Individual or Family Health Insurance Plan: Which One To Choose?

As the name suggests, an individual and a family health insurance policy offer coverage to an individual and a family respectively. These policies also give you the option to add more members without any hassle. These policies cover several medical expenses along with the hospitalisation costs.

Coverage provided by individual health scheme includes:

1. Pre and post-hospitalisation charges

Expenses like medicines, vaccinations, doctor visits, etc. begin before hospitalisation and continue long after you get out. Individual health policies are specifically made to take care of such expenses.

For example, individual health insurance plans from Bajaj Finserv can provide coverage for medical expenses 60 days before hospitalisation and 90 days after you are discharged. You can insure a sum ranging from Rs. 1.5 Lakh to Rs. 50 Lakh.

2. Cashless facility

Insurance providers have network hospitals where you don’t need to pay any cash to avail the treatment. These hospitals are directly connected with the company via a third-party administrator (TPA). The TPA coordinates the claims approval and rejection process.

Cashless facility is beneficial to address the necessary financial requirements. This feature also eliminates the need to file claims manually and wait for several days for the reimbursement to disburse.

The top-up health insurance cover offered by Bajaj Finserv can come in handy when your existing health insurance is exhausted and you cannot make anymore claims. You can avail the cashless facility in more than 5,700 network hospitals across India. This policy enables you to include up to 6 family members. Individuals aged below 55 years also don’t have to undergo any medical examinations.

3. Premium discounts on inclusion of more members

An individual health insurance policy helps you avail discounts when adding more family members to the plan. Insurance companies can provide around 15% and 10% discount when you include three and two members respectively.

4. Avail cumulative bonus

Your insurance provider offers a cumulative bonus every year when you don’t make any claims. This bonus can go up to 10% of the sum insured.

Coverage provided by family health scheme includes:

1. Free medical examinations

Insurance providers offer free medical tests to insured members. The family health insurance policy is one such plan offered by Bajaj Finserv that provides free medical check-ups every three years. This policy provides coverage of up to Rs. 50 Lakh.

2. Coverage for a variety of medical costs

Few of the medical expenses that a family health insurance can cover include organ donation, maternity care, new-born baby, etc.

3. Ambulance charges

Paying for ambulance services is not an inconvenience as you receive coverage of up to Rs. 20,000 every year specifically for that.

The following are some of the common features of an Individual Health Insurance Policy and a Family Health Insurance Policy:

I. Coverage for different medications

Both family and individual health insurance policies cover medicines other than allopathy like Ayurveda and homoeopathy.

II. No medical tests required

Individuals below the age of 45 don’t have to undergo any medical examinations to become eligible for these policies.

III. Coverage for bariatric surgeries

Bariatric surgeries are performed on individuals with obesity with the aim of weight loss. Both an individual and family health policy can cover expenses for such surgeries.

IV. Income tax exemptions

Opting for a family or individual health insurance policy enables you to save on income tax. These insurance schemes can help you save up to Rs. 60,000 under Section 80D of the Income Tax Act.

V. Avail discounts with plans longer than one year

Opting for a 3-year policy can help you receive a 10% discount while buying a 2-year policy provides an 8% discount.

The eligibility criteria for both an individual and a family health insurance policy are the same. You have to be between the ages of 18 and 65 years. Children dependent on you must be between the age of 3 months and 30 years.

The decision to pick the right plan rests upon you, your needs, and your premium-paying capabilities. Do make sure to check what is covered and not covered in the policy you apply for.

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