Individual vs family floater insurance

Individual vs Family Floater Health Insurance - Edelweiss General Insurance Blogs

21st November 2018 8min read 816 views

It’s a question as old as time. When most people start thinking of buying health insurance for themselves and their families, they wonder which one is better – an individual plan or a family floater policy. Before we answer this and end the debate once and for all, let’s understand what sets these two types of mediclaim policy plans apart in the first place.

1. Individual Cover

As the name suggests, an individual health insurance policy is issued in the name of a single person. This means the sum assured is dedicated to the insured in its entirety. For example, if you are the policyholder and find yourself in need of hospitalisation, the insurer will cover your expenses up to the sum assured. Any leftover amount will remain available for use during the rest of the policy period.

2. Family Floater Cover

A family floater plan covers the entire family under one umbrella policy. As opposed to individual health insurance, floaters require all the insured members to share the sum assured. For example, if you purchase a plan for a couple and two children with an assured sum of Rs. 4 lakhs, all four members will be covered by the insurer within that sum, regardless of who is hospitalised.

3. Pros And Cons Of Individual Cover:

Pros:

  1. 1. Whether it is maternity or critical illnesses, you get to pick the benefits in the policy. This can depend upon the kinds of expenses you anticipate in the future.
  2. 2. The policy offers an independent cover to be used as and when the situation calls for it. In case you ever have to be hospitalised, the medical bills won’t burden the other members of your family.
  3. 3. If you are a healthy individual, chances are your premiums will be lower than buying a family floater plan with someone in the family who’s older or suffers from health conditions.
  4. 4. You will be entitled to a No Claim Bonus if no claim has been made during the policy period.

Cons:

  1. 1. It is pricier than a family floater policy, especially if the family is young. For instance, if the sum assured is Rs. 5 lakhs for someone between the ages of 30 and 35, the premium would amount to an estimated Rs. 7,000 for a year. On the same sum, the premium for a family floater would be approximately Rs. 4,250 per member.
  2. 2. The approval of your health insurance application will depend solely on your financial and medical history. Those with major medical conditions may be denied by insurers or charged big premiums.

4. Pros And Cons Of Family Floaters:

  1. 1. It is more economical than an individual policy.
  2. 2. Any member of the family can file multiple claims in a year, up to the sum assured.
  3. 3. It is easier to manage than an individual policy, as you need to remember just one date for renewal.

Cons:

  1. 1. The premium will be calculated on the age of the eldest member. Thereby, including a senior person in the plan will increase the cost significantly.
  2. 2. Your cover is tied to your family. If someone in the plan happens to fall sick often or requires medical attention more frequently, it may not leave the other members with enough protection.
  3. 3. Once a family member makes a claim, you won’t be entitled to a No Claim Bonus. Talking about renewal you can renew your medical insurance policy easily and with easy whenever you need it.

At the end of the day, both policies can be described in a few words: a family floater as ‘one plan to cover them all’ and individual cover as ‘different strokes for different folks’. Your choice will depend entirely on factors such as your age, your kids’ ages, medical history, and budget. Keep these pros and cons in mind, and you are bound to make a smart decision that works for you and your family.

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