Health Insurance Plans for Family

Why Should You Buy a Family Health Insurance Plan?

A sudden medical emergency with any family member can result in significant hospital bills, requiring you to even borrow money or withdraw from your savings. And if more than one family member needs medical care in the same year or at the same time, managing multiple hospitalizations can put greater pressure on the entire family’s finances.

A health insurance plan for family covers eligible medical expenses for multiple family members under the same policy, helping you reduce your financial burden during a medical crisis. It usually covers costs related to hospitalization, surgeries, ICU charges, room rent, doctor's fees, day care procedures and modern treatments, subject to policy terms.

Why Do You Need Family Health Insurance?

Life brings new responsibilities at every step. A Family Health Insurance Plan helps protect your loved ones from rising medical expenses through every chapter of your journey.

Newly Married

A family starts with two.

First Child

Your family grows. Your responsibilities grow.

Growing Family

More smiles. More people to protect.

Parents Need Care

The people who cared for you, now depend on you.

One Policy. Multiple Family Members Get financial protection for your family when medical needs arise.

Here are some of the key reasons why you need a family health insurance policy:

• No Stress of Managing Multiple Policies

  Instead of managing different health insurance policies and paying separate premiums for your spouse, kids and parents, a family health insurance policy covers the entire family in a single plan. With a single policy renewal date, a single claims process and shared coverage limits, it is more cost-effective and easier to manage.

How Much Family Health Insurance Coverage Should You Buy?

For most families, health insurance coverage of ₹15-25 lakh can be a good starting point. However, the actual coverage your family needs can be higher or lower depending on where you live, the number of covered family members, their ages, and their specific healthcare needs.

For example, a family of three living in a smaller city needs a different coverage amount from a family of the same size living in a metropolitan city. Similarly, a family with older parents or members with pre-existing conditions needs a higher coverage amount.

While there is no single coverage amount that is appropriate for every family, the sections below can help you decide a suitable sum insured for your family health insurance policy based on your location and family size.

How Much Family Health Insurance Coverage Should You Buy Based on Your Location?

Check out the recommended coverage amount for family insurance plans as per your city of residence:

How Much Family Health Insurance Coverage Should You Buy Based on Your Family Size?

Your family's healthcare needs evolve with every stage of life. Check out the recommended health insurance coverage amount as per your family size:

1. Health Insurance Coverage for Family of 2 Members

   A sum insured of ₹15-25 lakh is sufficient to meet hospitalization costs of a couple living in a metropolitan area since their health risks are low.

   Coverage Tip: Choose a plan with maternity benefits if you are planning a child in the next 2-3 years.

2. Health Insurance Coverage for Family of 3 or 4 Members

   As your family grows, more members share the same sum insured, increasing the likelihood of multiple or recurring medical expenses. Opting health insurance for family with a sum insured between ₹20 lakh and ₹30 lakh is recommended to meet multiple hospitalization costs.

   Coverage Tip: Buy a plan with restoration benefits or no claim bonus for enhanced coverage.

3. Health Insurance Coverage for Family of 5 Members

   For a large family with 5 or more members, the main focus should be on ensuring that your policy is able to cover multiple medical needs in the same policy year. You can buy a plan with a coverage amount of ₹30-35 lakh or more.

   Coverage Tip: Choose a plan with higher sum insured to ensure adequate coverage for all members.

4. Health Insurance Coverage for Family with Senior Citizens

   Opt for a higher coverage of at least ₹30-50 lakh as elderly people are at a higher risk of chronic conditions and require frequent hospitalizations. You can also buy a critical illness cover for them to supplement protection and easily tackle any major illness.

   A major risk with adding senior citizens in the same policy is that as they age, their healthcare needs increase, and can exhaust the shared sum insured sooner.

   Coverage Tip: Instead of adding elderly parents to a family floater plan, buy separate health insurance for senior citizens.

*Disclaimer: The recommended sum insured mentioned above is indicative and may vary depending on different influential factors.

Factors Affecting Coverage Amount for a Family Health Insurance Plan

Here is how different factors can help you decide the right family health insurance coverage amount:

• Family size: A family with more members requires a higher sum insured.
• Age of members: Older members have more healthcare needs and require higher coverage.
• Existing health conditions: More people with pre-existing diseases, like diabetes, hypertension, etc., can increase the future healthcare costs.
• City of residence: Healthcare expenses are higher in metropolitan cities than in Tier-2 and Tier-3 cities.
• Medical inflation: Your family floater must cover not just today's but also future medical costs.

List of Family Health Insurance Plans in India 2026

Take a look at some of the ideal family health insurance plans from different health insurance companies below:

*Disclaimer: The insurers mentioned are arranged in order of highest to lowest gross direct premium income for health insurance(retail) of non-life insurers offering health insurance (retail) plans on our platform within India segment wise as per “Gross Direct Premium Income Underwritten By Non-Life Insurers Within India (Segment Wise) for the period up to March 2025 (Provisional & Unaudited ) in FY 2024-25”, published by General Insurance Council. The insurers/plans mentioned are offered by Policybazaar’s insurer partners offering health insurance plans on our platform for complete list of insurers in India refer to the IRDAI website www.irdai.gov.in

Popular Family Floater Plans in India: Brief Summary

While many insurers offer plans that can be purchased as individual or family policies, some plans are specially designed to cater to families. Here is a brief overview of popular health insurance plans for family in India:

1. Star Family Health Optima Insurance Plan

   It covers self, spouse, up to 3 dependent children, parents and parents-in-law. The Star Family Health Optima insurance Plan provides 100% restoration of the sum insured up to 3 times a policy year. It also offers free annual health check-ups for each claim-free year.

2. Niva Bupa Health Companion Family Floater Plan

   It covers in-patient hospitalization of 2 hours or more. You can buy the Niva Bupa Health Companion Family First Policy for yourself, your spouse and up to 4 children. There is no room rent capping under this policy, nor is there any maximum age to enroll in the plan. It also refills 100% of your sum insured upon its exhaustion for the same or different illnesses.

3. New India Assurance Floater Mediclaim Policy

   You can cover up to 6 family members under a single mediclaim policy, including self, spouse, dependent children and wards, parents and siblings. The New India Assurance Floater Mediclaim Policy offers a cumulative bonus of 25% for every claim-free year, up to 100%, depending on the plan variant. It also offers restoration of sum insured, maternity benefits and Day 1 protection (for lifestyle conditions) as optional covers.

4. New National Insurance Parivar Mediclaim Policy (Floater)

   The New National Insurance Parivar Mediclaim Policy covers self, spouse and up to two children. Along with standard coverage for in-patient hospitalization, ICU, daycare procedures, etc., it also has in-built benefits for maternity and infertility expenses. Day 1 PED coverage for diabetes & hypertension, OPD benefits and critical illnesses coverage are provided as optional covers.

5. Oriental Happy Family Floater Policy

   You can cover yourself, your spouse, up to 3 dependent children, parents, parents-in-law and unmarried siblings under this policy. Restoration benefit is available as an add-on. The Oriental Happy Family Floater Policy allows you to extend coverage when travelling to SAARC countries at no additional premium, but it has to be specifically requested. Depending on the plan variant, you can also avail yourself of a daily hospital cash benefit and attendant allowance.

6. United India Family Medicare Policy

   It allows coverage for self, spouse and dependent children and parents. The United India Family Medicare Policy provides a 100% restoration of the sum insured when the base coverage amount is exhausted. Maternity benefits and newborn coverage can be opted for by paying an additional premium. A lump-sum organ donor benefit is offered to the insured person if they donate an organ.

7. IFFCO-Tokio Family Health Protector Plan

   It covers self, spouse, dependent children, parents and extended dependent relatives under one policy. The IFFCO-Tokio Family Health Protector Policy covers in-patient hospitalization, 380+ day care surgeries and AYUSH treatments. It also provides coverage for critical illnesses as an add-on.

8. Royal Sundaram Family Plus Plan

   The Royal Sundaram Family Plus Plan covers up to 19 relationships, including parents, parents-in-law and siblings. It offers an automatic restoration of the sum insured upon its exhaustion and a no-claim bonus of 20% for every claim-free year. The policy also covers maternity and newborn medical expenses, and offers an emergency domestic evacuation benefit of up to ₹1 lakh.

What is Covered in a Family Health Insurance Plan?

Take a look at the most common coverage available under health insurance plans for family in India:

• In-patient Hospitalization – It covers medical expenses incurred on surgery, ICU charges, room rent, doctor's fees, nursing charges, etc., for hospitalization of at least 24 hours.
• Daycare Procedures – It pays for the cost of daycare procedures that require hospitalization of less than 24 hours.
• Pre and Post-Hospitalization – It covers medical expenses incurred before hospitalization (doctor visits, medical tests, etc.) and after discharge (follow-up consultation, etc.) up to a certain number of days.
• Ambulance Charges – It covers expenses incurred on availing ambulance services to the hospital during a medical emergency.
• AYUSH Treatment – It pays for availing alternative treatment through Ayurveda, Homeopathy, Yoga, Siddha and Unani.
• Domiciliary Treatment – It covers medical expenses incurred on availing treatment at home on the advice of a doctor.
• Maternity Cover – It covers pregnancy-related expenses like delivery charges, pre- and post-natal expenses and newborn baby expenses.
• OPD Cover – It pays for doctor consultations on an outpatient department (OPD) basis, along with expenses incurred on medicines and diagnostic tests.
• Organ Donor Expenses – It covers the cost of harvesting a donated organ in case of an organ transplant.
• Daily Cash Allowance – It provides a daily hospital cash allowance to the policyholder to cover day-to-day incidental expenses during hospitalization.
• Mental Illness Cover – It provides coverage for the treatment of mental diseases, such as depression, anxiety, schizophrenia, etc.
• Consumables Cover – It covers the cost of consumables or non-medical items, such as syringes, gowns, cotton, diapers, etc.
• Health Check-ups – It pays for availing preventive health check-ups at a network provider of the insurance company.

What is Not Covered in a Family Health Insurance Plan?

When buying health insurance for your family, you must thoroughly read the policy documents in order to understand the policy exclusions in detail. Following are the medical expenses generally not covered by family health insurance plans in India:

• Non-accidental dental treatments
• Routine medical check-ups
• Cosmetic treatment or plastic surgeries
• Treatment that was taken overseas unless it is included in the plan
• Any illness or injury resulting due to war conditions, nuclear reaction, rebellion, acts of foreign enemies, etc.
• Injury or illness due to participation in unethical or criminal activities
• Self-inflicted injuries or suicide
• Treatment for drug or alcohol addiction

Is Maternity Covered in Family Health Insurance Plans?

Some family health insurance plans cover maternity expenses; however, it is not a standard benefit provided in every family insurance policy. Most plans offer maternity coverage with an optional cover or add-on, meaning it is available at an additional premium.

Most maternity insurance plans cover medical expenses related to normal delivery, C-section delivery, hospitalization for childbirth, pre- and post-hospitalization and eligible newborn baby medical care, depending on the specific policy terms.

However, pregnancy-related expenses are not covered immediately and usually have a waiting period of 2-4 years; hence, you must buy a family health insurance plan with maternity benefits well before planning pregnancy.

How Does Family Health Insurance Work?

Under family health insurance, the same sum insured is shared by all the covered members, and a single premium is paid for everyone. This shared sum insured can be used by any one or multiple family members. When one member makes a claim, it is paid from the shared pool, reducing the coverage available to other members. Even two or more members can claim simultaneously under a family health insurance plan.

Claims can be made till the entire sum insured is exhausted, whether due to a single hospitalization or multiple hospitalizations. The biggest risk here is that if a single member requires major treatment, they can exhaust the entire sum insured, leaving little or no balance for other members.

Let us understand how a family floater health insurance plan works with an example:

• Suppose you buy family health insurance for yourself, your spouse and two kids with a coverage of ₹20 lakh.
• Now, your spouse needs surgery, and the eligible hospital bill amounts to ₹12 lakh.
• Your family insurance plan will cover this amount.
• Later in the year, your kid is hospitalized and the bill amounts to ₹2 lakh.
• This ₹2 lakh will be covered from the remaining coverage amount of ₹ 8 lakh (₹20 lakh minus ₹12 lakh).
• Now, the total coverage amount that the insured members can use in the same policy year will be ₹6 lakh (₹8 lakh minus ₹2 lakh).
• This process shall continue until the entire sum insured is exhausted.

Eligibility Criteria to Buy a Family Health Insurance Plan

Any individual aged 18 years or above can buy a family health insurance plan for themselves and their eligible family members. While the IRDAI has removed the upper age limit for buying health insurance, most insurers still cap the maximum entry age at 65 years. The eligibility criteria for family health insurance plans in India depend on the insurer and the policy you choose.

Age Criteria

• Primary Policyholder & Adult Members: Minimum entry age is 18 years, maximum entry age is usually 65 years.
• Children: Covered usually from 91 days of age to 25 years. Some plans or riders also provide Day 1 coverage.

Who Can Be Included in a Family Health Insurance Plan?

Knowing who you can include in your health insurance plan for family is important to help you determine the most suitable plan as per your family composition.

• Spouse
  • You can include your legally married spouse.
  • The policy premium is usually calculated based on the older partner’s age.
  • If your spouse has a pre-existing disease, it can increase the overall health insurance premium.
• Children
  • A child who is at least 90 days old can be included in the floater policy until they reach the specified maximum age.
  • You can include both dependent biological or adopted children.
  • A married child usually cannot be included as a dependent and needs a separate health policy.
• Parents and In-laws
  • Many modern plans allow you to cover your parents and parents-in-law to your family insurance policy.
  • It is better to buy separate health insurance for parents if they are very old or have existing health conditions.
• Extended Family
  • A select few plans also allow you to cover your siblings, grandparents, son-in-law, daughter-in-law, and other dependent family members.

The exact list of members that can be included in a family floater policy depends on the specific policy’s terms and conditions.

When Should You Buy Family Health Insurance?

The best time to buy a family health insurance plan is before your family's healthcare needs increase. Ideally, buying early in your late 20s or early 30s helps you to complete waiting periods and get comprehensive coverage before any major health issues arise.

How Health Insurance for Family Varies at Different Life Stages:

How Much Does a Health Insurance Plan for a Family Cost?

The premium for a health insurance plan for family depends on the number and age of covered family members, sum insured, medical history, location and policy features. 

Here is an indicative table illustrating the family health insurance premium:

Disclaimer: The premiums are calculated for a ₹10 lakh sum insured for a 33-year-old male, a 32-year-old female, kids between 5 and 16 years, and senior citizens aged 61 to 66 years, with no pre-existing diseases and living in Delhi, based on Policybazaar's journey.

Choosing health insurance plans for family with monthly premiums allows you to pay the amount every month rather than paying a lump sum amount at once, helping you manage your budget easily.

Which Factors Affect the Premium for a Family Health Insurance Plan?

Let us look at the factors affecting family health insurance premium:

1. Eldest Member's Age

   The higher the age of the eldest family member, the higher the premium. (The premium for a family with the eldest member of 56 years will be more than that where the eldest member is 37 years)

2. Number of Family Members

   The higher the number of the members being insured in a family floater plan, the higher the premium. (The premium for a family of 3 will be lower than that for a family of 5 members)

3. Sum Insured

   A plan with a high sum insured usually has a higher premium. (A plan with ₹10 lakh sum insured has a lower premium than the one with ₹25 lakh sum insured)

4. Family Medical History

   Multiple existing health conditions significantly raise the health insurance premium than a single PED. (Your premium will be higher if you have diabetes and heart problems than if you just have diabetes)

5. Location

   The premium for a family in a metropolitan or tier-1 city will be higher than the one in tier-2 or tier-3 cities. (The same family health plan costs more in Gurgaon than it would cost in Jalandhar or Haldwani or smaller towns)

6. Co-payment Clauses

   Higher the co-payment, lower the premium. However, it means you have to pay more from your pocket. (A plan with a 10% co-payment usually has a higher premium than the one with a 40% co-payment)

7. Lifestyle Factors

   If anyone in the family smokes or drinks regularly, the premium loading will be higher. (The premium for a family where no one smokes will be lower than the one where a member is a regular smoker)

Benefits of Buying Health Insurance Plans for Family

One of the several benefits of buying family floater health insurance policies is that they protect your entire family under a single plan, lowering your financial burden and helping you save your hard-earned money during medical emergencies.

Here is a quick rundown of the major benefits of buying a family health insurance plan:

1. Coverage for the Whole Family

   Unlike individual health plans, family floater insurance covers all your family members in a single policy. It allows you to share a single sum insured with your spouse, children, parents and parents-in-law. It saves you from the hassle of buying and renewing separate mediclaim policies for all family members every year.

2. Stress-free Hospitalization

   With family health plans, you and your family members can avail cashless treatment at any network hospital of your choice. The insurance company pays the eligible medical costs directly to the hospital, thus reducing your out-of-pocket expenses.

3. Coverage Beyond Base Sum Insured

   Most family health policies offer additional features that increase overall coverage, such as restoration benefits and no claim bonus. A restoration benefit refills or restores the coverage amount up to 100% of the base sum insured, and no claim bonus is the additional amount provided for not making a claim during a policy year.

4. Affordable Premiums

   Since all insured members share the same sum insured, the premium for a family health insurance plan is cheaper than buying separate individual policies for each member. This lets you get comprehensive coverage for yourself, your spouse, children, parents and other family members at a more cost-effective premium.

5. Add New Family Members Easily

   You can easily add a new family member, like your spouse or a newborn baby, to the family floater policy mid-term by paying an additional premium. Unlike an individual cover, you do not need to take a fresh policy every time there is an addition to your family.

6. Tax Benefits on Family Health Insurance Premium

   Under Section 80D of the Income Tax Act, you can claim up to ₹25,000 for the health insurance premium paid for your immediate family members and up to ₹75,000 if you also pay premiums for your senior citizen parents.

How Medical Inflation Impacts You & Makes Family Health Insurance Necessary?

As per the 2026 Aon's Global Medical Trend Rates Report, the annual trend rate in India is expected to be around 11.5% in 2026. This outpaces the global average rate of 9.8%, implying the healthcare costs in India are rising much faster than it is globally. 

Moreover, medical inflation in India is much higher than the general inflation rate of 4.1%. It means that healthcare costs are rising faster than everyday prices. From hospitalizations, surgeries, and treatments to diagnostic tests and doctor consultations, every medical facility is getting expensive.

This makes it difficult for many families to afford quality healthcare. Families often have to break their lifelong savings to pay medical bills in case of an emergency. A family health insurance policy safeguards your family against these rising medical expenses without exhausting your savings. 

You can get the required treatment for your family members without worrying about arranging money first to make initial deposits. Timely hospitalization ensures that you do not have to compromise with or delay their treatment.

How to Save Tax with Family Health Insurance Plans?

You can save tax by buying a family health insurance policy under the old tax regime. As per Section 80D of the Income Tax Act, the premium paid for a family medical insurance policy is eligible for a tax deduction. You can earn a tax benefit of up to ₹25,000 per year on buying family health insurance for yourself, your spouse and your dependent children.

If you buy a family health insurance plan for your senior citizen parents aged 60 years or above, you can earn an additional tax deduction of up to ₹50,000 per year. Thus, you can enjoy a total tax benefit of up to ₹75,000 if you buy a mediclaim policy for your family and parents.

However, Section 80D deduction for health insurance premiums is not available under the new tax regime.

Individual Health Insurance vs Family Health Insurance Plans

Check out the key differences between an individual health insurance plan and a family health insurance plan:

How to Choose the Right Family Health Insurance Policy in India?

Here are a few important points that you must consider while choosing a good health insurance plan for your family:

1. Check the Coverage Offered

   Before buying a family health insurance plan, it is important to check the coverage offered under the plan. Almost all family health plans provide coverage for day care expenses, in-hospitalization expenses, ambulance charges, pre & post-hospitalization expenses, etc. Moreover, some plans also cover maternity expenses, non-medical expenses and preventive health check-ups. Opt for a plan that appropriately covers your family’s health needs within your budget.

2. Choose a Plan with Unlimited Restoration of the Sum Insured

   Most health insurance plans for families offer the restoration benefit that recharges the sum insured by 100% before renewals on partial or complete exhaustion. While some plans allow unlimited restoration during a policy year, others may restore it only once a year. Moreover, the restoration benefit may or may not be available for claims arising from the same illness. Hence, you must choose a family plan that offers unlimited restoration of the sum insured for unrelated and same illnesses during the policy year.

3. Pick a Plan with a Minimal PED Waiting Period

   As per the latest guidelines by the Insurance Regulatory & Development Authority of India (IRDAI), pre-existing diseases are covered by health insurance plans after a maximum waiting period of 3 years. However, some family health plans also offer PED coverage from day 1 for some listed diseases. Therefore, you must pick a health plan that covers the pre-existing diseases of your family members after a minimal waiting period.

4. Opt for a Plan with the Sum Insured Enhancement Option

   The cost of medical facilities keeps increasing due to inflation. Thus, you must opt for a plan that comes with an option to enhance your sum insured during renewals. Several insurers offer cumulative bonus benefit that increases your sum insured amount by up to 100% if you do not raise a claim in the previous policy years.

5. Opt for Plans with Cashless Everywhere Facilities

   All health insurance companies in India offer cashless hospitalization facilities at their network hospitals. But with cashless everywhere benefit, you can avail cashless treatment at any hospital of your choice across India. This makes the hospitalization process seamless and hassle-free. Thus, you must go ahead with a family mediclaim policy with the cashless everywhere benefit.

6. Check the Maximum Entry Age

   Every family health insurance plan may have different eligibility and entry age criteria. Before buying a family plan, check the eligibility criteria to ensure coverage for all your family members. Moreover, you should opt for a family health plan that comes with a lifelong policy renewal facility.

7. Get Hassle-free Claim Settlement

   Before buying any health insurance plan for your family, make sure to check and understand the insurance company's claim settlement process. Opt for a plan that provides a quick claim settlement while approving cashless claims within a few hours. Moreover, check if the customer support team of the insurer is available 24x7 for claim assistance so that you can reach them out whenever a medical emergency strikes.

Should You Include Your Parents in Your Family Health Insurance Plan?

Generally, it is not advisable to add your elderly parents to your family health insurance policy.

This is because elderly parents are more likely to develop health issues due to their increasing age and file a claim. As a result, insurers charge them a higher premium. So, if you add your parents to your family policy, you will end up paying a hefty premium.

Moreover, since parents can raise frequent claims, the sum insured may be exhausted or insufficient when another family member wants to claim the family policy. Therefore, buying separate health insurance for parents is advisable instead of adding them to your family health policy.

A separate parents health insurance plan ensures better coverage for them, keeps the premium for your family health insurance plan manageable and lowers the risk of its sum insured being exhausted quickly.

Why to Buy Health Insurance Plans for Family Online?

Take a look at some of the reasons why you should consider buying a family health insurance plan online:

1. More Convenient

   Buying a health insurance plan for your family online is a convenient process. You can easily compare various plans or get expert advice anytime, anywhere. Besides, you do not need to fill out multiple forms at the time of buying the plan or stand in a queue to submit them.

2. Instant Quotes

   The process of buying family health insurance is very quick as you can get quotes from different insurance companies instantly. The quotes can be compared to help you choose the ideal plan within your budget.

3. Safe Payment Modes

   As the world has become more digitized, people prefer online payment over cash or cheques to reduce the risk of fraud. Digital payment options, such as debit cards, net banking, credit cards, wallets, etc., with safe payment gateways are available when the family health plan is purchased online.

4. Quick Policy Issuance

   Gone are the days when you had to wait for weeks to get your policy document. Instead, your policy will be issued within a few hours when you purchase it online.

Documents Required to Buy a Family Health Insurance Plan

Check out the list of documents required to buy a family health insurance plan:

You may also be required to submit passport-size photos, a duly filled proposal form and some medical documents at the time of buying the policy.

How to Buy a Health Insurance Plan for Family Online from Policybazaar?

Policybazaar Insurance Broker Private Limited allows you to compare multiple family health insurance plans online to buy the ideal one within your budget. Follow the steps given below to buy a family health insurance plan online from Policybazaar.com:

• Step 1: Go to Policybaaar.com and click on the ‘Health Insurance’ icon on the homepage
• Step 2: Select your gender and the family members you want to cover with their ages
• Step 3: Enter your city or Pin code and provide details of any past medical history of the family members to be insured
• Step 4: Select if your employer offers medical insurance and choose the sum insured range if they do
• Step 5: Family health insurance plans from multiple insurance companies will be displayed
• Step 6: Compare the plans and choose the ideal plan for your family’s health needs
• Step 7: Pay the premium for the plan you want to purchase online
• Step 8: You will receive your family health insurance policy once the insurer receives the premium payment.

In case of any query, you can reach out to insurance experts at Policybazaar.com by calling the toll-free number at 1800-208-8787 or by sending an email to care@policybazaar.com

Common Mistakes to Avoid While Buying Family Health Insurance

When buying health insurance for family, you must avoid choosing a sum insured without assessing the entire family's healthcare needs or choosing a plan because of the low premium. Here are some of the common mistakes that people make when buying a family health insurance policy:

• Low Sum Insured: Choosing a plan with lower sum insured can leave you with insufficient coverage, especially in case of major or repeated hospitalizations.

• Not Disclosing Pre-Existing Diseases: Hiding or providing incomplete information about medical history or existing health conditions of any family member can result in claim rejections or even policy cancellation.

• Ignoring Waiting Periods: Not checking the mandatory waiting periods, like pre-existing disease waiting periods, delays coverage of conditions you may want to get covered for from the start.

• Not Checking Network Hospitals: Not checking whether your nearby preferred hospitals are covered in the insurer's network hospitals list can cause delay and obstacles in receiving cashless treatment.

• Neglecting Room Rent Limit: Overlooking sub-limits and capping on room rent and specific disease treatment expenses result in higher out-of-pocket expenses.

• Ignoring Co-payment: A higher co-payment means paying more amount from your pocket at every claim. This is especially concerning for a family health plan where there are more chances of repeated claims.

• Including Old-aged Parents in the Same Policy: Elderly parents usually have age-related health conditions and require frequent hospital visits., It causes the sum insured to exhaust quickly, making the amount short for other family members.

• Ignoring Policy Exclusions: Not reading the list of treatments and diseases that are not covered by the insurer is one of the major reasons for claim rejections.

How to File a Claim for a Family Health Insurance Plan?

You can file a claim under your family health insurance policy in two ways - cashless claims and reimbursement claims. The procedure for both types of claims is given below:

Cashless Claim Process:

• Inform your insurance company about the health emergency within 24 hours of hospital admission. In case of planned hospitalization, intimate the insurer at least 48 hours in advance.
• Fill up the cashless treatment pre-authorization form, which you can find at the TPA or insurance desk of the hospital.
• Submit the pre-authorization form with other required documents to the hospital, which will forward it to your insurer.
• The claim management team of your insurer will send you the letter of approval if the cashless claim request is approved.
• If there is any query regarding your claim, the insurance company will contact the hospital for the same. In case the request is not approved, you will need to raise a reimbursement claim later.
• Once approved, obtain the treatment at the hospital and sign all the documents before discharge.
• Your insurer will settle your medical bills with the hospital.

Reimbursement Claim Process:

• Intimate your insurer about your medical emergency within 24 hours of getting hospitalized. For planned hospitalizations, the insurer must be notified at least 48 hours before being admitted
• Receive the treatment at the hospital.
• Pay all the hospital bills and collect all documents at the time of discharge.
• Submit the filled-in claim form along with other required documents to your insurance provider at the earliest.
• The claim management team of the insurance company will review your claim and verify all your documents.
• You will receive a letter of approval or rejection from the team after your claim has been verified.

Documents Required for Family Health Insurance Claim Reimbursement

The following documents must be submitted to raise a family health insurance reimbursement claim:

• Duly filled health insurance claim form
• Copy of the policy document or the insured’s health card
• Hospital discharge certificate
• Doctor consultation papers and OT notes
• Medical investigation results and test reports
• Hospital bills
• Bill payment receipts
• Pharmacy bills supported by doctor’s prescription along with payment receipts
• Any other document requested by the insurer
• You can check the complete list of documents by referring to your policy document.