Everything about Health Insurance for Family in India
What is a Family Health Insurance?
A Family Health Insurance is a type of Health Insurance Policy customized for you and your family members, under one single annual premium.
A family health insurance includes health benefits such as Daycare Procedures, Accidental Hospitalization, Critical Illness Hospitalization, Psychiatric Support, Advance Cash Benefit and Annual Health Checkups amongst others.
Today, when not only health expenses but even health issues are on the rise, a family health insurance online assures that you and your family will always be covered and protected during unfortunate medical situations.
Because protecting and caring for the people that we love is the most human thing to do.
Dedicated to the ones who always put their family first. For the ones who want to protect their loved ones through it all. Big and small. Major and minor. For the ones who oversee everything, who think about it all.
For the ones who value the importance of both health and wealth. After all, good health is everything. And for your family? More so. More than anything else.
Why Securing your Family's Health today matters more than ever?
What's great about a Health Insurance by Digit?
What is Covered in Family Health Insurance by Digit?
Additional Covers available with Family Health Insurance
What’s not Covered?
How to file a Claim?
Key benefits of Health Insurance by Digit
Co-payment |
No |
Room Rent Capping |
No |
Cashless Hospitals |
10500+ Network Hospitals across India |
Inbuilt Personal Accident Cover |
Yes |
Wellness Benefits |
Available from 10+ Wellness Partners |
City Based Discount |
Up to 10% Discount |
Worldwide Coverage |
Yes* |
Good Health Discount |
Up to 5% Discount |
Consumables Cover |
Available as an Add-on |
Why do you need a Family Health Insurance?
Types of Family Health Insurance Plans
Family Floater Health Insurance Plan |
Individual Family Health Insurance Plan |
Under this plan, the complete family shares the sum insured. For example; if your plan SI is Rs 10 lakhs, then the entire family will have to share this amount for the policy period. |
Under this plan, every family member gets an individual sum insured. For example; if your plan SI is Rs 10 lakhs, each family member gets to use up to 10 lakhs each for that policy period, i.e. if you’re buying an individual plan for three members, the collective sum insured for the three would be Rs 30 lakhs. |
A family floater health insurance plan works well for nuclear families or newly married couples. |
An individual family health insurance plan is recommended for families with more than one kid, and for those also wishing to insure their parents. This way, everyone will have just enough sum insured to cover them. |
In a situation where something happens to more than one family member at the same time, a single sum insured may not be enough. |
In a situation where something happens to more than one family member at the same time, an individual sum insured available in this plan will work effectively as each member will have just enough to be covered. |
Know more about Family Health Insurance
Coverage details of Family Health Insurance
Sum Insured: 2 lakhs | 3 lakhs | 4 lakhs | 5 lakhs | 10 lakhs | 15 lakhs | 20 lakhs | 25 lakhs
B. Plan Benefits
- All Hospitalization: Up to SI
- Additional Sum Insured for Accidental Hospitalization
- Additional Sum Insured for Critical Illness Hospitalization
- Copayment: No Age Based Copayment
- Room Rent Cap: No Room Rent Restrictions
- Post Hospitalization Lump-sum: Up to 3% of Approved Claim Amount
- Annual Checkup: 0.25% of SI
- Hospital Cash: Rs 500 per day
- Road Ambulance: 1% of SI
- ICU Room Rent: Up to SI
- Psychiatric Cover: 5% to 20% of SI (depends on plan chosen)
- Bariatric Surgery: 5% to 100% of SI (depends on plan chosen)
- Refill Sum Insured: Once in a year, for an unrelated illness (Comfort Plan only)
- Organ Donation Expenses: Only available for Comfort Option
C. Additional Covers
- Maternity Benefit & Newborn Baby Cover (up to 2 kids): 10% of SI
- Zone Upgrade Cover
D. Waiting Periods
- Critical Illness: 30 days
- Accidental Hospitalization: No Waiting Period
- Maternity Benefit: 24 months
- Bariatric Surgery: 48 months
- All other benefits: 30 days
What is a Family Health Insurance?
A Family Health Insurance is a type of Health Insurance Policy customized for you and your family members, under one single annual premium.
Today, when not only health expenses but even health issues are on the rise, a family health insurance assures that you and your family will always be covered and protected for during unfortunate medical situations. These situations could include hospitalization due to accidents or illnesses, critical illnesses, and mental health illnesses amongst others.
Know more about Health Insurance Tax Benefits.
Why do you need a Health Insurance policy for Family?
A lot of people take up a family health insurance for the tax benefit it allows. However, a wiser reason to take up one is to financially secure yourself from hefty expenses and to ensure your family’s good health and well-being no matter what.
Why should I take a Family Health Insurance online?
In India, health insurance is often underutilized, misunderstood and often bought without too much thought and precision. However, now that things have gone digital, health insurance too is made available online.
This now makes it easier for you to evaluate your options at your own pace, read about the different benefits and customize your plan accordingly online. Moreover, buying a health insurance online also insures zero paperwork and less time wasted!
Compare Family Health Insurance Plans
If you’ve never bought a health insurance online, we know this could probably get confusing for you. But, that’s why we’ve always kept our insurance simple and here we’ll give you a basic guide on how to compare health insurance plans wisely and eventually make the right choice for you and your family:
- Sum Insured: Sum Insured is the maximum value your health insurance company will give you in case of a claim. So make sure you don’t just buy the cheaper plan just because the premium is less, causes chances are- your sum insured too will be less!
- Real Benefits: Please read the policy terms & conditions before buying a plan as a lot of benefits look fancy but when you get to their conditions you may realize that claiming them is tough because of the ifs and buts associated with them.
- Claim Settlement Record: Talk to your insurance company about how they are settling their claims. If the company is new, then ask about the processes they follow for Claim Settlement.
- Processes: As mentioned above, look at the Claim Processes your insurance company has. New age companies are making sure that the processes eliminate paperwork as much as possible- and we all know, that only makes our lives so much easier!
- Premium: Of course, this is something you will definitely do and yes, it is important to look at the premium and try and go not only for the most cost-effective one but one that offers you valuable benefits at a justified price.
How the premium is calculated for Family Health Insurance policy?
So, how exactly do we calculate your family health insurance premium?
Age of you and your family members: With age, the probability of certain diseases or conditions may go up, which is why we need to factor in ages of both you and your family members.
Lifestyle: Certain habits or lifestyles may invite a higher risk of diseases or conditions. These affect your premium. But here, you need to make sure you declare everything about you or your family members honestly, as when a claim is made, the investigation will automatically show the cause of the illness or condition and if it is due to a habit which was not declared, like smoking or heavy drinking, then it may result in a claim denial.
Pre-existing Diseases or Conditions: If any condition, ailment or injury (applicable to you or any members of your family) for which there were signs or symptoms or which was diagnosed within 48 months prior to the first policy issued by the insurer or renewed continuously thereafter, you need to declare the same to the insurance company at the time of buying or renewing the policy.
This also might affect your premium. But as for lifestyle, even these conditions or diseases should be declared before-hand so that one can serve the waiting period (the time till which a claim cannot be made for that condition or disease).
Location: Different cities have different pollution levels, accident risks, medical costs etc. which is why the premium may vary by the city you and your family are living in.
What is Cashless Claim?
As the name suggests, a cashless claim is when you won’t be required to pay anything from your pocket. However, this is only possible if you’re being treated at one of our network hospitals.
How to settle a cashless health claim?
1. Get in touch with us via phone call or email, before 72 hours of the hospitalization in case of a planned hospitalization or, within 24 hours of the hospitalization in case of an emergency.
2. Share your health card/copy of e-card along with an ID proof with the concerned hospital authority and obtain the pre-authorization form from the hospital.
3. Fill in the form, sign and submit to the concerned hospital authority.
4. Ensure that the hospital shares your signed form to the Third-Party Administrator (TPA) or Service Provider for further processing.
5. Once your form is processed, the TPA will issue an authorization letter after confirming the claim along with your policy terms and conditions directly with the hospital.
6. Once everything is approved and you have a go-ahead, the required treatment must take place within 15 days from the date the respective form was filled in.
What is Reimbursement Claim?
One of the most common claims used is the reimbursement claim. This is mainly because, whether you go to one of our network hospitals or not, this kind of claim can be used at any hospital in India. All you have to is submit required documents in due time and receive the reimbursement amount from us.
What is the process to settle a reimbursement claim?
1. Inform us or the TPA within 48 hours of hospitalization or treatment for which you’re using the hospital services.
2. Submit all original documents and bills related to your hospitalization or treatment within 30 days of discharge.
3. Our team will go through the documents submitted and reimburse the required amount within 30 days. In case we don’t, we’ll be liable to pay an interest of an additional 2% than the current bank interest rate to you.
How to choose the right Sum Insured for Family Health Insurance?
1. Age: Choose a higher sum insured if you aren’t married yet or are just about to get married. The younger you are, the lower your premiums will be and most of your waiting periods too will be over.
2. Life Stage: When the life-stage changes, you may need a higher sum insured. Say if you’re about to plan for a second child or if your parents are old and you’re their sole caretaker.
3. No. of Dependents: Insuring all the members of the family under a Health Insurance policy is a wiser way to protect your family against future financial risks related to high medical costs.
4. Health Conditions: If there is a hereditary disease in the family or a common health condition seen rising in the city you or your family is staying, you should then consider a higher sum insured.
5. Lifestyle: If you live in a polluted metro city, toiling with traffic and bearing office stress every day, you may be at a higher risk of falling ill. Which in turn means, you need to cover yourself for the better.
Know more about the Sum Insured in Health Insurance.
What is the Critical Illness Cover in a Family Medical Insurance?
An add-on anybody can opt for, this benefit specifically covers you and your family members for any critical illnesses and all expenses arising out of the same. These critical illnesses include all types of Cancer treatments and medications, Kidney Failure, Heart Attacks, Paralysis, amongst others.
Know more about Critical Illness Insurance.
What is the Maternity Benefit and when should I get it?
If you or your spouse is below 40 and are planning to have your first or second child soon, then you should probably opt for the Maternity cover. This cover usually has a waiting period (so it’s better to opt for it in advance) and covers all expenses during labor hospitalization.
Additionally, it also covers any complications in the pregnancy and necessary medical termination of the pregnancy as well. The ideal time to opt for it is when you’re getting married or at least one to two years before you plan on having your baby.
What is the best age to buy a Family Health Insurance?
Honestly, the earlier the better! That way, you’ll have a lower premium and would also cross the waiting period for select benefits. We live in a time where health issues are on a rise and healthcare expenses aren’t getting any lower! A Family Health Insurance won’t only protect you but all your family members under one single armor.
Myths about Family Health Insurance
- Family Health Insurance is only for people who have senior parents
- Family Health Insurance is only for those with diseases and existing illnesses
- Family Health Insurance is only good for tax benefits
- Only people without savings need a Family Health Insurance
Mistakes to avoid when buying a Family Health Insurance Policy
- Choosing a lower sum insured to save on premium
- Not revealing existing habits and illnesses such as smoking, drinking, diabetes, etc.
- Not taking a maternity cover early on when you have plans of having a family
- Not customizing your health insurance plan according to you and your family’s needs
- Not reading the policy terms and conditions properly
Tips for a healthy and happy life
Good health is everything. After all, it affects everything else in our lives. Here are some brief tips to ensure you have a healthy and happy life.
- Eat a balanced diet. Our diets are responsibly for 70% of our health. Therefore, always make sure you’re having enough fruits and vegetables along with the right amount of protein, vitamins, healthy fats, carbohydrates, etc.
- Drink lots of water. Our body needs it more than we think it does. A minimum of 8 glasses of water are a must.
- Reduce the intake of salt and sugar in your diet or, replace sugar with other alternatives like jaggery and honey.
- Exercise frequently. Even if you’re not going to gym, you can include small things in your day to day life to ensure movement and flexibility. Take the stairs when you can, walk to nearby places, practice stretches, etc.
- Keep a regular check on your health. Many times, we can never tell what’s happening inside our body. Therefore, make it a point to get an annual health checkup done every year.
- Sleep well. We live in a world where we’re constantly stressed or occupied with something or the other. It's important to just switch off sometimes and get some rest. A healthy adult should at least get 7-8 hours of sleep every day. This will not only maintain your stress levels but will also ensure happier days.