Vijay, a 40-year-old IT employee in Bangalore, always thought his employer-sponsored health insurance was enough for the family. It was when his wife had to undergo an emergency surgery that shattered his belief. His mediclaim insurance provided by the company could only cover a fraction of the hospital bill, depleting his savings. This example underscores the need for a comprehensive family health plan that could protect the entire family against unexpected medical emergencies.
If you have been living in Bangalore, you would have already noticed the rising cost of healthcare year after year. Hospitalisation for even a minor health issue can cost you INR 50,000 to 60,000, while major surgeries can set you back several lakhs. This is when having comprehensive family health insurance in Bangalore can offer peace of mind and financial security.
Benefits of Family Health Insurance
Here are the benefits of having family health insurance in Bangalore:
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Complete Protection
A single-family health insurance policy provides comprehensive coverage for the entire family, including all the members. Combined coverage includes coverage for you, your spouse, dependent children and dependent parents. Its comprehensive coverage ensures you are not financially burdened in the midst of health mishaps. However, it is important to check the scope of the policy, the maximum age at entry, the renewal age, and restrictions on a number of members to be included in the policy.
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Cashless Facility
Generally, insurance companies have their network of hospitals where you and your family can avail of a cashless claim benefit. That means you are not required to pay any upfront payment at the time of a medical emergency, and the insurance company settles the bill directly with the network hospital. Check the network hospital list while buying the policy to ensure your preferred hospital is on the list. Having a cashless facility helps your family to avail themselves of quality treatment at the right time.
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Cost Effective
Family health insurance plans come at a relatively lower cost than individual health insurance plans. When you avail individual health insurance plans for each family member, customizing each policy and curating medical insurance benefits as per individual needs make it quite costlier than the family floater plan that covers everyone under a single umbrella with comprehensive coverage.
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Tax Benefits
You can claim tax benefits on the family health insurance premium under Section 80D of the Income Tax Act of 1961. With a family health plan, you can claim a tax deduction for the premium of up to INR 25,000. If one of the family members insured is a senior citizen, you can claim up to INR 50,000.
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Additional Benefits
Many family insurance plans come with additional benefits, such as free health check-ups for you and your family every two years or so. Along with preventive health check-ups, many insurers even offer wellness programs. Other benefits like non-claim bonuses, are also applicable for family health plans.
What is Covered Under a Family Health Insurance Policy in Bangalore?
Let us understand how does family health insurance works in Bangalore by understanding the scope of coverage. The following are the policy coverages offered under the family health insurance policy in Bangalore:
- Hospitalisation expenses (minimum 24 hours of admission), including room rent, doctors’ charges, nursing charges and ICU charges
- Pre and post-hospitalisation expenses (generally vary from 30 days to 90 days) including consultations, diagnostic tests and follow-up treatments
- Daycare procedures (treatment or procedures that do not require prolonged hospitalisation) like cataract surgeries.
- Some policies provide coverage for AYUSH (Ayurveda, Yoga, Naturopathy, Unani, Siddha, and Homoeopathy) treatments.
- Some policies provide maternity and newborn cover
You can also opt for add-ons like telemedicine coverage, critical illness coverage, etc. to enhance the family health insurance coverage.
How to Choose the Best Family Health Insurance Plan in Bangalore?
Choosing the best family health insurance plan in Bangalore is no longer a challenging task. Platforms like Secure Now help you compare family floater health insurance plans from various providers in your city in no time. You can compare them based on various factors to arrive at a rational decision.
Here are some important things to keep in mind while choosing a family health insurance plan in Bangalore:
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Sum insured
Consider healthcare costs and the year-on-year inflation rate in Bangalore before you make a buying decision. It is important to be adequately covered. Evaluate your needs and the city’s healthcare cost to arrive at the coverage amount. For example, a family of four would require a minimum coverage of INR 15 lakhs.
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Insurer’s reputation
Check on the insurance company’s reputation related to their service quality, claim efficiency, etc., for a smooth claims experience in times of need. It is also important to consider the claims settlement ratio. Ensure to go with insurers having a higher claim settlement ratio.
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Network hospitals
The insurer’s network of hospitals is an important consideration when buying health insurance in Bangalore. An insurance company with a wider network of hospitals is an ideal choice to ensure a cashless claim experience in case of medical emergencies.
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Co-payment clause
Many family floater health insurance plans come with a co-payment clause wherein you are required to pay a portion of the claim amount. Be sure to avail of policies with no co-payment or lower co-pay percentage to avoid out-of-pocket expenses.
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Waiting period
Health insurance policies generally cover pre-existing illnesses and specific treatments only after the waiting period. The waiting period generally ranges from 24 months to 48 months, depending on the insurance company. Pick a plan with a shorter waiting period, especially when you have a family member with health issues.
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Add-ons
When you are availing of family insurance, it is important to ensure the policy offers add-ons like maternity and newborn cover. Also, consider critical illness coverage if there is a family history.
Conclusion
To sum up, Bangalore is home to world-class healthcare facilities, but quality healthcare comes at a cost. Late realisation and waiting until a medical emergency to buy insurance can be a costly mistake. Despite having corporate health insurance, investing in a good family health insurance plan ensures you are financially prepared for any health crisis. Plan in advance, choose wisely, and secure your family’s health with adequate coverage.
Frequently Asked Questions (FAQs)
Q) What is the difference between cashless and reimbursement claims in Bangalore?
A) Here is a difference between cashless and reimbursement claims:
| Cashless claims | Reimbursement claims |
| Get treatment at the network hospitals without making an upfront payment | You pay the hospital bill at the hospitals that are not listed in the network and then claim a reimbursement. |
| The insurance company directly settles the bill to the network hospital. You don’t need to submit bills after discharge | You need to submit the medical bills and discharge summary to claim reimbursement from the insurance company. |
| Quality treatment without any hassles and financial burden | Takes time to reimbursement and upfront payment can be a temporary financial burden. |
Q) What are the general exclusions under the family health insurance plan?
A) Family health insurance plans generally exclude coverage for pre-existing conditions (till the waiting period is over), outpatient treatment expenses, cosmetic treatments, dental treatment, STDs, self-inflicted injuries, etc.
