Including your new born in existing family floater health insurance policy?

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Escalating healthcare expenses have made it mandatory to have a medical insurance plan in place. Consumers are constantly seeking a health insurance plan that protects them as well as their family in the event of illness and also from age-related health issues.

Health insurance is generally of two types:

  • Individual health policies that meet the individual’s requirements
  • Family floater plans that cover the whole family including the individual, spouse, children and parents

The family floater policy comes with several advantages, the most important one being the convenience of a single policy for the whole family that is easy to manage. It includes free health checks for dependants covered under the plan, thereby saving money. It also allows the addition of family members. Each member is eligible for cashless treatment and health cards for use during emergencies. In the event of death of a family member who is in the plan, the rest of the family continues to get the benefits of the policy without loss of benefits.

When a new baby is born into the family, there is provision to include her in the existing family floater health insurance policy.

Points to consider while including a new born baby in the family floater policy 

In an era where parents-to-be are conscious about healthy lifestyles and consider cord blood banking as part of their health protection plan, health insurance is foremost in their minds to protect them from the risk of steep medical expenses. While a new born baby is not eligible for an individual health insurance policy, it is possible to include them in an existing family floater policy.

Some considerations to bear in mind while doing this are as follows:

The baby’s age

It is standard practice to allow the inclusion of the child in her parent’s health plan when she is 90 days old. However it is also possible to include the new born from the date of birth under what is called the “maternity benefit” available in the family floater policy. These also cover the first set of vaccinations the child must receive and/or post-natal care.

Criteria for inclusion

When an insurance company allows a baby to be added to the policy it imposes certain terms and conditions, which are:

  • It must be informed of the arrival of the baby within a week of its birth
  • It reserves the right to put a ceiling on the cover offered to the child

Where the insurance cover is offered when the baby is 90 days old, the inclusion into the policy can be done at the time of renewal of policy.

Paperwork and procedure

The application for inclusion of the child must be made when the policy is due for renewal, along with the following documents to the insurance company:

  • A copy of the child’s birth certificate
  • Mother’s discharge card
  • Medical history

After the application is submitted, the next step is premium calculation.

Premium involved

A revised premium is worked out based on the application, on payment of which the revised policy is issued. It is important to check with the insurer to know which post-birth complications are included and which ones are not since the treatment of these can mean additional expenses. Some policies cover both normal and caesarean delivery charges, pre-and post-natal expenses up to a limit, automatically including the new born’s coverage that may include both internal and external congenital problems and vaccinations. Generally, typical coverage includes hospitalisation due to illness.

Cover validity

Children included under the family floater policy are covered until the age of 21. Sometimes, individual covers can be sought for children who are five years and above.  New born babies can only be covered in their parents’ group policies or at the time of renewal of their parents’ individual health policies, due to their ineligibility for individual health cover. Depending on the insurance company, for an additional premium payment, the baby’s treatment, with exclusions are covered by the policy provided the maternity expenses are also part of the same policy.

Although it is possible to get coverage for new borns under the family floater policy, insurance companies prefer to cover babies when they are three months or older. This is because the possibility of hospitalisation in new borns is high, involving a higher cost factor for the insurance company. Another reason is the mortality and morbidity rates in new born babies due to various reasons.

It is important to ask the insurance company about the effective date of maternity coverage under the policy as this usually starts after a specific number of months after enrolment.

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