Switching from individual to family health plan? Here's 4 things to know

After having an individual health plan, you have now decided to switch to a family health plan to cover your loved ones. Read on to know which things you must focus on before buying the plan:

#1 Compute the sum insured carefully.

Since you are about to include your family members in the health plan, the sum insured amount must account for the needs of the entire family. It must be sufficiently high so that all members can equally avail of the coverage amount. You may be tempted to take a basic family health insurance plan with a low premium, but check the sum insured first. Keep the family’s medical history in mind, and also the age of older family members (such as parents and/or in-laws, who might have pre-existing diseases that require treatment). The sum assured should be at least 10 times your annual income. You can enhance coverage at the time of renewing the policy annually. You can also opt for a super top up plan to get supplementary coverage over that of the primary plan. If there is a history of hereditary illness in the family for yourself or your spouse, you should consider buying critical illness insurance.

#2 Check these terms carefully before you buy.

There are certain important terms mentioned in the policy, which determine if the plan is suitable for you. They are:

• Waiting period: This is a period of time after the policy purchase during which you and your family members cannot avail of the plan benefits. It may be up to 30 days for a new plan, but it might be higher for older family members with pre-existing diseases (three or more years)
• Range of hospital expenses: Check what the insurance provider covers under ‘hospital expenses’. Ideally, it should cover pre- and post-hospitalisation, ambulance costs, day care expenses, daily cash benefit, free annual health check-ups, etc.
• Add-on covers: These are value additions to the plan that enhance its overall scope, generally upon the payment of a slightly higher premium
• No Claim Bonus: The insurance provider offers a cumulative bonus or a discount on the succeeding premium for every year of not filing a claim against the plan
• Exclusions: No family health insurance plan covers every possible thing that you require or want. Indeed, the policy document will have a clear set of exclusions, or items that are not covered under the health plan. Being aware of the exclusions helps you choose the best health insurance plan for the family, and avoid potential disputes at the time of settling the claim
• Deductible: It is the money you pay from your pocket before the insurance provider covers the medical expenses. As part of the insurance contract, you are legally mandated to share the deductible cost

#3 Choose a plan that offers ‘lifetime renewability’.

Lifetime renewability allows you to renew the plan without a corresponding increase in the premium. The plan is renewed at the same premium even as you grow older, which would not happen if you were to buy a plan without this clause.

#4 The premium matters, but it’s not the only factor to account for.

You decided to choose family health insurance because its premium is more affordable than paying individual premiums on separate plans for each family member. However, a low premium cannot and should not be the sole deciding factor when choosing a health plan. Please check the list of inclusions, exclusions and features and decide on the premium using an online calculator.

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