Family Floater vs. Individual Mediclaim: Which One is Better?

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When it comes to securing health insurance, one of the most crucial decisions families face is whether to opt for a family floater mediclaim policy for family or individual health insurance plans. Both options come with distinct advantages and cater to different needs, and understanding the key differences can help you make a more informed choice for your family’s health protection. In this article, we will explore both types of policies, discuss their features, and compare which one is better for you.

What is a Family Floater Mediclaim Policy?

A family floater mediclaim policy for family is a health insurance plan that covers multiple members of a family under one policy. Instead of purchasing individual plans for each family member, a family floater policy combines the coverage for all members under a single sum insured. This is a popular choice for families as it is cost-effective and provides a shared coverage amount that can be utilised by any member of the family, depending on the need.

Key features of the family floater mediclaim policy:

Single Sum Insured: The family is covered under one sum insured, and any member can avail the benefits depending on their healthcare needs.
Cost-Effective: Premiums are generally lower compared to individual policies because the coverage is pooled together.
Flexibility: Family floater policies often allow you to add or remove members as required (spouse, children, and sometimes even dependent parents).
Comprehensive Coverage: These policies typically cover hospitalisation, surgery, daycare treatments, pre- and post-hospitalisation expenses, and sometimes critical illness.

What is Individual Mediclaim?

On the other hand, an individual mediclaim policy is designed to cover one individual’s health-related expenses. Each family member would need their own policy if they choose individual mediclaim plans. The coverage under an individual policy is separate for each person, meaning that the sum insured is available only for the specific policyholder.

Key features of individual mediclaim policy:

Separate Coverage: Each individual has their own sum insured, which is separate from the others. The coverage amount is entirely dedicated to that person.
No Sharing of Limits: Since each family member has their own policy, there’s no concern about exhausting the sum insured by others.
Higher Premiums: Individual policies tend to have higher premiums since each policy is tailored to cover one person.
Personalised Plans: Individual policies can be customised to suit the healthcare needs of the individual, including add-ons like critical illness cover.

Family Floater vs. Individual Mediclaim: A Comparison

Choosing between a family floater mediclaim policy for family and an individual mediclaim policy largely depends on your specific requirements, the size of your family, and your budget. Let’s explore the pros and cons of each to determine which might be better for you.

Factors	Family Floater Mediclaim Policy	Individual Mediclaim Policy
Cost Considerations	More Affordable: It covers multiple family members under one sum insured. The premium is shared, making it cost-effective for families.	More Expensive: Each family member needs to be covered separately, leading to higher premiums, especially for large families.
Coverage Flexibility	Limited Flexibility: The sum insured is shared, which may not be sufficient if multiple members need treatment simultaneously.	More Flexible: Each member has a dedicated sum insured, ensuring that their coverage isn’t impacted by others’ medical needs.
Family Member Inclusions	Can Cover Multiple Members: Includes spouse, children, and sometimes parents. Additional members might require higher premiums.	One Person per Policy: Tailored to one individual. If you want to cover others, separate policies need to be bought, increasing the cost.
Claim Settlement & Sum Insured Utilisation	Shared Sum Insured: If one member depletes the sum insured, it may affect the coverage for other family members.	Separate Coverage: Each member has their own insured sum, preventing one member from depleting the coverage of others.
Suitability for Larger Families	Best for Small to Medium Families: Ideal for families with fewer medical needs, but may not be suitable for larger families or those with chronic conditions.	Better for Larger Families: Suitable for families with more members or those with ongoing medical conditions, as each person gets their own coverage.
Renewal and Portability	Shared Renewal: Renewing a family floater policy may require you to renew for all members at once, which could be a hassle if there are multiple members with different health conditions.	Individual Renewal: Easier to renew for each member separately. It also provides more control over the policy, especially for those with changing health needs.
Tax Benefits	Limited Tax Benefits: In some cases, tax benefits under Section 80D of the Income Tax Act are applicable, but it might not be as substantial for large families.	Maximised Tax Benefits: Each individual policy can avail tax benefits under Section 80D, especially for senior citizens or if multiple policies are involved.

Which is Better for You?

The moment of truth. It might not surprise you, but the choice of any mediclaim solely depends on two things:

If You Have a Small Family with Generally Good Health

For a small family with no major health concerns, a family floater mediclaim policy for family is a good choice. It’s affordable, convenient, and can provide adequate coverage for all family members. It’s especially useful if you want to save on premiums without compromising on the health protection of your loved ones.

If You Have a Large Family or Specific Health Concerns

If you have a large family or members who have chronic health conditions, individual mediclaim policies may be more beneficial. This allows you to tailor the coverage to the needs of each member, ensuring that everyone gets appropriate protection. While individual plans are more expensive, they provide a higher level of flexibility and peace of mind.

Concluding Thoughts

Both family floater mediclaim policy for family and individual mediclaim policies have their advantages and drawbacks. The family floater plan is more cost-effective and convenient for small families, while individual policies offer more personalised coverage and better protection for larger families or those with specific health issues.

When deciding which health insurance is best in India for you, consider your family’s needs, the number of people to be covered, their health conditions, and your budget. Ultimately, the right choice depends on your unique circumstances, but ensuring you have adequate coverage, no matter which option you choose, is what matters most.