every claim-free year up to a maximum of 100% of the sum insured.
Wellness Programs/Services Available as built-in or add-on covers depending on the chosen policy
Pre-Policy CheckupsUp to 45 Years: No medicals/No Tele- Medical Examination Report 45 - 65 years: Tele-Medical Examination Report (TeleMER)
Premium Calculation   Calculated by adding the premium of respective individual members and applying a family floater discount
Renewability  Lifelong on timely premium payments (Renewal premiums are only charged when you move into a higher age group or change your plan/coverage)
Tax Benefit  Maximum deduction of ₹1.5 lakhs available under Section 80D

At Tata AIG, we offer four types of MediCare policies that can be modified to be family floater plans. These plans can be purchased online through our website or in person. We recommend buying them online as they make you eligible for discounts and offers on our site.

Here is a brief description of each health insurance plan offered**

**MediCare -This standard health insurance for your family is a simplified plan with comprehensive coverage. It offers a sum insured of up to ₹20 lakhs so that you and your family members are covered for medical expenses and any medical emergencies. Under the family floater option, you can get up to a 32% discount on premium payments and access to quality healthcare services. You can also opt for an optional accidental death rider under this plan.

MediCare Protect - This MediCare variant offers comprehensive health coverage for you and your family while maintaining an affordable premium rate. Under this policy, you get a sum insured of up to ₹5 Lakhs and an additional ₹5 lakhs as a death benefit if you have opted for an optional accidental death rider.

MediCare Premier - This is our best health insurance plan for your family, as it provides extensive coverage for you and your family. This MediCare variant offers you a sum insured that can be enhanced up to ₹3 Crores. This can be done on renewals and new policy purchases before the commencement of the new policy term. As a benefit of having an increased sum insured amount, you get access to several benefits like high-end diagnostics, death benefit cover (built-in), and emergency air ambulance, to name a few.

Criti MediCare -This is a plan specifically meant to cover critical illness. Under it, you can expect comprehensive coverage for up to 100 critical illnesses. You are paid a lump sum amount if you or any of your insured family members are diagnosed with a critical illness listed in this plan. The Criti MediCare policy gives you critical illness coverage under three sections and an optional fourth section**

Section A Critical illness -You can opt for coverage under this section under either a** Smart Century Premier Plan (100 critical illnesses) or a Smart Half Century Plan (50 critical illnesses). Under both subsections, you can expect coverage for**

Critical Illnesses Treatment (for illnesses listed under the plan/subsection).

Health Check-ups.

Smart Cancer Care.

Second Medical Opinion.

Section B Cancer 360 Degree Indemnity Cover - This section specifically covers medical expenses relating to cancer treatments. So, if you or your family member has recently been diagnosed with cancer, opting for coverage under this specific section would be beneficial.

Section C Hospital Cash - As the name suggests, this covers hospitalisation expenses for treatments and emergency medical care for consecutive and completed (24-hour) hospitalisations with varying degrees of coverage.

Section D Wellsurance Benefit (Optional)** - This is an additional cover you can opt for to undergo medically necessary minor and major surgeries. Moreover, it also covers post-operative expenses like physiotherapy and ambulance expenses.

Section E Personal Accident (Only applicable for section A Critical Illness)**- The benefit under this section is applicable if no claims are reported in the expiring policy year under Section A. It provides a sum insured of ₹3 lakhs if the insured individual suffers an injury due to an accident during the policy year, which is the sole cause of death within 12 months from the date of the accident. A minimum of one section from the provided base benefit sections has to be opted for, and all family members will share the same plan coverage. You get ₹5 lakhs — ₹2 Crore sum insured (in multiples of ₹5 lakhs) in each category (sections A/B/C), which is given on an individual basis.

Benefits of Getting Family Health Insurance From Tata AIG

Below are some of the benefits of purchasing health insurance plans from Tata AIG.

Cashless Services at Network Hospitals - At Tata AIG, we have 8000+ network hospitals pan-India that offer cashless facilities to our policyholders. We settle claims directly with the network hospital in your stead up to the extent of the liability so that you and your family can focus on treatment and recovery while we handle the rest.

To avail of this benefit under your family medical insurance plan, you must notify us or our TPA (Third Party Administrator) 48 hours before planned hospitalisation or treatments. For emergency hospitalisations at network hospitals, we must be notified within 24 hours after the treatment or hospitalisation. To check for network hospitals in your city or region, you can use our Network Hospital Locator to know their addresses.

Restore Benefits - Medical emergencies and the hospitalisation costs that come with them can be expensive. This is why our MediCare plans come with an automatic restoration benefit. It enables the automatic refilling of your sum insured amount if you have exhausted your sum insured during a single policy year.

Wellness Programs and Services - At Tata AIG, we understand that nothing is more important than your health. Our wellness programs under our health insurance plans exemplify this and encourage you and your family to improve your health and fitness. We do this by offering redeemable vouchers for fitness services and discounts on pharmacy and diagnostics. You can also collect wellness rewards that can be accumulated through fitness activities and used as payment towards health check-ups/diagnostics, medication/supplements, and OPD consultations/treatments.

Guaranteed Cumulative Bonus - Under our MediCare plans, you can get a maximum cumulative bonus of up to 100% of your sum insured. This bonus is available on consecutive renewals with Tata AIG without a break. A 10% - 50% (depending on the policy) cumulative bonus will be applied to your sum insured for the next policy year after every claim-free policy year. If you find these features to be helpful, it is time you browse our plans and purchase a health insurance plan for your family from Tata AIG

How To Buy Tata AIG's Health Insurance Policy For Families Online?

Below is the procedure to buy a health insurance policy for a family from Tata AIG.

Step 1: Open the Tata AIG official website.

Step 2: Click on 'All Products' and click on 'Tata AIG MediCare'.

Step 3: Choose the family members you want to add to your plan and click on 'Get Plan'.

Step 4: Enter the required details and click 'See Plan.'

Step 5: Fill out the application form and upload any required documents.

Step 6: After submitting your application, an insurance agent will contact you to guide you through the process.

Tata AIG Family Health Insurance Claim Process

Below is the procedure for Tata AIG health insurance policies.

Reimbursement Claims Process

Step 1: Visit the Tata AIG official website.

Step 2: Click on 'Claims' on the top tab.

Step 3: Click 'Initiate Claim' and choose your product; in this case, it will be 'Health.'

Step 4: Log in to the site using your registered details if you have not already done so.

Step 5: Fill out the claims form and upload the required documents.

Step 6: After submitting your claim, an insurance agent will contact you to guide you through the process.

Cashless Claims Process

Step 1: Notify the TPA/us through email or letter 48 hours before any planned hospitalisations/treatments. For unplanned or emergency hospitalisations, we must be notified 24 hours after the treatment/hospitalisation.

Step 2: Upon notification, we will check your coverage and eligibility and send an authorisation letter to the provider.

Step 3: You have to provide the ID card issued to you along with any other information or documentation that is requested by the TPA/us to the network hospital.

Step 4: If approved, we will directly settle the bill with the network hospital.

Step 5: In case of a rejection of the cashless claim, you can still apply for a reimbursement claim, as a rejection of cashless claims in no way indicates rejection of the claim itself.

Documents Required for Family Health Insurance Claims

Below is the list of documents required for filing the family health insurance claims.

  • Original health insurance policy documents.

  • All medical reports, case histories, investigation reports, indoor case papers/ treatment papers, etc.

  • Documents to prove policyholder identity, such as Aadhar cards, passports, etc.

  • Document to proof address such as ration card, etc.

  • Any additional documents needed by the insurance company representatives.

Things To Consider Before Buying Family Health Insurance Plans In India

Here are some points you need to consider to ensure you buy the best health insurance plan for your family:

Plan Coverage - When choosing a medical insurance plan for your family, always check the coverage offered under the plan and if it applies to you and your family. It is best to choose a family health plan with extensive coverage options such as day care expenses, pre and post-hospitalisation expenses, etc.

Cashless Hospitalisation - Another thing to look for while purchasing an affordable family health insurance is cashless hospitalisation benefits. This allows you and your family members to claim cashless medical treatment at network hospitals, where the insurer directly settles the bill with the hospital.

Sum Insured Enhancement - Another thing you need to look for while purchasing a family medical insurance plan is sum insured enhancement.

A single hospitalisation can deplete your coverage amount. Thus, a plan that allows you to upgrade your sum insured as needed should be considered.

Policy Inclusions and Exclusions - While you may always think to check for policy inclusions when comparing health insurance policies, it is equally important to check the policy's exclusions.

This allows for a better understanding of the policy's terms and allows you to choose the best Mediclaim policy for your family.

**Claim Settlement Ratio (CSR) - It is best to choose an insurance company that offers a high settlement ratio and has an easy claim settlement procedure. While it should not be the only thing to look for, an insurer’s CSR can clue you in on the likelihood of your claims getting accepted and settled. So, a high CSR should be preferred.


Getting a medical insurance plan for a family is essential due to rising medical expenses. No matter how healthy our lifestyle is, unforeseen incidents can happen to anybody.

Hence, family health insurance policies are a much-needed asset when it comes to securing your family members at the time of a medical crisis.

Health Insurance Terminologies

Sum Insured - This is the amount of money you are provided access to by your insurer on policy purchase, which is used to cover your medical expenses.

Health Insurance Premium A premium is a regular payment made to your insurer in exchange for the health insurance coverage they provide. This amount can vary depending on your policy type, your age and the sum insured amount.

Restoration Benefit - This is a feature included in our health insurance plan that recovers your full sum insured upon exhaustion during the policy term. For example, if you have a sum insured amount of ₹10 lakhs and it has been exhausted due to a medical emergency, then we will restore the amount up to the base sum insured (₹10 lakhs) upon exhaustion.

Cumulative Bonus -This is a benefit offered to policyholders on renewal if they have not filed any claims in the previous policy year. It increases your sum insured amount by a certain percentage without the need for an extra premium.

Critical Illness Insurance - This is a separate health insurance plan or add-on cover that provides coverage for critical illnesses like cancer. These plans have higher sum insured amounts and higher premiums as well.

Waiting Period - This is a time frame within which you can not claim coverage under your health insurance plan. The waiting period is only waived in case of accidents or emergencies. Most health insurance plans have a waiting period of 30 days from policy inception, after which you can claim medical coverage.

Network Hospital - This is a hospital that has a tie-up with the insurance provider to provide cashless claim facilities and lower fee rates to policyholders. Every health insurance provider has a list of network hospitals.

Some Helpful Documents

claim additional service

Disclaimer / TnC

Your policy is subjected to terms and conditions & inclusions and exclusions mentioned in your policy wording. Please go through the documents carefully.

Related Articles

Which health insurance is best for a family?

Which health insurance is best for a family?


There is no single health insurance plan for a family that can be termed “the best.” You need to assess your specific insurance needs, health history and budget and then find a plan that suits all these requirements.

You can check out the Tata AIG family insurance plans - the Tata AIG Medicare, Tata AIG MediCare Protect, and Tata AIG MediCare Premier, which can be ideal for a family. These plans offer wide coverage that is suitable for all ages.

How much does family health insurance cost per month?


The average premium can depend on a number of factors like the age of all insured persons, the lifestyle and health history of all members, the chosen sum insured etc. You can use the health insurance calculator available on our health insurance page to determine the exact cost of your coverage.

How do I choose a family health insurance plan?


Start by analysing the needs of your family members. Pay attention to every member’s age and health. For instance, your aging parents may require regular medical attention and hence a higher cover. Other aspects that you should pay attention to are the premium costs and features of a plan. Compare different plans and pick the one that is the most cost-effective. Lastly, check the claim settlement ratio of the insurance company. The higher the claim settlement ratio, the lower are the chances of your claim being rejected.

How much does a family of 4 spend on health insurance?


A family of four can spend anywhere between ₹1700 per month and ₹2200 per month for a family floater plan of ₹10 lakh.

What is a family health insurance plan?


A family health insurance plan is a plan that protects all family members under a single policy. This type of coverage is known as umbrella coverage, where the entire family shares the sum insured and pays a unified premium in return.

Why buy a family health insurance plan?


A family health insurance plan can offer better protection to a family. It also helps reduce costs and removes unnecessary confusion of purchasing multiple policies.

How can I add my family member to an existing policy?


You can contact the Tata AIG customer support on 1 800 266 7780 and request to add a new family member to your existing plan.

What is the difference between family health insurance and group health insurance?


Family health insurance plans cover the individual along with their family members. They can be bought by private individuals for their families. The premium here will be paid by the family member purchasing the policy. In contrast, group health insurance plans are only available to organisations, start-ups, and groups where the employees and group members are provided coverage. The premiums are paid by the employer. Family members of the employees can be included as dependants under group plans. However, the insured individual must work under the company offering the group health plan to access its health benefits.

Do I need a separate family health insurance policy if my family members and I are already covered under a group policy?


While it is not mandatory, is it advised to purchase family medical insurance to cover specific illnesses or conditions not covered under the group plans offered by your employer. If you are interested in purchasing a family mediclaim policy, contact us through our helpline.

What is the difference between mediclaim insurance and a fixed benefit health insurance plan?


Mediclaim Insurance  Fixed Benefit Health Insurance
Indemnity-oriented plans that pay for pre and post-hospitalisation expenses up to the sum insured amount.  Pays a lump sum amount on diagnosis, irrespective of treatment costs. 
Claims are usually processed based on diagnostic reports, written consultations with doctors, medical bills and other documents listed above on this page.  Claims are processed based on diagnostic reports confirming the insured illness or condition. No extra documentation is needed.
Provides cashless facilities at network hospitals The sum assured is paid directly to the policyholder to receive treatment at any hospital or clinic. 
Some plans require you to pay part of the expense while the rest is paid by the insurer.   The insurer pays the full benefit (sum assured amount). 

What are the best family health insurance plans in India?


Family Health Insurance Plan  Network Hospitals  Sum Insured*
Tata AIG MediCare Premiere 8,000+ ₹5 Lakh - ₹3 Crores
HDFC Optima Restore - Family Plan 13,000+ ₹3 Lakh - ₹50 Lakh
Care Family Health Insurance 19,000 + ₹5 Lakh - ₹6 Crore
ICICI Lombard Complete Health Shield plan 6,700+ ₹3 Lakh - ₹50 Lakh
Royal Sundaram Family Plus Health Insurance Plan 11,800+ ₹3 Lakh - ₹50 Lakh
Bajaj Allianz Family Health Insurance Plan 8,000+ ₹1.5 Lakh - ₹1 Crore
Star Family Health Optima Insurance Plan 12,000+ ₹3 Lakh - ₹25 Lakh

Can I add family members during my family medical insurance policy's term?


New family members can only be added to your family medical insurance plan on new policy purchases or renewals. The only exceptions to this rule are newborns and legal spouses upon marriage. These mid-term policy additions also require you to pay an extra premium.

What is the exit age for dependants under a family health policy?


The maximum age up to which dependant children can be covered under a family health insurance plan is 25 years. The maximum age for dependant parents is 65 years, after which they qualify for a senior health insurance policy.

*Disclaimer: Some coverage and policies may change over time and may differ from what is said in this blog; so, it is highly recommended to read the policy document carefully before purchasing it.

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