Family floater health insurance is designed to typically cover your entire family within a single insurance arrangement. With family floater health insurance, you have the option to include your spouse, children, parents and dependent in-laws and siblings under one unified coverage. This policy comes with a predetermined sum insured and covers various medical expenses like hospitalisation, pre and post-hospitalisation costs, day-care procedures and ambulance fees. Depending on the policy's terms and conditions, it might also extend its coverage to include your maternity expenses, newborn care and pre-existing medical conditions. By understanding who cannot be covered under a family floater policy, you can make an informed decision about purchasing this insurance.
What is the family floater policy?
A family floater health insurance policy is a type of medical insurance that covers multiple family members under a single sum insured. Instead of buying individual policies, you can cover yourself, your spouse and dependent children in one plan. All members share the sum insured, which can be utilised by any insured member in case of hospitalisation or medical treatment.
This approach is not only cost-effective but also easier to manage, as it involves one premium, one renewal date and one set of policy documents.
What are the benefits of taking a floater policy?
There are several advantages to choosing a family floater plan:
- Affordable premiums: Compared to buying separate policies for each family member, floater plans come at a lower cumulative cost.
- Simplified management: With a single medical insurance for the family, keeping track of renewals and benefits is easier.
- Flexible coverage: If one member needs a higher payout during an emergency, the entire insured sum is available for use.
- Tax benefits: Under Section 80D of the Income Tax Act, if you pay premiums for health insurance, you are eligible for tax deductions.
Who cannot be covered under a family floater policy?
Typically, almost every family floater policy defines a family uniquely, and there are specific rules governing who can be included and who cannot be covered under a family floater policy. The definition of family typically includes your spouse, children and parents. Some policies may offer coverage for siblings and parents in law if they are financially dependent on you. However, uncles, aunts, grandparents, cousins and other relatives cannot be covered under a family floater plan. The specifics differ from insurer to insurer.
It's also important to note that certain policies impose a restriction on the count of adult family members covered, allowing up to a maximum of two adults in some cases. In contrast, others are more lenient, extending coverage to as many as four adults within a single policy.
Following are some exclusions applicable for the floater across age groups:
- Family floater health insurance plans generally don't cover pre-existing medical conditions. This means that if any member within your family already has a health issue diagnosed before you acquired the insurance policy, the costs tied to managing that specific condition might not be included in the protective coverage of the policy. However, these costs are usually covered after a fixed period of time such as 24 or 36 months.
- When considering a family floater plan, remember that expenses related to cosmetic procedures—like plastic surgery or hair transplants—are usually not covered unless these procedures are deemed medically necessary and can be proven as such.
- It's vital to understand that expenses not directly associated with medical treatments, which typically include administrative fees, service charges, or admission expenses, typically aren't included by these insurance policies.
- Moreover, family floater health insurance policies often don't account for expenses resulting from self-inflicted injuries or injuries sustained during risky activities or sports engagements.
- Keep in mind that instances involving health hazards or disorders arising due to nuclear or radioactive incidents in your geographic vicinity aren't part of the coverage provided by family floater health insurance plans.
- Medical costs that emerge due to the consumption of intoxicating substances are usually excluded from the coverage scope of family health insurance plans.
Should you include your parents in your floater policy?
Including your parents in a floater policy may seem like a loving and protective move, but it comes with caveats. Older individuals are more likely to make frequent claims, which can exhaust the sum insured quickly and affect the premium during renewals. Moreover, since most family floater plans have age restrictions, you may not even be allowed to include them if they are above 60 years.
Instead, opting for a separate health insurance for senior citizens is a more suitable choice. These policies are specifically designed to meet the medical needs of the elderly and come with features like higher coverage for age-related ailments, annual health check-ups and pre-existing disease coverage.
Should you include your children in your floater policy?
Including children in your family floater policy is usually a wise decision—especially when they are young and financially dependent. Most medical insurance providers allow dependent children up to the age of 25 years to be covered. However, once they cross the age limit or become financially independent, they must be insured under a separate policy.
For younger children, a family floater ensures cost-effective coverage and reduces the need to manage multiple policies.
Conclusion
In summary, family floater medical insurance policies present a holistic approach to include your entire family under one insurance plan. However, it's crucial for you to be mindful of the exclusions inherent in these policies. Prior to finalising your policy, always ensure a thorough review of the terms and conditions within your family floater insurance plan to gain a thorough understanding of its coverage and limitations.
Disclaimer: The information provided in this blog is for educational and informational purposes only. It is not intended as a substitute for professional advice, diagnosis or treatment. Please consult a certified medical and/or nutrition professional for any questions. Relying on any information provided in this blog is solely at your own risk, and ICICI Lombard is not responsible for any effects or consequences resulting from the use of the information shared.