Family Floater Mediclaim
A POLICY FOR MEDICAL EMERGENCIES: Family floater health insurance also known as family health insurance covers your entire family under a single plan. The sum insured under this plan floats upon all the family members insured in it. A family floater policy is one where several members of a single family can be covered for a sum assured by paying a premium for a year. In case of multiple illnesses in the family, the sum assured can be distributed between family members, and multiple claims entertained. A family floater health insurance is one of the best options when it comes to safeguarding the health of your loved ones. Since it is a single policy offering family benefits, it relieves you from the task of maintaining and keeping track of several HEALTH INSURANCE policies & offers affordability also. Family floater health insurance plans usually cover the individual, spouse, and children. However, some insurance providers do have provision to cover dependent parents, siblings, and parents-in-law. Hence these kinds of (HEALTH –FAMILY FLOATER POLICIES) is becoming more popular because of the advantages it offers. One of the best parts about a family health insurance policy is that it saves the hassle of maintaining multiple policies. It covers your entire family under one policy including the extended family and your in-laws.
ELIGIBILITY
- Minimum entry age: The minimum entry age is 91 days. Childrens between 91 days and 5 years can be insured provided.
-
Maximum entry age: The maximum entry age is 65 years. There is no maximum cover ceasing age.
FEATURES
- Pre-Hospitalisation: 60 days
- Post-Hospitalisation: 90 min days & max 180 days
- Day Care Procedures: Covered upto SI
- Domiciliary Treatment: Covered upto SI
- Organ Donor: Covered upto SI
- Restore Benefit: Covered upto SI
- Multiplier Benefit: Bonus of 10 % , 50 % of basic sum insured for every claim free year , maximum upto 100 % , in case of claim , accumulated bonus will be reduce by 10 or 50 % .
- Health Check-up: As per limit
- Coverage: For Advance treatment and Robotic Surgery.
MAJOR EXCLUSION
- Any treatment within 30 days of cover except any accidental injury.
- Any preexisting disease/ conditions will be covered after a waiting period of 3 or 4 years.
- 2 Years exclusions for specific disease like cataract, hernia, hysterectomy, joint replacement etc.
- Hospitalization due to war or an act of war or due to nuclear, Chemical or biological weapon and radiation of any kind.
- Non allopathic treatment, Congenital external diseases, cosmetic surgery .
CLAIM PROCESS
Cashless Claim:
- The insurance company would directly interact with the hospital and take care of the expense.
- There are two pre-requisites for the same. Firstly, your MEDICAL INSURANCE PLAN must cover the ailment that you or your family member is diagnosed with.
- Secondly, the hospital you want to visit should be in the list of network hospitals of your insurer.
- If the above two conditions are fulfilled and it is a planned or emergency hospitalization, you can opt for a CASHLESS CLAIM.
Reimbursement Claims:
- Reimbursement claim is the opposite of cashless claims. If you fail to opt for the cashless facility or have to be hospitalized in a non-network hospital, reimbursement claim would come into the picture.
-
You can go through your normal hospitalization process and complete the payment. Once you are discharged, ensure that you reach out to your insurer at the earliest and submit a claim along with all the relevant hospital documents. The approved amount will then be submitted to your bank account.