An individual health insurance policy aims at securing one person under the plan. In such plans, the insurance coverage is extended to one person alone. For instance, if you buy an individual plan for yourself, you will be able to raise a claim for your medical expenses like hospitalization, doctor’s consultation, ambulance costs, surgery costs, diagnosis costs, AYUSH treatment, and more.

Now, if you get married and have children, your existing policy will not cover them. In this case, you will have to buy a health insurance plan for the family to cover your dependents. Individual health insurance plans are typically ideal for youngsters who do not have any dependent family members. However, as you age and have more responsibilities, you may find such a plan inadequate. This is where family insurance plans come in.

Family health insurance is a type of health insurance that secures the entire family. This includes the spouse, dependent children, and dependent parents. Such insurance plans cover all members of your family with unified protection. There is only one premium and one insurance amount. This implies that the insurance company does not charge you a separate premium for all members of your family. So, you pay only one premium, and in return, the insurance company offers insurance protection to all the individuals insured under the policy. The sum insured of a medical policy for the family is shared between all the insured family members.

This is how this works: Consider a scenario where you purchase a family medical insurance plan. There are four people insured under this plan, including you, your spouse, and your dependent children. The insurance cover or the sum assured for this health plan is ₹8 lakhs. Now, you undergo surgery and require an insurance claim amount of ₹2 lakhs. This money will be deducted from the sum assured (₹8 lakhs – ₹2 lakhs), and the rest of the family will be able to claim ₹6 lakhs for their medical expenses.

Family health insurance plans are more suitable for families as they help reduce the additional cost incurred on individual plans. They also help organize your finances greatly as you no longer have to remember the premium payment dates or renewal dates of each individual policy. Moreover, it becomes easy to cover dependent members who may not be able to afford a health insurance plan on their own.

Here are some benefits of buying a medical policy for the family:

• Tax benefits: Health insurance income tax deduction can help you save money. You can claim a tax deduction of up to ₹25,000 (under the age of 60) or ₹50,000 (over the age of 60) under Section 80D of the Income Tax Act, 1961 for a policy for yourself, your spouse, or your children. You can claim another tax benefit of up to ₹50,000 if you’ve bought a health insurance plan for your parents, taking the total allowed health insurance tax deduction limit to ₹1 lakh. To know more, check our resource on Tax Benefits with Health Insurance.

• Peace of mind: Since a single policy covers all your loved ones, you have nothing to worry about. A family health plan helps you protect your peace of mind by protecting all members of your family.

• Preventive health insurance check-up: The best mediclaim policy for family offers coverage for preventive health check-ups. This helps you detect a disease in its nascent stage and get the right treatment in time. Medical check-ups also help you stay fit by motivating you to adopt a healthier lifestyle in general.

• Comprehensive coverage: You get comprehensive coverage with a health policy for the family. These plans take care of diverse expenses like pre and post-hospitalization, ambulance costs, organ donation, AYUSH treatments, and more.

• Affordable premium: The best family health insurance policy can offer you cost-effective premiums that are light on the pocket but heavy in features and benefits. This lets you secure your loved ones without hampering your present lifestyle and other future financial goals.

• Discounting: Compared to individual health plans, health insurance plans for the family help you save money. You pay one premium as opposed to several. The money spent is greatly reduced, and there are no comprises on the benefits. So, if you want to save some money, you should consider purchasing the best family health insurance.

If you are looking for health insurance for your family, you can explore the following three plans:

Tata AIG Medicare: The Tata AIG Medicare medical insurance for the family offers sum assured amounts ranging from as low as ₹3 lakhs to as high as ₹20 lakhs. This is a budget-friendly plan that can suit most income groups.

You get all basic benefits like a global cover, consumables benefit, bariatric surgery, daycare procedures, in-patient treatment, organ donor expenses, pre-hospitalization medical expenses, post-hospitalization medical expenses, daily cash for choosing shared accommodation, ambulance cover, AYUSH benefit, Free health checkup, in-patient dental treatment, and more.

However, this family health insurance plan does not include OPD treatment, OPD dental treatment, accidental death benefit, maternity cover, etc.

Tata AIG Medicare Protect: Tata AIG MediCare Protect is another cashless mediclaim policy for the family. This plan is better suited for people concerned about hospitalization costs. This health insurance policy covers pre-hospitalization medical expenses, post-hospitalization medical expenses, consumables benefit, daycare procedures, in-patient treatment, organ donor expenses, daily cash for choosing shared accommodation, ambulance cover, AYUSH benefit, health check-up, etc.

But the plan does not include a global cover, bariatric surgery, emergency air ambulance, high-end diagnostics, accidental death benefit, maternity cover, OPD treatment, vaccination cover, etc.

Tata AIG Medicare Premier: If you are looking for the best medical insurance for your family with enhanced features and wholesome protection, the Tata AIG MediCare Premier is what you can select.

This plan offers sum assured amounts of as high as ₹50 lakhs. However, you can also pick lower amounts starting from ₹5 lakhs.

Moreover, the plan offers benefits like a global cover, consumables benefit, bariatric surgery, daycare procedures, in-patient treatment, organ donor expenses, pre-hospitalization medical expenses, post-hospitalization medical expenses, daily cash for choosing shared accommodation, ambulance cover, AYUSH benefit, health check-up, in-patient dental treatment, bariatric surgery, emergency air ambulance, high-end diagnostics, accidental death benefit, maternity cover, OPD treatment, vaccination cover, etc.

Tata AIG offers ideal family health insurance plans for varied needs, budgets and health conditions. To enjoy all benefits and features, make sure to pick a plan that is suited to your needs.

Here are some ways in which a mediclaim policy for the family can help you:

Health insurance covers all medical expenses: Mediclaim for the family covers all kinds of medical expenses, right from basic health check-ups to major surgeries. It also covers unexpected expenses like emergency air ambulance costs, AYUSH benefits, and more. So, you stay protected from all possible costs.

• Health insurance covers the cost of hospitalization: Hospitalization can lead to high-value bills that can be hard to cover on a salary. A cashless mediclaim policy for the family helps cover hospital charges in a seamless manner.

• Health insurance offers quality medical attention: Family insurance plans ensure that you receive quality medical attention without compromising on anything. When money is no longer an issue, you can seek the best medical treatment and recover quickly.

• Health insurance covers ICU charges: Not only does the best medical insurance for families cover general hospitalization expenses, but also ICU charges.

• Health insurance covers preventive health check-ups: Family medical insurance plans cover the expenses of preventive health check-ups. These routine check-ups contribute to better overall health and help you catch a medical problem in its nascent stage.

• Health insurance covers ambulance costs: Additional and unexpected costs like ambulance charges can also be covered with a good family floater insurance plan.

• Health insurance helps you beat inflation: Medical inflation can make it hard to plan or save for your future health expenses. However, the best medical policy for the family offers high sum assured amounts to counter the rising costs.

• Health insurance covers daycare procedures: Daycare procedures are also covered in health insurance. So, you do not necessarily have to be admitted to a hospital to make a claim.

• Health insurance lets you save tax: The tax deductions under Section 80D of the Income Tax Act, 1961, enhance your savings.

• Health insurance covers AYUSH treatments: The best cashless mediclaim policies for families in India cover alternative treatments like Ayurveda, Yoga, Naturopathy, Unani, Siddha, Sowa-Rigpa, and Homoeopathy.

• Health insurance reduces costs: You can avail of discounts like the No Claim Bonus (NCB) to reduce the overall costs incurred on purchasing a plan.

• Health insurance offers peace of mind: One family health insurance policy can cover multiple people at the same time. Such comprehensive security offers you peace of mind and lets you live stress-free.

In order to ensure that you buy the best family health insurance, make sure that you pay attention to the following things:

• Daycare: Look for a medical policy for your family that covers daycare procedures as well as overnight hospitalization. Many a time, you may not require hospitalization, but the costs of treatment can still be high. Having health insurance for the family that covers all kinds of treatments is essential and will help you save money.

• Organ donor expense: Organ transplant surgeries are not only extremely taxing on the body but can also be financial straining. The costs of surgery can be enormous. However, while most health plans will cover the surgery expenses, not all plans cover the organ donor expenses too. Look for a family health insurance plan that covers these expenses so you do not end up spending money out of your pocket.

• Ayurvedic or homoeopathic hospitalization: In a country like India, medical treatments are not limited to allopathic procedures. The best family health insurance plans in India cover alternative forms of treatment too. When you are looking to purchase a family health insurance plan, make sure to check if the plan covers AYUSH benefits. If not, then try looking for another plan.

• Mental illness cover: With rising stress levels and tension, mental illnesses are becoming more and more common every day. People of all ages and incomes are suffering from varied types of mental illnesses that can require a professional’s guidance. Look for a plan that covers mental illnesses to ensure that you are fully protected.

• Pre-post hospitalization expenses: Pre-hospitalization expenses are those that you incur before being admitted to the hospital. These can include the cost of medicines, tests, consultations, etc. The best family health insurance plans in India cover both pre-and post-hospitalization costs.

• The right sum insured: The most important thing while buying insurance is to pick a suitable sum insured amount. A high coverage amount can lead to higher premiums. But a low sum insured may not be adequate for your needs. So, make an informed decision by analysing your requirements, age, medical history, and medical inflation.

• Policy term: A long policy term can help you save costs. You can use the NCB discount from the previous term, and lower the premium for the next year. In addition to this, a longer policy term also ensures that you are covered for a long time.

The difference between an individual health insurance plan and a health insurance plan for the family is simple. An individual health plan covers an individual or a single person, and a family health insurance plan covers an entire family. For instance, the former will cover only your medical expenses. However, the latter will also cover the medical expenses of your spouse, dependent children, and dependent parents.

Another difference that lies between the two plans is in the premium and the sum assured. In an individual plan, the premium you pay is used to secure you alone. The sum insured can also only be claimed by you (the insured) and nobody else. You do not share this plan with anybody. Contrarily, in the case of family medical insurance plans, the insurance coverage can be claimed by all the people insured in the plan. However, there is only one premium. Not every insured person is asked to pay the premium separately, but they all enjoy umbrella coverage.

Lastly, when you raise a claim for an individual health insurance plan, you can claim up to the sum insured for your policy for yourself. For instance, if you have a health plan of ₹5 lakh and raise a claim for ₹1 lakh, you would still have Rs. 4 lakh left to claim. In the case of a family health plan, the insurance cover would be used by everyone. For instance, consider a scenario where you have a health plan that is being shared by you, your spouse, and your parents. The sum insured of your policy is ₹15 lakhs. If you raise a claim for ₹2 lakhs, the remaining ₹13 lakhs can then be used by any other insured person.

The premiums for individual health plans are decided based on the individual’s age, health history, lifestyle habits, occupation, etc. On the other hand, the premiums for health insurance plans for family are decided on the basis of every insured person’s age, health history, lifestyle habits, occupation, etc.

Tata AIG cashless mediclaim policy for family helps secure your loved ones and offers you different insurance solutions catered to your requirements. Find out why you should get the best health insurance for family from Tata AIG:

• Cashless claims: Tata AIG has tie-ups with over 7200 hospitals all over the country. You can use the cashless hospitalization facility at any of the 7200 network hospitals. There is no need to produce any hospital bills, as a result of which, there are no delays in your treatment.

• Tax benefits: Your Tata AIG family health plan offers tax benefits too. You can claim a total of Rs. 1 lakh under Section 80D of the Income Tax Act, 1961, on the premium paid towards your insurance policy in a year.

• Paperless policies: All your policy documents are sent to your email address in a soft copy. This lets you carry your documents on the go. No matter where you are, you can raise a claim with your paperless health policy without any hassles.

• High claim settlement ratio: Tata AIG is committed to delivering an unmatchable experience to our customers. The claim settlement ratio of the company stood at 98% in FY 2020-21. With a quick and smooth claim settlement process, you can access funds immediately and have nothing to worry about.

• Discounts according to the number of members and number of years: Tata AIG provides you with several discounts that help save money. You can get the same cover at a lower cost by switching to a family floater plan from an individual health plan. Tata AIG also offers a No Claim Bonus (NCB) if you do not make any insurance claims in a year. The NCB can be availed in the next year to get a discount on the premium of your policy.

• 24x7 assistance: You can contact our round the clock customer support for any queries, settlement requests, renewal issues, etc. No matter the hour, our team of experts is always at your disposal. Simply dial 1800 266 7780.

Although family insurance plans are comprehensive plans with a wide scope of coverage, there are some things that are not covered by such policies. Here’s a list of exclusions not included in a medical policy for family:

• Adventure sports injuries: Injuries caused due to an adventure sport, such as paragliding, sky diving, deep sea diving, etc., are not covered under medical insurance plans for family.

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

• Injuries in war are not covered: Injuries suffered in a war or a war-like situation are not covered in your family health insurance plan.

• Congenital external diseases, defects or anomalies: Health defects and illnesses present from birth are not covered by a family health insurance plan. These include illnesses like down syndrome, metabolic disorders, cleft lip, club foot, etc.

• Treatment for alcoholism and drug abuse: Rehab costs and other kinds of treatment for alcoholism and drug abuse are not included in a family health insurance plan and hence not covered.

Before you buy a health insurance plan, you must meet its eligibility criteria. Here are some factors that play a role here:

• Age: The age of the insured is one of the primary factors that an insurance company considers before selling a health insurance plan. Age plays a crucial role in the health and well-being of a person and is, therefore, an important parameter in eligibility for health insurance. Typically, health insurance can be bought for dependent children below the age of 18. Individuals over 18 are considered adults and can therefore buy a different cover for themselves. In the case of senior citizens, the maximum age can range between 60 and 65 years. Make sure that you check the eligibility criteria of the family health plan and see if all your family members can be added to it or not.

• Previous medical conditions / pre-existing illnesses: The insurance company may request you to undergo a medical test to determine if you have any pre-existing illnesses, such as hypertension, diabetes, thyroid, etc. Pre-existing illnesses are generally not covered during the waiting period of the policy. This implies that you would not be able to raise a claim to cover a medical expense arising out of an illness that you had before buying the health plan.

In some cases, the insurance company can also request you to submit a self-declaration of your pre-existing illnesses. It is important for the insurance provider to know if you have any pre-existing illnesses as it helps them assess the right premium and sum assured for your policy.

If you are looking for a health policy for family, following the steps given below can ensure that you purchase the right plan:

• Compare different plans: Compare different plans and closely look at the features and services of each available mediclaim for the family. Analyse the ages and health of all your family members, including yourself and see if these features will be suitable for everyone. When you compare different plans, look at the premium amount too. Check your budget and pick a plan that fits into it.

• Pick the adequate sum insured: Since a single family health insurance plan will be covering multiple people, it is important to pick a sum insured amount that is adequate for everyone’s needs and does not fall short in case of an emergency. Consider the ages, lifestyles, pre-existing illnesses of all members to decide a suitable amount. Also, make sure to keep in mind the rising costs of medical treatments, equipment, etc., in the country and around the globe.

• Pay attention to the inclusions and exclusions: Certain health insurance plans for the family may not include all dental treatment expenses. If you pick such a plan, you may end up spending money out of your pocket. Similarly, some plans may not offer a global cover or include experimental treatment. It is important to thoroughly check the list of inclusions and exclusions to know what kind of claims you can raise in the future.

• Check the available riders: Riders enhance your existing family health plan by offering you increased protection. Look at the riders that the plan offers and the cost for each and see how they can add value to your life.

• Go through the network of hospitals: Check the list and number of network hospitals included in your medical insurance plan for the family. It can help to pick a plan with a wide number of network hospitals in your city of residence and across the country. Network hospitals offer cashless services for better convenience during a hospital visit.

• Check the pre-existing illness waiting period: The waiting period is the time after you purchase the policy when you cannot raise a claim for a pre-existing diseases. All insurance family medical insurance plans have a waiting period. Make sure you check this and pick the lowest one.

• Look for discounts: If you are switching from an individual health plan to a family health plan, you can get a discount on the premium of the new policy. Similarly, if you have an NCB from the previous year, you can use it to get a discount for the new plan. Check if you can get a discount and lower your premium amount.

After you have completed the steps given above and picked a suitable family health plan, follow the steps given below:

• Go to the Tata AIG website
• Go to All Products and select Health Insurance
• Select the family members that you want to secure like father, mother, son, daughter, spouse, or yourself. You can also select the number of children.
• Click on Get Plan to purchase a new family medical insurance plan.

Given below is the cashless mediclaim policy for family claim process. The need to raise a claim can arise in different circumstances. While in most cases, treatment can be pre-scheduled at a network hospital, there can be times where you or your loved ones may require emergency treatment or you may end up visiting a non- network hospital. Here are the steps that you can take in each of these situations:

If you have received treatment at a network hospital, you can enjoy quick and easy cashless claims for non-emergency hospitalizations. Here are the steps for the same:
Cashless Claim

• Send us an email or letter with the cashless claim form or file a claim online at least 48 hours prior to your treatment.
• We will verify the details of the form and inform the hospital about the treatment from our end. You will also receive a confirmation letter for the same.
• You can submit your health card and the confirmation letter to the hospital on the day of the treatment.

If you are getting treated at a non-network hospital, you can file a reimbursement claim by following these steps:
Reimbursement Claim

• After the treatment, clear all hospital bills.
• Go through your policy documents to check if the treatments you have received are covered or not.
• Call us on 1 800 266 7780 or file a claim online on the Tata AIG website. Make sure to attach all necessary documents like your health card, medical papers, and the hospital bill.
• Once the claim has been verified, your money will be reimbursed to you.

If you need to go to the hospital for emergency treatment, you may not have the time to raise a claim request in advance. In this case, you can follow the steps given below:

• Call a network hospital and inform them that you need emergency treatment. You can also call us and let us know the same.
• Share your policy number with us and the hospital TPA.
• As soon as we receive your policy number and request, we will initiate processing your claim as soon as possible.