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Difference Between Family Floater vs Individual Health Insurance

Difference Between Individual vs Family Floater Health Insurance

What are the Individual and Family Floater Health Insurance?

Let us understand both individual and family floater health insurance and their working:

individual-health-insurance

Individual Health Insurance

  • As the name suggests, Individual Health Insurance is health coverage for a single individual; i.e., it doesn’t cover you or your family members in one plan but gives you each a separate plan to cover all health benefits. 
  • This type of plan works best if you want to protect your senior parents (since health conditions and consequently health expenses post a particular age grow twofold) or are only looking for a plan to protect your individual health needs. 
  • Look up your yearly health insurance tax benefits, and you’ll find that Individual Health Insurance (for yourself and your family members or even your senior parents) makes it to the list. This strengthens your financial plans and helps protect your greatest asset: your health!
family-health-insurance

Family Health Insurance

  • A Family Floater Health Insurance is a type of health insurance plan that protects you and your family members under one plan; the annual health insurance premium and the total sum insured will be shared amongst all family members.  
  • Families in India are often stressed due to the financial burden of today’s health expenditures. In such cases, a Family Floater Health Insurance plan can be a smart option for both financial and overall health.
  • For example, say your family floater cover is ₹4 lakhs, and you are a family of four. Now, if the need arises, any one member can use this entire amount of ₹4 lakhs in case of a medical emergency, or all four members can use whatever amounts they require as and when the need arises, staying within the boundary of the sum insured, i.e. ₹4 lakhs. 
  • The point to note here is that if one person uses the entire sum insured, the others will be left with nothing to use. A family floater plan is flexible when using insurance coverage for a group and is especially beneficial and suited for couples and nuclear families.

Key Differences Between Family Floater and Individual Health Insurance

Point of Comparison Individual Health Insurance Family Floater Health Insurance
Definition Individual Health Insurance is a policy that provides individual medical coverage for every single person in a family rather than being shared among all members. Each individual has their own set of benefits, coverage limits, and premiums. It is particularly beneficial for families where each member requires distinct healthcare coverage. A Family Floater Health Insurance is a type of health insurance plan wherein you and your family members share one plan. This means both your health insurance premium and sum insured would be shared amongst all members in the plan.
Coverage This plan offers individual coverage to all insured in your family. For example, if you’ve taken a plan with an SI of ₹10 lakhs per person, every individual in the family is covered up to ₹10 lakhs each during the policy period. Thus, for a family of three, the total sum insured would amount to ₹30 lakhs. This plan offers coverage to all family members insured in the plan. For example, if your plan SI is ₹10 lakhs, the entire family will have to share this amount for the policy period.
Advantages The biggest benefit of an Individual Health Insurance plan is that the coverage is much more extensive since every individual has their own sum insured, unlike a family floater, where the sum insured is shared amongst all insured in the plan. This especially works out well for senior parents. The biggest benefit of a family floater plan is that the health insurance premium is cost-effective, as the premium is a one-time premium for all family members.
Disadvantages One significant disadvantage of Individual Health Insurance is the cost of premiums. These premiums can be quite high, especially for individuals with limited incomes or tight budgets. One of the main disadvantages of a Family Floater Plan is that the sum insured may not be sufficient for all family members.
Example A 30-year-old working woman takes an Individual Health Insurance plan for herself and her senior father. She takes an individual plan, each of up to SI ₹5 lakhs. This means she and her father will both have ₹5 lakhs each to cover for their health needs throughout the year. A couple with two kids chooses a Family Floater Health Insurance Plan; all four members must share the total insured under this. For instance, if they’ve taken a plan of SI ₹5 lakhs, they can only use up to ₹5 lakhs for all their health claims during the year.
Preferred Choice Individual Health Insurance is highly recommended for bigger families, or those with senior parents as a family floater may not be sufficient. A Family Floater Health Insurance would work well for a young couple or small and nuclear families.
Tips & Recommendations If you’re going for an Individual Health Insurance plan, make sure you opt for relevant add-ons for every member too. For example, if you’re taking an individual plan for your parents, then the critical illness add-on would be a recommended add-on to include in your plan. If you’re going to opt for a family floater plan, then opt for a higher sum insured since you’ll need to ensure that the sum insured is sufficient for all family members.

How Does Premium Payment Work Under Individual & Family Floater Health Insurance?

Premium Calculation and Savings

Insurance Type Premium Calculation (Annual) Sum Insured Number of Insured Total Premium
Individual Health Insurance Rahul pays ₹15,000 for ₹5 lakh coverage. ₹5,00,000 1 ₹15,000
Family Floater Health Insurance Kumar family pays ₹25,000 for ₹10 lakh coverage. ₹10,00,000 4 ₹25,000

The total premium for Family Floater Health Insurance: ₹25,000 per year.

The total premium for Individual Health Insurance if each family member takes separate policies:

Mr. Kumar: ₹15,000

Mrs. Kumar: ₹15,000

Child 1: ₹8,000 (estimated)

Child 2: ₹8,000 (estimated)

Total for individual plans: ₹15,000 + ₹15,000 + ₹8,000 + ₹8,000 = ₹46,000 per year.

Savings with Family Floater Health Insurance: ₹46,000 - ₹25,000 = ₹21,000 per year.

Therefore, the Kumar family saves ₹21,000 annually by opting for Family Floater Health Insurance instead of individual plans for each family member.

 

Disclaimer: Premiums and savings depicted in the table are for illustrative purposes only and may vary based on insurance provider, policy specifics, age, health conditions, and other factors. Actual premiums can differ based on individual circumstances and market conditions.

Benefits and Limitations of Family Floater Health Insurance

Following is a detailed breakdown of the benefits and limitations of Family Floater Health Insurance:

 

Benefits of Family Floater Health Insurance

Parameters Benefits
Family Coverage Family Floater Health Insurance covers the entire family under one plan, making it convenient.
Cost-effectiveness It is generally more cost-effective compared to purchasing Individual Health Insurance for each family member.
Administrative Ease Simplified administration with a single policy covering all family members, reducing hassle.
Flexibility Adding new family members is typically straightforward, offering flexibility in coverage.
Comprehensive Coverage Family Floater plans provide comprehensive coverage for all family members under one policy.
Additional Benefits Additional benefits like maternity cover are often included in Family Floater Health Insurance.

Limitations of Family Floater Health Insurance

Parameters Limitations
Limited Sum Insured The total sum insured is shared among all family members, potentially limiting coverage.
Premium Variability Premiums may increase significantly with the age and health conditions of elder family members.
Age Restrictions Some plans have restrictions on the age of children covered, which could impact coverage.
Dependency on Health Dependence on the health condition of the eldest member can affect overall coverage.
Inadequate Coverage Risk In cases of severe illnesses or hospitalizations, coverage may prove to be inadequate.

Benefits and Limitations of Individual Health Insurance

The following tables outline the key benefits and limitations of Individual Health Insurance, highlighting essential parameters such as cashless hospitalisation and coverage flexibility:

 

Benefits of Individual Health Insurance

Parameters Benefits
Personalised Coverage Individual Health Insurance plans provide personalised coverage tailored to individual health needs.
Higher Coverage Limit It allows for higher coverage limits compared to family floater plans, ensuring adequate protection.
Cashless Hospitalization Provides cashless hospitalisation facility at network hospitals, ensuring timely medical treatment.
No Dependency on Others It provides independence as coverage is not dependent on the health conditions of other family members.
No Age Restrictions There are generally no age restrictions, ensuring coverage throughout different life stages.
Tax Benefits It offers tax benefits under Section 80D of the Income Tax Act, reducing taxable income.

Limitations of Individual Health Insurance

Parameters Limitations
Higher Premiums Premiums can be higher compared to family floater plans due to individualised coverage.
Limited Coverage for Family It does not provide coverage for other family members; separate plans are needed for each individual.
Administrative Complexity It may involve administrative complexity when managing multiple policies for each family member.
Limited Additional Benefits Additional benefits, such as maternity cover, may not be included and may require separate add-ons.
Coverage Limits Coverage is limited to the sum insured chosen for each individual, potentially restricting coverage.
Less Economical for Families It may be less economical overall for families compared to family floater plans covering multiple members.

Family Floater vs Individual Health Insurance - Which is Better?

How Much Health Insurance Coverage Do You Need?

FAQs about Family Floater vs Individual Health Insurance