Child Health Insurance Plans in India: All You Need to Know

A parent's love for their child knows no bounds, and they go to great lengths to ensure their little one leads a fulfilling life. From providing top-notch education and healthcare to offering a comfortable lifestyle with healthy food and engaging entertainment, parents strive to give their children the very best. Unfortunately, despite their best efforts, children are often beset by illnesses due to unhealthy dietary choices and rising pollution levels, leaving them susceptible to infectious diseases such as malaria, pneumonia, and diarrhoea. Even more concerning is the recent rise in serious health conditions like diabetes, obesity, and cancer among children.

As the prevalence of health risks among children continues to rise, parents are increasingly worried about the potential long-term impact on their child's physical and mental well-being. Unfortunately, the financial burden associated with medical treatments and medications can add yet another layer of stress to an already trying situation. To ensure that your child receives the best possible healthcare, it is advisable to consider adding them to your existing family floater health insurance plan or purchasing an individual health insurance plan specifically for them. Doing so can provide you with the peace of mind that comes with knowing your child is covered in the event of unexpected illness or injury.

When considering health insurance coverage for your child, you have two options: You can either opt for a child health insurance plan or add your child's name to your existing family floater health insurance plan. To better understand which option is right for you, it is important to explore how each of these plans works.

1. Individual Child Health Insurance Plan:

If you are looking for a separate health insurance plan for your child, an individual child health insurance policy is a good option. While it can be costly to buy individual plans for each family member, having a dedicated policy ensures your child has a separate sum insured, which will especially be beneficial if they require frequent healthcare or have pre-existing conditions that could raise the premium of a family plan.

2. Family Floater Health Insurance Plan:

For parents who already have a joint or family floater health insurance plan, adding their child to the policy is a common choice. This type of plan provides coverage to all family members under a single policy, which is often less expensive than purchasing individual policies for each member. However, the sum insured is shared among all members, so if one person exhausts the coverage, the other members cannot benefit from the policy.

In addition to these two options, salaried individuals may be able to add their child to their employer's corporate health insurance plan if coverage is offered for spouses and children. However, relying solely on a corporate plan is not advisable, as employers may alter the terms or discontinue coverage at any time. Inadequate health insurance coverage can ultimately hinder access to quality medical treatment.

What are the eligibility criteria for buying a Child Health Insurance Plan?

A child's health insurance eligibility requirements may differ from insurer to insurer. However, there are some standard conditions that the child/parent needs to fulfil to obtain a child health insurance policy in India:

1. If the parents have a family floater policy, their newborn baby will automatically be covered from the day of birth until 90 days. After 91 days, the baby can be included in the family floater policy by paying an extra premium. However, critical illness and personal accident benefits will only be available once the child turns 18.

2. For an individual health insurance plan, a child as young as one day old can be covered if at least one parent is included in the plan.

3. The maximum age limit for a child to be included in a family floater policy is typically 20 to 25 years.

4. To purchase an individual child health insurance plan or add a child to an existing family floater plan, specific documents, such as the child's birth certificate, maternity discharge summary, and medical reports in case the child has a pre-existing medical condition, must be provided.

Join Now: PersonalFN is now on Telegram. Join FREE Today to get 'Daily Wealth Letter' and Exclusive Updates on Mutual Funds

What are the benefits of buying a Child Health Insurance Plan for your child?

The primary reason for purchasing health insurance for your children is to ensure that they receive optimal medical treatment during health crises. Buying child health insurance offers several other advantages, as mentioned below:

1. Child health insurance plans typically provide extensive coverage, including hospitalisation expenses and infant vaccinations, among others. These policies can cover newborn babies from the day of their birth, ensuring that they have access to necessary medical care from the start of their life.

2. Child health insurance plans have lower insurance premiums because insuring a child carries less risk. This applies to both individual and family floater plans. By purchasing a health insurance policy for your child earlier, you can lock in a lower premium amount.

3. A child health insurance plan can offer benefits like access to expert consultations and advice on nutrition and diet. This can provide peace of mind to parents, knowing that their child's health needs are being taken care of.

4. If you don't file any claims in the preceding policy period, the insurance company offers you a No Claim Bonus (NCB). This discount can be applied to the insurance premium while renewing the policy.

5. A child health insurance policy can provide you with financial support by alleviating the burden of rising healthcare costs. With medical expenses increasing steadily, a health insurance policy for your child can offer peace of mind and financial security.

6. In today's digital age, nearly everything can be accomplished online, including purchasing insurance. Buying child health insurance online has become a simple and hassle-free process compared to the traditional offline method. With the ability to compare different insurance plans, you can find and purchase the most suitable health insurance policy for your child with ease.

How does the Child Health Insurance Plan work?

Child health insurance plans function similarly to standard health insurance plans by providing coverage for your child's medical expenses. Depending on the desired coverage benefits, you can either opt for a separate/individual health insurance policy for your child or add them to an existing family floater health insurance policy. Typically, child health insurance plans offer coverage for pre and post-hospitalisation, day-care treatment, and domiciliary treatments, among others. An individual child health insurance plan may also provide additional coverage for services like lab diagnosis, ambulance costs, etc. Certain insurance companies may also cover critical illnesses and offer free annual medical check-ups for claim-free policy renewals, although benefits may vary depending on the policy's terms and conditions.

What are the things to keep in mind when buying a Child Health Insurance Plan?

1. Age of a Child:

The age of the child plays a crucial role when choosing a health insurance plan for your child.

For newborns, many insurance policies have a waiting period of at least 90 days before coverage begins; however, some policies may have longer waiting periods. To cover a newborn, it makes sense to look for a plan that includes maternity cover or to purchase a separate maternity add-on with the health insurance plan.

For children up to their teenage years, you can add them to a family floater health insurance plan or buy an individual health insurance plan that meets their specific health needs. If the child does not have any particular requirements, it is cost-effective to add them to the family floater plan.

Family Floater Health Insurance Plans typically provide coverage for children up to the age of 25. As children grow up and start managing their own expenses, it is more practical for them to have their own health insurance coverage.

2. Coverage And Sum Insured:

You should consider the coverage provided by the policy to ensure that your child's health insurance plan provides adequate financial support. Coverage refers to the treatments and situations for which the policy provides financial assistance. You should ensure that all basic and potentially required treatments are included in the child's health insurance plan. By having broader insurance coverage, you can ensure that you receive financial support for most illnesses.

Apart from the coverage, you need to pay attention to the sum insured you choose. The sum insured is the maximum claimable amount under your health insurance policy. Some individuals opt for policies with lower premiums that may not offer adequate coverage. This defeats the purpose of having health insurance because you will eventually have to pay for any additional medical expenses out of your pocket. Therefore, you should ensure that your child's health insurance policy has an adequate sum insured to meet all their healthcare needs.

3. Additional Benefits:

When it comes to child health insurance plans, you must compare the benefits provided by different insurance companies. For instance, you should consider factors like the cap on room rent, day-care treatments, coverage for critical illnesses, ambulance charges, and inclusions before selecting a plan that best suits your child's healthcare needs.

While a maternity plan covers delivery costs, there could be additional expenses like vaccinations and inoculations that need coverage. Hence, purchasing a maternity plan or a maternity add-on cover can provide comprehensive coverage for all post-delivery expenses.

4. Premium:

It is essential to compare and evaluate the premium, sum insured, and benefits offered by different health insurance policies. You can use premium calculators available on the insurer's official websites to determine the premiums of various plans. As mentioned earlier, including your child in a family floater health insurance policy is an economical way to provide them with health coverage.

5. Claim Settlement Ratio:

A swift claim settlement process and efficient customer service should be on your checklist when choosing a health insurance provider. The claim settlement ratio, which is the number of claims settled successfully compared to the total number of claims filed in a year, shows the insurer's reliability. Opting for an insurance company with a high claim settlement ratio increases the likelihood of having your claim settled successfully.

To conclude:

Make sure you are completely informed before buying a health insurance policy for your child or adding them to your family's health insurance plan. It is necessary to understand and compare different plans, their benefits & premiums, and carefully read all policy documents before making a purchase.

KETKI JADHAV is a Content Writer at PersonalFN since August 2021. She is an MBA (Finance) and has over seven years of experience in Retail Banking. Ketki specialises in covering articles around banking, insurance, personal finance, and mutual funds and has been doing it for over three years now.