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Family Floater Health Insurance

What is Family Floater Health Insurance?

Understand Family Floater Health Insurance with this Video

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Features of Family Floater Health Insurance

  • Shared Sum Insured - The most striking feature of Family Floater Health Insurance is that it offers a shared sum insured. An umbrella of sum insured that covers all family members under a single policy. The total coverage amount can be utilized by any family member in case of hospitalization or medical treatment. 

    Hence, depending on the number of family members and their profile, a policyholder can decide their required coverage. 

  • Network Hospitals - Health Insurance provides access to an extensive network of hospitals where policyholders can avail of cashless treatment. The convenience of cashless transactions ensures a smooth and stress-free hospital experience.
  • Room Rent - Family Floater plans usually cover room rent expenses incurred during hospitalization. The coverage amount for room rent may vary based on the sum insured and the specific plan chosen.
  • Co-Pay - Some Family Floater Health Insurance plans may come with a co-pay clause, where the insured is required to bear a certain percentage of the medical expenses while the insurer covers the remaining portion.

  • Medical Examination - Family Floater Health Insurance plans might require a pre-policy medical examination especially when a higher sum insured, higher age members or members with medical history are involved. 
  • Add-Ons - Family Floater plans often come with optional add-ons or riders that policyholders can customize to suit their specific needs. Some popular add-ons include critical illness cover, maternity cover, and accidental disability cover.

How Family Floater Health Insurance Works?

What’s covered in our Health Insurance?

Coverages

Double Wallet Plan

Infinity Wallet Plan

Worldwide Treatment Plan

Important Features

All Hospitalization - due to Accident, Illness, Critical Illness or COVID

This covers for all hospitalization expenses including due to an Illness, Accident, Critical Illness or even pandemics like Covid 19. It can be used to cover for multiple hospitalizations, as long as the total expenses are up to your sum insured.

Initial Waiting Period

You need to wait for a defined period from the first day of your policy to get covered for treatment related to any non-accidental illness. This is the Initial Waiting period.

Wellness Program

Exclusive Wellness Benefits like Home Healthcare, Tele consultations, Yoga and Mindfullness and many more available on our App.

Sum Insured Back Up

We provide a back-up Sum Insured which is 100% of your Sum Insured amount. How does Sum Insured Back Up work? Suppose your policy Sum Insured is Rs. 5 lac. You make a claim of Rs.50,000. Digit automatically triggers the wallet benefit. So you now have 4.5lac + 5 lac Sum Insured available for the year. However, one single claim, cannot be more than the base Sum Insured as in the above case, 5 lac. .

Once in a policy period Related and unrelated illness No Exhaustion Clause Same person also covered.
Unlimited Reinstatement in a policy period Related and unrelated illness No Exhaustion Clause Same person also covered.
Once in a policy period Related and unrelated illness No Exhaustion Clause Same person also covered.
Cumulative Bonus
digit_special Digit Special

No claims in the Policy year? You get a bonus -an additional amount in your total sum-insured for staying healthy & claim free!

10% of Base Sum Insured for every claim free year, up to max 100%.
50% of Base Sum Insured for every claim free year, up to max 100%.
50% of Base Sum Insured for every claim free year, up to max 100%.
Room Rent Capping

Different categories of rooms have different rents. Just like how hotel rooms have tarrifs. Digit plans give you the benefit of having no room rent cap, as long as it is below your Sum Insured..

Day Care Procedures

Health insurance covers medical expenses only for hospitalizations exceeding 24 hours. Day care procedures refer to medical treatments undertaken in a hospital, requiring less than 24 hours due to technological advancement such as cataract, dialysis etc.

Worldwide Coverage
digit_special Digit Special

Get a world class treatment with the Worldwide Coverage! If your doctor identifies an illness during your health examination in India and you wish to get a treatment abroad, then we’re there for you.You’re covered!

×
×
Health Check-up

We pay for your health check-up expenses upto the amount mentioned in your Plan. No restrictions on the kind of tests! Be it ECG or Thyroid Profile. Make sure you go through your policy schedule to check the claim limit.

0.25% of Base Sum Insured, Max up to ₹ 1,000 after every two years.
0.25% of Base Sum Insured, Max up to ₹ 1,500 after every year.
0.25% of SI up to ₹ 2,000 after every year.
Emergency Air Ambulance Expenses

There may be emergency life-threatening health conditions which may require immediate transportation to hospital. We absolutely understand this and reimburse for expenses incurred for your transportation to a hospital in airplane or helicopter.

×
Age/Zone Based Co-payment
digit_special Digit Special

Co-Payment means a cost sharing requirement under a Health Insurance Policy that provides that the Policyholder/Insured will bear a specified percentage of the admissible claims amount. It does not reduce the Sum Insured. This percentage depends on various factors like age, or sometimes also on your treatment city called zone based copayment. In our plans, there is no age based or zone based Co payment involved.

No Co-payment
No Co-payment
No Co-payment
Road Ambulance Expenses

Get reimbursed for the expenses of road ambulance, in case you are hospitalized.

1% of Base Sum Insured, Max up to ₹ 10,000.
1% of Base Sum Insured, Max up to ₹ 15,000.
1% of Base Sum Insured, Max up to ₹ 10,000.
Pre/Post Hospitalization

This cover is for all expenses before and after hospitalization such as for diagnosis, tests and recovery.

30/60 Days
60/180 Days
60/180 Days

Other Features

Pre-Existing Disease (PED) Waiting Period

The disease or condition that you are already suffering with and have disclosed to us before taking the policy and has been accepted by us has a waiting period as per plan opted and mentioned in your Policy Schedule.

3 Years
3 Years
3 Years
Specific Illness Waiting Period

This is the amount of time you need to wait for, until you can make a claim for a specific illness. At Digit it is 2 years and starts from the day of policy activation. For the full list of exclusions, read Standard Exclusions (Excl02) of your policy wordings.

2 Years
2 Years
2 Years
Inbuilt Personal Accident Cover

If You sustain an Accidental Bodily Injury during the Policy Period, which is the sole and direct cause of Your Death within twelve (12) months from the date of accident, then We will pay 100% of the Sum Insured as mentioned in Policy Schedule against this cover and as per plan opted.

₹ 50,000
₹ 1,00,000
₹ 1,00,000
Organ Donor Expenses
digit_special Digit Special

Your organ donor gets covered in your policy. We also take care of the pre and post hospitalization expenses of the donor. Organ donating is one of the kindest deeds ever and we thought to ourselves, why not be a part of it!

Domiciliary Hospitalization

Hospitals can go out of beds, or the patient’s condition may be rough to get admitted in a hospital. Don’t panic! We cover you for the medical expenses even if you get treatment at home.

Bariatric Surgery

Obesity may be the root cause of so many health issues. We absolutely understand this, and cover for Bariatric Surgery when it is medically necessary and advised by your doctor. However, we DONOT cover if hospitalization for this treatment is for cosmetic reasons.

Psychiatric Illness

If due to a trauma, a member has to be hospitalized for a psychiatric treatment, it will be covered under this benefit, upto INR 1,00,000. However, OPD consultations are not covered under this. The waiting period for Psychiatric Illness Cover is same as Specific Illness waiting period.

Consumables Cover

Before, during & after hospitalization, there are many other medical aids & expenditures such as walking aids, crepe bandages, belts, etc.,which need your pocket’s attention.This cover takes care of these expenses that are otherwise excluded from the policy.

Available as an Add-On
Available as an Add-On
Available as an Add-On

What’s not covered?

Pre-Natal & Post-Natal Expenses

Pre-natal and post-natal medical expenses, unless it leads to hospitalization.

Pre-Existing Diseases

In case of a pre-existing disease, unless the waiting period is over, the claim for that disease or illness cannot be made.

Hospitalization without Doctor’s Recommendation

Any condition you get hospitalized for, that doesn’t match with the doctor’s prescription is not covered.

How to file a Claim?

  • Reimbursement Claims - Let us know in case of a hospitalization within two days of admission at 1800-258-4242 or email us at healthclaims@godigit.com and we'll send you a link where you can upload your hospital bills and all relevant documents to process the reimbursement. 
  • Cashless Claims - Choose the network hospital. You can find the complete list of network hospitals here. Display e-health card to the hospital helpdesk and ask for the cashless request form. If all is good, your claim will be processed then and there.
  • If you have claimed for Coronavirus, make sure you have a positive test report from an authorized centre of ICMR – National Institute of Virology, Pune.

Why do You Need a Family Floater Health Insurance?

Key Benefits of Family Floater Health Insurance by Digit

Co-payment

No

Room Rent Capping

No

Cashless Hospitals

16400+ Network Hospitals across India

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

*Available only on Worldwide Treatment Plan

Family Floater Health Insurance Plan Vs Individual Family Health Insurance Plan

Point of Comparison

Individual Health Insurance

Family Floater Health Insurance

Definition

An individual health insurance is a type of health insurance plan wherein only one person can be covered in each plan. This means, both the health insurance premium and sum insured is dedicated for one person only and cannot be shared.

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 only offers coverage to the single individual insured in this plan. For example; If you’ve taken a plan of SI Rs 10 Lakhs, you alone will have up to 10 Lakhs to benefit from, for the entire policy period.

This plan offers coverage to all family members insured in the plan. For example; if your plan SI is Rs 10 lakhs, then 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 a lot 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

The single disadvantage of an Individual Health Insurance is that one will have enough to cover for them in one policy year. Additionally, even if they haven’t claimed during the year, they can benefit from a No Claim Bonus 😊

One of the main disadvantages of a family floater plan is that, the sum insured may not be enough for all family members.

Example

A 30 something working woman chooses to take 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 both will have 5 lakhs each to cover for their health needs throughout the year.

A couple with two kids chooses to go for a family floater health insurance plan; under these all four members will have to share the total sum insured amongst themselves. For instance; if they’ve taken a plan of SI 5 lakhs, then they can only use up to 5 lakhs for all their health claims during the year.

Preferred Choice

An 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 a 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 AYUSH 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 make sure that the total sum insured is sufficient for all family members.

Things to Consider before Buying Family Floater Health Insurance

Family Profile

Family Profile

Assess your family's health profile before selecting a Family Floater Health Insurance plan. Consider the age, medical history, and specific healthcare needs of each family member. It will help determine the appropriate coverage required to meet your family's medical expenses adequately.

Coverage

Coverage

Review the coverage offered by different Family Floater plans. Ensure that the policy provides comprehensive coverage for hospitalization expenses, pre- and post- hospitalization, daycare procedures, and critical illnesses. Additionally, check if the plan offers optional add-ons to further enhance coverage based on your family's needs.

Network Hospitals

Network Hospitals

Check the list of network hospitals associated with the insurance provider. Ensure that there is a wide network of hospitals in your city or region, as this allows for cashless treatment and easy access to quality healthcare services during emergencies.

Waiting Period

Waiting Period

Understand the waiting period associated with the policy. Some Family Floater plans may have waiting periods for specific illnesses or pre-existing conditions before coverage becomes active. It is an important factor especially if senior citizens are included in the policy. Be aware of these waiting periods to plan your health expenses accordingly.

Claim Settlement Ratio

Claim Settlement Ratio

Research the claim settlement ratio of the insurance provider. A higher claim settlement ratio indicates a better track record of settling claims efficiently and promptly. Choose an insurer with a good reputation for claim settlement to ensure a smooth claims process when needed.

Co-Pay and Sub-limits

Co-Pay and Sub-limits

Familiarize yourself with any co-pay or sub-limit clauses in the policy. Co-pay requires you to bear a certain percentage of the medical expenses, while sub-limits impose a cap on specific medical expenses. Being aware of these conditions helps manage your out-of-pocket expenses effectively.

Exclusions

Exclusions

Thoroughly review the list of health insurance exclusions mentioned in the policy document. Familiarize yourself with the medical conditions, treatments, or circumstances not covered by the plan to avoid any surprises during claims.

Premiums and Affordability

Premiums and Affordability

Compare the premiums of different Family Floater plans and choose one that fits within your budget. Consider the premium amount along with the coverage offered to ensure the policy provides value for money. Along with the premium, also consider the discounts and benefits like Cumulative Bonus.

FAQs about Family Floater Plans