A family health insurance policy is designed to safeguard the health and well-being of your all your family members under a single plan. It offers coverage for hospitalization, medical emergencies, diagnostic costs and preventive care, ensuring that you and your family have access to quality healthcare without worrying about finances. With customizable options, family health insurance provides peace of mind and security for every family member.
When selecting health insurance plans for your family, it’s essential to consider two key factors: the number of members to be covered and the sum insured. Choose a plan that offers the best coverage for the premium you pay. At HDFC ERGO, we provide comprehensive family health insurance plans that come with numerous benefits, including coverage for hospitalization charges, consultation fees, medications, and more. You can explore these policies online to find one that fulfils your needs and ensures that every family member is well taken care of in case of a medical emergency.
While you may think the savings accumulated over the years may be enough to take care of your family’s medical needs. The corpus might run out earlier than you think. Health insurance for families is a crucial tool to safeguard your life savings while taking care of your family’s healthcare needs. A comprehensive family health insurance plan will help you take care of your medical needs even in an era of rising medical costs.
Medical inflation has led to a steady rise in healthcare costs, making it increasingly difficult to manage out-of-pocket medical expenses. From routine consultations and diagnostic tests to surgeries and emergency treatments, the cost of healthcare services has gone up with every passing year. This has placed a significant financial strain on families, especially when faced with sudden or long-term medical issues.
Given this scenario, having a family health insurance plan is crucial. It shields families from the high costs of medical treatments by offering coverage for hospitalization, surgeries, medications, and more, ensuring that quality healthcare is accessible without exhausting savings.
In India, medical inflation has been significantly higher than general inflation in recent years. Here are some India-specific data points on medical inflation:
Medical Inflation Rate: As of 2023, India's medical inflation rate was around 12-14%, compared to a general inflation rate of about 6%. This makes healthcare costs double every 5-6 years.
Healthcare Costs: Over the past decade, hospitalization costs in India have surged by about 10-15% annually. In urban areas, the cost of a single hospital stay can range from ₹50,000 to ₹5 lakh, depending on the treatment and the hospital.
Out-of-Pocket Expenses: Indians spend more than 60% of their total healthcare expenses out-of-pocket, one of the highest rates globally. This is largely due to rising treatment costs and limited government healthcare funding.
Treatment Costs: For example, the cost of heart surgery has increased by nearly 15% annually, and cancer treatment expenses can range from ₹5 lakh to ₹20 lakh, depending on the stage and complexity of the disease.
Prescription Drugs: The cost of medicines, especially chronic disease management drugs, has risen sharply, contributing to the overall increase in healthcare expenses. For chronic conditions like diabetes or hypertension, treatment costs have increased by 10-12% annually.
These rising costs highlight the need for health insurance as medical inflation continues to outpace income growth for most Indian households.
When deciding between family health insurance and parents’ health insurance, understanding their key differences can help you choose the best plan for your needs. Here’s a comparison:
Feature | Family Health Insurance | Parents Health Insurance |
Coverage Scope | Family Health Insurance: Covers the policyholder, spouse, and children under a single plan. It ensures medical protection for the younger family members, with options for comprehensive coverage such as hospitalization, surgeries, and maternity benefits. | Parents Health Insurance: Specifically designed for elderly parents, this plan focuses on covering age-related ailments and health issues. It offers tailored coverage for critical illnesses, pre-existing diseases, and higher hospitalization needs often faced by seniors. |
Premium Costs | Family Health Insurance: Premiums tend to be lower when covering younger, healthier family members. Since the overall health risk is considered lower, insurers offer more affordable premiums. | Parents Health Insurance: Premiums are higher because parents, typically in their senior years, are more prone to health issues. As medical risks increase with age, insurers charge higher premiums for these plans. |
Pre-Existing Conditions | Family Health Insurance: Typically, fewer pre-existing conditions, and they may have shorter waiting periods for coverage. | Parents Health Insurance: Often, parents have more pre-existing conditions, which may come with longer waiting periods or exclusions, though many plans now offer coverage for such conditions after a specified period. |
Critical Illness & Specialized Care: | Family Health Insurance: Critical illness cover may be available as an add-on, but the primary focus is on overall family healthcare. | Parents Health Insurance: Often includes coverage for critical illnesses like heart disease, kidney ailments, and cancer, given the higher likelihood of these conditions in senior citizens. |
Tax Benefits | Family Health Insurance: Premiums paid for family health insurance are eligible for tax deductions under Section 80D, up to ₹25,000 for individuals below 60 years. | Parents Health Insurance: An additional tax benefit of up to ₹50,000 is available under Section 80D for premiums paid for parents’ health insurance if they are senior citizens. |
Optima Secure
Optima Restore
my:health Medisure Super Top-up
We value your family as much as you do and so we have designed insurance products that cater specifically to the emerging needs of a family.
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Our family health insurance plans cover all types of hospitalisation for every family member covered under the plan for emergencies and planned procedures. If you choose or Optima Restore plan for your family, you get 100% restoration of your sum insured after a claim so you don’t have to worry about medical expenses for your loved ones throughout the year.
Some illnesses might need prolonged care and attention. To ensure your loved ones heal in peace our family insurance plan covers medical expenses for 60 & 180 days pre and post hospitalisation respectively, instead of 30 & 90 days availed normally.
Medical advancements help in wrapping up important surgeries and treatments in less than 24 hours, and guess what? We cover you for that as well. So for small surgeries and procedures, you or your loved one don’t have to stay back in the hospital for long, instead head back home after the procedure, while we take care of the rest.
Prevention is certainly better than cure and that’s why our family health insurance policies offer a free health check-up on renewal for all members included under the plan. This helps to get help earlier if a medical condition is detected for any member and lowers hospital bills and painful recovery periods in the future.
If you or your loved one needs to move from one place to another by air for better medical facilities and attention, our Optima secure plan for families is tailored to reimburse the cost of air ambulance transport up to ₹5 lacs.
The cost of hospitalisation, medicines and other medical expenses are not the only expenses that are involved during a medical crisis. You might need a well-equipped ambulance to reach the nearest healthcare centre on time. This is why our health insurance plans for families cover road ambulance costs to ensure safety and timely treatment for you and your loved ones.
There can be several expenses that can crop up when you or your loved one is hospitalised, like travel expenses, food and other out-of-pocket expenditures. To ease the trouble we give you a daily cash allowance of ₹800 per day up to a maximum of ₹4800 on hospitalisation, with our Optima Secure Plan.
Second opinions can at times be a lifesaver and if you want to consult a specialist. Sometimes meeting the experts in person might not be a possibility. To ensure there are no hiccups in your treatment and care we have enabled e-opinion for 51 Critical Illnesses through our network provider in India under Optima Secure plan.
Sometimes we heal better within the four walls of our home or need attention from our loved ones to heal faster. In such scenarios, we will pay for the medical expenses incurred by you on home hospitalisation, if advised by the Doctor on a cashless basis.
Organ donation can be lifesaving but it is an expensive treatment and requires the best medical expertise and attention to make it a success. We cover medical expenses for harvesting a major organ from the donor’s body where the insured (individual or family) is the recipient.
While advancements in medical technology have maximised outcomes and minimised mortality rates some of us still believe in alternative therapies and traditional medicine. To ensure your faith is preserved and you get the preferred treatment, we cover treatment costs up to the sum insured towards in-patient care for alternative therapies like Ayurveda, Unani, Siddha, Homeopathy, Yoga and Naturopathy.
Optime Secure plan has your back. Our health insurance policy covers your medical expenses for a lifetime on break-free renewals. This way you can rest assured that you and your family members get the right care and support during a medical emergency without any worry or financial anxiety.
Please read the policy wordings, brochure and prospectus to know more about my Optima Secure.
Adventures can give you an adrenaline rush, but when coupled with accidents, it can be hazardous. Our health insurance plan does not cover accidents encountered while participating in adventure sports.
We do not cover expenses for treatment directly arising from or consequent upon any insured person committing or attempting to commit a breach of law with criminal intent.
War can be disastrous and unfortunate. However, our health insurance plan does not cover any claim that is caused due to wars.
We do not cover expenses incurred towards treatment in any hospital or by any Medical Practitioner or any other provider specifically excluded by the Insurer. (Contact us for list of de empanelled hospital)
We understand that treatment towards congenital external disease is critical however, we do not cover medical expenses incurred for Congenital external diseases defects or anomalies.
(Congenital diseases refer
to birth defects).
Treatment for Alcoholism, drug or substance abuse or any addictive condition and consequences thereof remains uncovered.
The number of members covered under a family health insurance policy depends on the sum insured and the number of people included in the plan. Usually, family health insurance plans permit inclusion for spouses and dependent children. A few plans also permit the consideration of ward guardians. In addition, certain family health insurance plans offer a provision to cover individuals, spouse, dependent children, and dependent parents along with relationships like siblings, parents-in-law, grandfather, grandmother, grandson, granddaughter, son-in-law, daughter-in-law, sister-in-law, brother-in-law, nephew, and niece. However, make sure that if you are including more members of your family, you choose a premium that will ensure coverage for all. Your premium in that case could also increase.
The sole purpose of buying a health insurance plan for the family is to get financial support at the time of a medical emergency. Hence, it is important to read the below steps to know how the Health Insurance claims process works differently for cashless claims and reimbursement claim requests.
Fill up the pre-auth form at the network hospital for cashless approval
Once hospital intimates us, we send you the status update
Hospitalisation can be done on the basis of pre-auth approval
At the time of discharge, we settle the claim directly with hospital
You need to pay the bills initially and preserve the original invoices
Post hospital discharge send us all your invoices and treatment documents
We verify your claim related invoices and treatment documents
We send the approved claim amount to your bank account.
Don’t just protect your family from health emergencies, but also save on taxes with family health insurance. Reduce your tax liability up to ₹1,00,000 in a year under Section 80D of the Income Tax Act, 1961.
Also Read : Income Tax Return
Investing in family health insurance can help you avail of deduction of up to ₹25,000 in a financial year.
Get an additional tax deduction of ₹25,000 for the health insurance bought for parents. If any of your parents is a senior citizen, the deduction limit increases to ₹30,000.
You can get tax benefits up to ₹5000 in a year for preventive health check-ups.
Please note that the above-mentioned benefits are as per the current tax laws prevailing in the country. Your tax benefits may change subject to tax laws. It is advisable to reconfirm the same with your tax consultant. This is independent of your health insurance premium value.
A few factors which you should consider while purchasing a family health insurance plan are as follows:
When buying a family health insurance plan, it is important to check the coverage and the benefits it offers. Usually, family health insurance plans cover you for in-patient hospitalization, pre and post-hospitalization, daycare expenses, domiciliary hospitalization, organ donor harvesting, and road ambulance expenses. Other inclusions are lifetime sustainability benefits, tax benefits, etc.
Healthcare costs in the country are increasing each day. Hence, you should buy health insurance for your family that is flexible and helps you to expand your total protection at the time of restoration. Some health insurance companies offer you an increase in the sum insured as a reward if you have not made any claim in the previous year. Look for those benefits.
This benefit keeps you stress-free as you do not have to arrange funds at the last minute, to get the required treatment. So, while choosing a family health insurance policy, make sure that the insurance company has a strong list of network hospitals. Also, check if some of them are near your residence so that in case an emergency arises, you do not waste time running pillar to post for hospital admission.
Usually, family health insurance plans come with lifetime renewability benefits. However, some health insurance companies limit the renewability age to 60-65 years. So, if you have your parents under your policy, check if they are still eligible for the benefits offered under the plan if they cross the age limit.
Even though the claim settlement process of every health insurance company is the same, it is still important to check if the insurance company you are choosing as your preferred partner has a smooth claim settlement ratio. If not it will defy the need to buy a health insurance plan for the family.
While it is obvious to check the inclusions under a family health insurance policy, it is equally important to check the exclusions as well. Choose a policy which has the least amount of exclusions and gives you and your family comprehensive coverage.
While buying health insurance, we often think if all our family members are eligible for getting insurance. The eligibility for health insurance primarily depends on
It is extremely important to declare your medical history honestly while buying health insurance. Non-severe illnesses like fever or flu may not matter, but diseases like cancer or heart ailments have to be declared. The insurer may cover certain pre-existing diseases after the waiting period, while some diseases may require additional premium.
If you are over the age of 18 years, you will not face any problems while getting health insurance. Senior citizens can get insured up to the age of 65. With HDFC ERGO, you can also get insurance for your new born baby, but you need to have mediclaim insurance with us to get the baby covered.
Lower dependancy on group plans
Your employer may have offered you health insurance that also covers some of your family members. It is, however, important to remember that employer health insurance remains active only till you are part of the company. Your family may not have any kind of coverage when you look for a new job. Moreover, many employers do not offer health coverage during the probation period. Do not rely on the cover provided by the employer for the health of your family.
Remain prepared for all emergencies
Many of us delay health insurance for the future and realise our folly only when an emergency hits. Do not let any untoward incident disturb the peace and happiness of your family. Get family health insurance and ensure good health for all the members.
Comprehensive coverage
Just buying a health insurance plan may not be enough. If you do not have adequate coverage, your family members may not be able to avail of certain healthcare facilities when needed. It is important to get all the members insured so that your family has comprehensive coverage, especially if you reside in a large city as medical facilities in cities are relatively expensive.
Feature | Individual Health Insurance | Family Health Insurance |
Definition | Covers only one person and the insurance amount is kept for their treatment, with no scope to share it. | The plan is shared among the family members and has a capped amount, which when crossed, cannot be utilized by any other member. |
Coverage | The amount covered in this case is solely meant for the individual policyholder. | This amount can be used by the entire family, with no set amount for each member. But they can only utilize upto the sum insured |
Premium | The premium is calculated based on the age of the policyholder. | Usually, the age of the oldest family member is considered for calculating the premium. |
The number of members covered under a family health insurance policy depends on the insurance. Usually, family health insurance plans permit inclusion for spouses and dependent children. A few plans also permit the consideration of ward guardians. In addition, there are certain family health insurance plans that offer a provision to cover individual, spouse, dependent children, and dependent parents along with relationships like siblings, parents-in-law, grandfather, grandmother, grandson, granddaughter, son-in-law, daughter-in-law, sister-in-law, brother-in-law, nephew, and niece.
A list of the documents required while purchasing family health insurance plans:
Since most insurance companies set an entry age, it is an important document required at the time of buying health insurance. You can give a copy of any of the following documents:
• PAN Card
• Voter ID Card
• Aadhaar Card
• Passport
• Driving License
• Birth Certificate
For communication purposes, the health insurance provider would need to know the postal address of the policyholder. The following documents can be submitted by the policyholder:
• Driving License
• Ration Card
• PAN Card
• Aadhar Card
• Utility Bills such as telephone bill, electricity bills, etc.
• Rental Agreement in case applicable
Identity proofs help the insurance company to distinguish the sort of inclusion proposed to the policyholder. The following documents can be submitted by the policyholder:
• Passport
• Voter ID Card
• Driving License
• Aadhar Card
• Medical Reports (in case asked by the insurance company)
• Passport Size Photo
• Duly filled and signed proposal form
Why take the pain of filling out lengthy documents and standing in a queue? Online health plans offer unprecedented convenience. You can conduct research, seek expert opinion and buy the right family health insurance plan, with the click of the mouse.
With contactless payment becoming the norm, why make cash or cheque payments. Use your debit card, credit card or net banking facility to make secured payments online.
You can customise the plan, change the number of members or modify the plan and get the premium instantly. You do not need a person to calculate the health insurance premium for different scenarios. Everything is at your fingertips when you buy online.
Eliminate the wait for the policy document. Get the policy document instantly in your mailbox as soon as you pay the first premium.
Get access to all policy-related documents in the my:health services mobile application. You can book online consultations, monitor calorie intake and calculate BMI all through the mobile application.
HDFC ERGO offers you a wide range of family health insurance plans. You can buy the plans online as well as offline. To buy these plans online, you are required to follow the easy steps given below:
1. Visit hdfcergo.com and click on the ‘health insurance’ tab.
2. Enter personal details asked on the form.
3. Then you will be guided to the plans, choose accordingly and follow the instructions.
A family health insurance plan covers your entire immediate family. A single health insurance plan that provides comprehensive coverage and several additional benefits such as preventive health check-ups, cashless treatment, lifelong renewability, etc. A fixed sum is insured under a family health insurance plan which covers the members.
Healthcare costs have been on the rise since the onset of Covid19. With rising medical expenditures and prevailing ailments, a family health insurance policy with an adequate cover acts as a shield to safeguard you and your family. Besides, a family health insurance policy is lighter on the pocket as compared to buying individual policies for each family member.
The floating sum insured in a family floater health insurance plan is fixed and is shared by all family members. When a family member is hospitalised due to a medical emergency or a planned hospitalisation, you can choose to go for cashless treatment at your insurance provider’s empanelled network of hospitals. In the case of non-network hospitals, you can claim reimbursement by submitting treatment and billing-related documents to your insurance provider’s claim settlement team. While choosing an insurance provider, it is advisable to select the one with a high claim settlement ratio.
Yes, you can include your parents in the family floater policy. You can do so while buying the policy or include your parents during the renewal of your policy.
Yes, you can include your newborn in the family floater policy. If you have a maternity cover, then your newborn is covered for up to 90 days in the policy. Else, you can add your new born to your existing policy after a waiting period of 90 days.
Yes, a cashless treatment option is available if you choose from the empanelled network of hospitals. The bill is settled directly with the empanelled hospital by your insurance provider. HDFC ERGO health insurance policies covers 13000+ˇ network hospitals across India.
Yes, family members can be added to the health insurance plan at the time of renewal of the policy. Subject to terms and conditions of the policy.
On average, a cover of 10 lakhs can cost you anywhere between 25,000 to 30,000 INR annually.
Yes, you can avail a cashless facility for self or family members from any of the network hospitals of your insurer. At HDFC ERGO we provide cashless hospitalisation in our 1200+ network hospitals.
You need to get in touch with your insurer to add a family member to your existing policy with all the required documents such as identity proof, age proof etc.
Yes, it is advisable to buy a separate health insurance policy even if you are already covered under an employer health plan. An employer health insurance policy is valid till the time you are working with the organisation. Your health cover will cease to exist as soon as you change the organisation or start your own venture. You will be left uninsured till you find another job and in case of a medical emergency, you’ll be left stranded without a safety net. In such scenarios, a separate health insurance policy will come to your aid.
Features listed below highlight why one should opt for HDFC ERGO Family health insurance plans.