Family Health Policy for Parents and Children in India

Purchasing health insurance for your family may seem quite simple at first. But once you actually start reading the terms and conditions that include sections like the co-payment clauses, age limitations, and exclusions, it can often get more complicated. Both parents and children can be added and covered under the same health insurance policy. However, it is not always the best option for your family. This article gives you an overview of what a family floater health insurance plan is, who it covers, its features, and everything else you need to know. 

What is a Family Health Insurance Policy, and Who Does it Cover?

A family floater health insurance policy is a single plan that pools a single sum insured for all members under one policy. Instead of buying individual plans for each family member, the entire family shares one cover. This is generally more cost-effective than individual policies if all members are young and healthy. 

The members covered under family floater plans in India are typically:

• You and your spouse
• Dependent children (usually up to age 25)
• Dependent parents and/or parents-in-law

An important thing to note here is that this is if they are your “dependents”. Some policies do cover financially independent or married adult children. However, not all do. So, always read the member eligibility section carefully before making a decision. 

How Can You Include Parents in a Family Health Policy in India?

It is fairly straightforward to include parents in a family health insurance plan in India, as most insurers allow you to add them to a family floater plan. However, there are some things you should keep in mind while comparing policies: 

• Age limits: Many family floater plans often include the entry age limit of 60 to 65 years for parents. So if your parents are beyond this age, then they may not be considered for the standard family floater health insurance plan at all. 
• Co-payment may be mandatory: Including parents above 60 in a family floater plan might come with a mandatory co-payment clause for members. A co-payment clause means that you will have to bear a specified amount of the total bill out of your own pocket. 
• Increase in premium prices: The premium amount is usually calculated based on the oldest included member of the family plan. If the parent being added is over 60 or 65 years, then the premium amount can sometimes double or triple as well. 
• Separate senior citizen policy vs family floater: If your parents already have a pre-existing condition or fall under the senior citizen category, then buying a separate senior citizen health plan would be a better choice. With that, they will get a customized health plan for themselves without inflated premiums for the family floater plan. 

What Does a Family Health Policy Actually Cover? 

While the coverage of each health insurance plan can change significantly, these are some features that should ideally be included in your policy: 

It is also important that you check if the policy includes organ donor expenses, mental health treatment, and home hospitalization benefits. These are especially important if you are insuring elderly parents. 

What Should You Check Before Buying a Family Health Policy for Parents and Children?

While a health insurance brochure provides an overview of the policy, it may not highlight every detail that can affect your experience during a medical emergency. Factors such as claim settlement processes, hospital network coverage, waiting periods, exclusions, and policy limits can have a significant impact on how useful your coverage is when you actually need it. Before making a decision, consider the following key factors:

Sufficient Sum Insured

For a family that includes parents, a sum insured of ₹5 lakh may not always be enough because of high medical inflation in India. A single cardiac event or orthopaedic surgery can easily cost ₹4 to ₹6 lakh in a private hospital. This is why you should try to consider health insurance plans with a sum insured of ₹10 lakhs or above, as they should be sufficient for your entire family. If you want additional coverage beyond just the basic sum insured, you could also opt for a super top-up policy. 

Room Rent Caps

In many policies, room rent coverage is capped at 10% of the sum insured. If your sum insured is ₹5 lakh, then you might get a room rent benefit of ₹5,000 per day. Choosing a more expensive room type could lead to a proportional reduction in your claim amount. 

Co-payment Clauses

This is especially relevant when adding parents to your plan. If you choose a 20% co-payment option, then you could end up paying ₹60,000 on a claim of ₹3lakh. Make sure to know the co-payment fixed amount before a claim is made. 

Network Hospital Coverage 

A large network of hospitals ensures that your preferred hospital is also accessible to you. This would also ensure that you can access cashless treatment. 

Restoration Benefit

If one family member uses up the entire sum insured for the year, the restoration benefit will help restore the sum insured to its original amount for the other family members. This is very useful when insuring elderly parents. 

Waiting Periods

There is usually a 30-day waiting period for general illnesses and a 1 to 4-year waiting period for pre-existing diseases. Check exactly when coverage for conditions like diabetes or hypertension begins if your parents already have pre-existing conditions. 

How Does Adding Parents and Children Affect the Premium Cost?

The premium on a family floater is distributed equally. It is calculated based on the risk profile of all the members, with the oldest member usually having the biggest influence. Other factors that typically affect the premium are: 

• Number of family members: Usually, with each additional family member added to the plan, the premium also increases. 
• Sum insured: A higher sum insured also increases the premium. 
• Co-payment options: Choosing a co-payment option generally lowers your premium. 
• City/zone of residence: Rates for metropolitan and non-metropolitan cities usually change from different insurers. 
• Pre-existing medical conditions: You need to disclose any pre-existing health conditions when buying a policy. This can impact both the premium and the waiting period. 

Adding parents to a family floater plan will almost always raise the premium significantly. If you are on a tight budget, make sure to compare the sum insured difference between family floater plans and separate individual health insurance plans for your parents. 

To Sum It Up

There is no single perfect family health insurance policy. The top 5 health insurance plans for families in India may seem impressive on a comparison chart, but they may not necessarily work the best for you. 

If you have young children and relatively healthy parents under 60, a family floater plan makes a lot of sense. If your parents are older or have existing conditions, then a separate senior citizen policy would be a smarter choice. 

We at Niva Bupa offer family health insurance plans that are tailored with you in mind. We include options for parents with flexible co-payment structures and wide hospital networks across India. If you are not sure where exactly to start, you can also speak to a certified insurance adviser or a trusted comparison portal. It is important that you make a decision early, as it can save you a lot of stress when it might matter the most. 

FAQs

1. Which Health Policy is Best for Families in India?

   There is no one ‘best’ policy for families in India. The right one for you depends on your family’s age range and their health history. 

2. Can my Health Insurance Cover my Parents in India?

   Yes. Most standard family floater plans tend to include parents. However, keep in mind that a lot of insurers can also exclude or add an age limit for parents between 60 and 65 years. 

3. Can I Add my In-Laws to the Same Policy as my Parents?

   Generally, no. Most Indian health insurance plans define ‘family’ as the policyholder, your spouse, and your children. Your in-laws can typically be added to your spouse’s policy plan instead. 

4. Is the Tax Benefit Different If the Parents are Senior Citizens?

   Yes. Under Section 80D, you can claim up to ₹50,000 per year for health insurance premiums paid for senior citizen parents (aged 60+).