An individual health insurance policy, as the name suggests, provides coverage for only one person. Insurance providers offer discounts of premium when you add family members.

A family floater health scheme is for an entire family. You only have to pay one premium to avail coverage for all of your family members. You can also add a new person to the plan without any hassle.

Similarities between these two schemes include:

  1. Income tax benefits

You can avail income tax exemptions when paying health insurance premiums. Both policies help you save up to Rs. 60,000 under Section 80D of the Income Tax Act.

  1. Discounts for long-term schemes

Some health insurance companies provide 8% discount on premiums when you opt for a 3-year policy and a 4% discount for a 2-year plan.

  1. No need for medical tests

Both individual and family floater health insurance policies eliminate the need for a medical examination if you are under the age of 45.

  1. Covers non-allopathic medications

Other than allopathic medicines, an individual and family floater scheme also covers expenses pertaining to Ayurveda and Homoeopathic medication.

  1. Covers surgeries

You can avail coverage in case of bariatric surgeries with both of these health insurance policies.

  1. Eligibility criteria

The applicant should be between 18 to 65 years of age. Dependent children must be between 3 months and 30 years to avail the benefits of these policies.

Differences between these two schemes include:

Individual health scheme

  1. Cashless hospitalization

Cashless hospitalization is a feature offered under the individual health insurance policy that enables you to avail healthcare without the need of making any payments. A third-party administrator (TPA), appointed by the insurance provider acts as a coordinator between the insurer and the network hospital.

A network hospital is an empanelled medical facility with the insurance company which provides cashless facility. This facility is beneficial when an insurer is facing cash shortages. it also eliminates the hassles in filing claims, which can end up as a time-consuming process.

Individual Health Insurance Plans offered by Bajaj Finserv provides the cashless facility at more than 5,700 network hospitals. The amount of sum insured for each ranges from Rs. 1.5 Lakh to Rs. 50 Lakh.

  1. Pre and post-hospitalisation expenses

Your medical expenses begin before you are admitted to a hospital and continue even after you are discharged. Some of these expenses might include doctor fees, medications, etc.

A health insurance policy can cover such expenses. You get reimbursement for all healthcare expenditures 60 days before and 90 days after hospitalisation.

  1. Cumulative bonus for claim-free years

You avail a cumulative bonus every year when you don’t make a claim. Usually, most lenders offer bonuses of 5% to 10% of the sum insured.

  1. Discounts on premium for adding more members

A 15% discount on premium is available to include 3 family members and a 10% discount for two members into this policy.

Do note that standard health insurance plans may not cover critical illnesses. For that, you may opt for a separate policy.

The critical illness planfrom Bajaj Finserv however can cover diseases like paralysis, stroke, heart attack, kidney failure and cancer amongst others.

Family floater health policy:

  1. Coverage for ambulance charges

Family health insurance policies provide coverage for ambulance services as pre-specified in the insurance terms. For instance, the Family Health Insurance Plans from Bajaj Finserv provides up to Rs. 20,000 in a policy year to help you cover ambulance costs. You can insure a sum up to Rs. 50 Lakh for an entire family.

  1. Covers several medical expenses

A family health insurance plan may cover the financial requirements for healthcare of new-borns, maternity care, organ donation, etc.

  1. Free healthcare tests

All members enrolled in this scheme are eligible for a preventive healthcare examination every 3 years.

Both family floater and individual health insurance policies have features that can benefit the different needs of individuals. Make sure to compare the same and read the terms and conditions before you opt for one.


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