What is floater cover in tcs health insurance?

A family floater policy is a health insurance plan which covers the entire family on the payment of a single annual premium. The sum assured covers the entire family and can be used in case of multiple hospitalizations in the family.

But, when you have to buy policies for more than one member of your family, should you buy separate health plans for each of them or a floater health insurance policy that covers the entire family? Which plan is more beneficial under what circumstances? What are their merits and demerits? In this blog, we will talk about everything related to individual health plans and floater health plans.

First, let’s understand what are individual health insurance policies and what are floater health insurance policies.

When a health insurance policy covers only one person it is an individual health plan. And the yearly premium amount depends on the person’s age and the coverage amount.

For example, you are 30-years-old and you buy an individual health insurance policy for yourself and another individual health insurance policy for your 56-year-old mother. The coverage amount for both the policies is Rs 5 lakh. Now, the annual premium amount for your policy would be Rs 15,000, and the yearly premium for your mother’s policy would be Rs 30,000.

A floater health insurance plan covers more than one member of a family. That is, if you buy a floater health insurance plan it will provide cover to you, your spouse, children, and parents – depending on whose name you want to include in the plan. The premium amount of the plan will depend on the age of the eldest person covered under the floater health plan and the coverage amount that you seek.

Under a floater plan, the sum insured can be availed by any member of the family for a particular year. Say, you have a Rs 10 lakh family floater health insurance policy that includes you, your spouse, and two children. Now let’s suppose, on being hospitalized, the bill amount incurred by you was Rs 2 lakh which was covered by your floater health insurance policy. Now, the remaining Rs 8 lakh can be availed by you or any other member named in the policy during that year.

Now that we know the difference between an individual health insurance policy and a floater health insurance policy, let’s look at the advantages and disadvantages of buying a floater policy over an individual health insurance policy.

In case you buy individual policies for each member of your family that means you have to maintain each policy separately, read and understand the terms and conditions for each of them, remember different due dates for their premium, then accordingly calculate the combined premium amount for all the policies to keep a tab on your expenses.

On the other hand, if you buy a floater health insurance policy, your entire family can be covered under a single policy. It saves you from the hassle of maintaining too many policies.

In case the insured are in a similar age group, floater health insurance plans are much cheaper as compared to individual health insurance plans. For example, for a young couple in their early 30s, the yearly premium amount for a floater health insurance plan (Rs 10 lakh coverage) would be Rs 14,000. But if they want to do it separately, i.e. Rs 5 lakh individual policies each, then the premium amount would be Rs 10,000 per year for each policy or Rs 20,000 yearly combined premium.

Now that we know about the advantages, let’s look at the disadvantages of floater health insurance policies against individual health plans.

For individual health plans, each member has a separate sum insured. Say, you have a Rs 5 lakh individual health insurance policy.  On being hospitalized the bill amount was Rs 2 lakh which was covered by your health insurance. And, the rest of the Rs 3 lakh sum insured can be availed by you again in case you are hospitalized for the second time in the same year.

But for a floater health insurance policy, the entire sum insured is meant for all the members covered under the same policy. A particular amount is not fixed for each member. So if one family member makes a claim, the cover reduces on the rest by that much. It is not fixed like Rs 2 lakh each if five members are covered under a floater health insurance policy of Rs 10 lakh. Let’s understand with an example.

Say you have a Rs 10 lakh floater health insurance policy that covers you, your spouse, and your two children. Now, you were hospitalized for certain treatment and the bill amount was Rs 5 lakh. Now, this entire amount will be covered by the floater health insurance policy. But for that year, the cover amount for your spouse and children will be reduced to Rs 5 lakh.

For every claim-free year, your health insurance company rewards you by increasing your coverage amount or decreasing your yearly premium amount. This benefit is called a no-claim bonus (NCB). This benefit can be availed for both individual and floater health insurance policies.

Now, if one member covered under a floater health insurance policy makes a claim in a particular year, then the entire NCB would be nullified for the year. But if each member had separate individual health policies, then the NCB (for the individual health insurance policy) would be nullified for the person who was hospitalized, while others would be able to avail NCB for their own health policies.

In a floater health insurance policy, once a child covered under the policy reaches a specified age – ranges between 18 to 25 (it differs from policy to policy), they are treated as adults and have to be removed from the floater health insurance plan for the plan to continue.

In that case, along with the floater health insurance plan, you will also have to buy a separate health insurance policy for your son or your daughter.

Now that we have looked at the merits and demerits of both – individual health insurance policy and floater health insurance policy, let’s understand which one is more suitable under what circumstances.

The premium amount for a floater health insurance policy is determined on the basis of the age of the oldest member covered under the policy. So whether you should buy a floater policy or an individual health plan should be determined according to the age gap between the oldest person covered under the policy and the other members in it.

So, it makes sense to buy an individual health insurance policy if you are single and your parents already have their own health plans. Meanwhile, if you are a young couple or you have a family including young children, then buying a floater health insurance policy is beneficial.

Bottom Line

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Here are some key features and benefits of family floater health insurance plans.

Unlike other insurance policies, which provide coverage only for the insured individual, a family floater health insurance plan covers multiple individuals. As a result, you can add your spouse, children, parents, and siblings to a family floater health plan.

Family members under a family floater plan can receive cashless health insurance benefits. They can benefit from cashless hospitalisation at network hospitals if they notify their insurance within 24 hours of admission.

For each hospitalisation day, a family floater health insurance policy may cover the room rent. The coverage is up to a specific amount as specified by the policy.

All members covered under a family health insurance policy can avail of daycare treatment benefits. A daycare procedure requires hospitalisation for less than 24 hours.

Family health policy covers the ambulance expenses to transport any enrolled member to the hospital.

Given below are the leading family floater plans offered by top insurance providers through Bajaj Finance. You can claim benefits across 7,000+ network hospitals across the country.

Here are the things that you should keep in mind before purchasing family floater health insurance for your family.

The sum insured in a policy must be sufficient to meet the entire family's medical expenses. Generally, insurance companies offer family floater plans with a sum insured starting from Rs. 50 lakh.

To avail of cashless treatment, choose an insurer with a sizable network of hospitals. You can then claim for cashless settlement at any network hospitals.

Choose an insurance company with a high claim settlement ratio. The insurer must have simple process to accept and resolve claims. This will guarantee that the claims processed quickly and with minimal difficulty.

Usually, most insurers impose a waiting period of 2-5 years. People cannot submit claims for any pre-existing conditions or add-on benefits like free annual checkups, dental care, etc. during this time.

Apart from these, you must thoroughly go through the inclusions and exclusions of a family floater health plan. Also, check if the company gives any add-on covers to expand the coverage.

Step 1: Click here to open our online application form. Step 2: Fill in the application form with basic details of the proposer. Provide name, gender, mobile number, date of birth, and residential PIN code. Step 3: Now click on ‘Get Quote’ to proceed. Step 4: From the list of policies shown, choose your preferred family health insurance plan by clicking the ‘Buy Now’ button placed under each plan. You can further modify the insured amount, policy term, and plan type to get a list of policies tailored to your preference. Step 5: Based on the plan, you choose you may get the option to select the policy term and premium amount. Step 6: Enter your email ID and check if all personal details shown are correct. Click ‘Next’ to proceed. Step 7: Enter some additional details, such as height, weight, nationality, marital status, address, and nominee details (if applicable). Step 8: Answer a few questions about your health and lifestyle by clicking the relevant checkboxes. Click on the ‘Next’ button to proceed. Step 9: Verify if the previously filled details are correct and click on the ‘Proceed’ button to visit the payment page. Step 10: Make the payment through net banking, UPI, debit, or credit card to buy the policy.

After successful payment, your policy document will be available for you to download instantly. You will receive a copy of the policy document on your registered email ID within 5-7 working days..

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