How do Family Health Insurance Plans Work?

Safeguarding the family is the first and the most important thing for anyone. People work hard to provide their parents, spouses, and children with everything possible. And it is not only about giving them the best food, clothes, and education but also about securing their health and medical needs. That is why people must invest in buying the best family health insurance plans for their loved ones.

What are Family Health Insurance Plans?

A health plan that covers the entire family is known as a family health insurance plan. In such plans, the whole family gets covered with a single premium and does not have to pay a separate premium for each member. They protect spouses, children, parents, and even parents-in-law.

What are the Advantages of Using Family Medical Insurance?

Certain advantages offered by the best family health insurance plans create a strong case in their favour. Here are some for your reference:


With the rise of treatment and a never-ending list of ailments and illnesses, buying a mediclaim plan is necessary. However, purchasing an individual plan would mean paying different premiums. Family insurance solves this issue. In one policy, everyone in the family gets covered in exchange for a single premium payment.


With family insurance, you don’t need to remember to pay multiple premiums; one premium takes care of all. You can thus avoid the hassle of remembering multiple payment schedules and documentation requirements.

Tax Savings

As per the Indian Income Tax, 1961, you can avail of tax benefits from a family insurance plan under section 80D Deduction. You can claim ₹25000 for yourself and ₹30000 for your parents.


In family medical insurance, adding a new member is simple. So, if you have a newborn, you can add them without taking a new policy.

Additional Benefits

Most insurance companies offer discounts and additional benefits to their customers if they take a family insurance plan.

What Expenses are Covered by a Family Insurance Plan?

Like any plan, even family insurance has certain inclusions and exclusions.

Here is the list of typical inclusions:

  1. Hospitalisation expenses, including room rent, nursing, and boarding charges
  2. Pre and post-hospitalisation expenses for a specified period of time
  3. Coverage for daycare procedures that do not require hospitalisation
  4. Ambulance charges for emergency transportation to the hospital
  5. Doctor consultation fees, diagnostic tests, and medicines prescribed during hospitalisation
  6. Maternity expenses, including pre and post-natal care, delivery, and complications arising from the pregnancy
  7. Coverage for newborn baby’s medical expenses for a specified period
  8. Outpatient care, including doctor consultation fees, diagnostic tests, and medicines prescribed during outpatient treatment
  9. Coverage for specific illnesses and medical conditions as mentioned in the policy
  10. Optional add-ons such as dental, vision, or critical illness coverage.

Here are some of the things that don’t come under the family insurance plans, i.e., a list of exclusions:

  1. Pre-existing medical conditions that were present before purchasing the policy, except if the policy has a waiting period for coverage of pre-existing conditions
  2. Cosmetic or elective treatments and procedures
  3. Alternative treatments such as Ayurveda, Unani, Homeopathy, and Naturopathy
  4. Treatment of sexually transmitted diseases or HIV/AIDS
  5. Treatment of injuries or illnesses resulting from participating in hazardous activities such as adventure sports or racing
  6. Treatment of injuries or illnesses resulting from drug abuse or alcohol consumption
  7. Treatment of injuries or illnesses resulting from war or acts of terrorism
  8. Treatment of mental health disorders or psychiatric conditions, except if the policy explicitly covers them as an optional add-on
  9. Treatment outside the geographical limits of the policy coverage
  10. Treatment for infertility or assisted reproductive techniques, except if the policy explicitly covers them as an optional add-on.

The healthcare insurance sector has significantly evolved in India over the past few years and is now one of the biggest industries. In India, there was a time when there were no adequate resources, and as a country, the mortality rate was also very high. Those conditions arose the need to focus on health and thus started the medical insurance era. As a result, the government developed the best health insurance that people could afford. There has been a shift toward more value-based healthcare, in which providers are compensated based on the quality of care provided rather than the number of benefits provided. This shift has led to insurers partnering with providers to offer more integrated and coordinated care, which has helped to reduce costs and improve patient outcomes.

The above inclusions and exclusions may vary depending on the specific policy and insurance provider. Thus, reviewing the policy document carefully is important to understand the particular provisions. Choosing the best family health insurance plans with adequate coverage can provide peace of mind and financial security in case of medical emergencies. Therefore, it is recommended to compare various plans offered by different insurance providers to find the best one that meets your family’s healthcare needs and budget.