5 Basic Questions You Might Have About Health Insurance

Should you avail a Health Insurance from a General Insurer or a Health Insurer? Should you avail an Individual Health Insurance plan if you already have a Family Floater or Group Health Insurance plan? Can you convert an Individual Health Insurance plan into a Family Floater plan?

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5 Basic Questions You Might Have About Health Insurance

1) Should you buy a Health Insurance Plan from a General Insurer or a Life Insurer?

Health Insurance plans are offered by both Life and Health Insurance companies. Consider the following before deciding on your insurer:

1. Health Insurer offers reimbursement of hospitalization costs. This means the actual cost of hospitalization is covered. Contrastingly, Life Insurer mostly offers a fixed amount on diagnosis of a particular disease. They may or may not be able to cover the entire cost incurred.
2. Health Insurer gives you an option to opt for a cashless facility which Life Insurer does not.
3. Health Insurer charge lesser premiums for Health Insurance plans than Life Insurer.
4. Health Insurer offers portability of Health Insurance plans but Life Insurer doesn’t.
5. Health Insurer can revise premiums as you grow older, whereas, Life Insurer is unlikely to change premiums.

2) Should you avail an Individual Health Insurance plan if you have a Group Health Insurance plan?

An individual insurance policy is necessary to cover what group insurance doesn’t offer. Avail an individual health plan in the following cases:

1. When group insurance restricts coverage only to you, spouse, and children and NOT your parents.
2. When your group insurance doesn’t cover an illness or medical condition specific to you.
3. If you have a family medical history of a particular illness and the group insurance doesn’t cover it.
4. If you are planning on retiring/quitting your job or leaving a group/association. Group insurance cover lasts only as long as you are a member of the group.
5. Your new employer or group may or may not offer a Health Insurance plan as it is not mandatory to do so.
6. Benefits may be taken away at any time at the discretion of your employer in case of a company group insurance.

3) What is the definition of a family for a family floater? Can you add new members to a family floater?

1. For a family floater, family means self, spouse and 2 kids. Although few family floater plans cover dependent parents, parents-in-law, and siblings as well.
2. Yes, you can add new members to a family floater policy.

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4) What is the age criterion to be a member of a family floater?

1. You (proposer) and spouse should be 18yrs – 55yrs
2. Children should be aged between 3 months – 25yrs

5) Can you convert an individual Health Insurance into a family floater? What happens if you develop a disease during this period of time?

Yes, that is possible. When you convert an individual Health Insurance into a family floater you alone will get benefits of continuity of your Health Insurance, i.e. you can carry forward the benefits of the individual Health Insurance but for others, the family floater is as good as a new policy.

The continuation is limited to your existing sum insured. Anything over and above it will mean an enhancement in sum insured and hence will not attract benefits of continuity.

Also, it is best to think along the lines of what your family’s Health Insurance needs are. If you are newly married, you will have to consider if you need to take a maternity cover for wife or riders or a separate maternity Health Insurance plan altogether.

If you happen to develop a disease during this period, it will not be considered as a pre-existing disease only for your current sum insured. Any increase in the sum insured will attract a higher premium.

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