How Family Size Affects Health Insurance Cost – Know Now!
29 July 2025
5 Mins Read
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When you buy health insurance for your family, you are providing them with the best protection against medical emergencies. With health insurance, they can access quality healthcare services during an emergency without worrying about the cost.
However, before you can avail yourself of these benefits, you need to pay an insurance premium. Moreover, the amount of this premium is directly affected by the number of family members getting covered under a family health insurance plan.
That is why it is essential to understand how the health insurance costs of your family are determined and how they affect your pocket.
Impact Of Family Size On Health Insurance Costs
The size of a family is one of the major factors that affect health insurance costs. However, having a large family does not necessarily mean you have to pay a higher premium for your family’s health insurance.
Suppose there are two families, one with four members and the other with two members. The family of four might have lower medical costs than the family of two because they have better health conditions than the family of two, which may have some pre-existing conditions.
This means that a family of four has only one claim per policy year, whereas a family of two with poor health may make multiple claims in the same policy year.
Let us understand how family insurance works with an example. Suppose Mr B. buys a health insurance policy covering himself, his spouse, and two minor children with coverage of ₹40 lakhs. The premium of insurance is calculated based on Mr B’s age, as he is the oldest member.
During the policy duration, Mr B has to undergo surgery that costs ₹4 lakhs, which the insurance will cover. Then, for the rest of the policy duration, the family can make claims up to ₹36 lakhs.
Again, if in the same term, Mr B’s wife gets hospitalised for a kidney operation costing ₹5 lakhs, now the family can claim up to ₹31 lakhs for the rest of their term.
Things To Consider Before Buying Family Health Insurance
When you decide to buy a family health insurance plan, you will find different kinds of plans that will align with your healthcare needs. Some of the important things that you should consider before you buy medical insurance.
1. Sum Insured
The sum insured is the highest amount of money that your insurer will pay in the event of a medical emergency. Therefore, it is essential to verify the sum insured before you buy a health insurance policy. The amount should be adequate to cover all the medical costs of your family.
2. Premium Amount
If you choose a health insurance plan with a higher sum insured for your family, you will also have to pay a higher premium.
Moreover, if you choose add-ons such as accidental death cover, critical illness cover, or any other add-ons, they also increase your premium amount. Therefore, it is essential to select a premium wisely, based on your coverage needs and budget.
3. Pre-And Post-Hospitalisation Cover
Another important consideration before you buy health insurance for your family is pre- and post-hospitalisation coverage.
It is because there are instances when medical expenses occur before and after the hospitalisation of any insured family member. Having this cover will avoid any out-of-pocket expenses.
4. Hospital Network
A large hospital network is another key consideration when purchasing health insurance for a family.
Your selected insurer should have a large network of hospitals across India, and it would be better if some of them were located near your area. It helps you get the fastest healthcare services during a medical emergency.
5. Day Care Procedures
Before you get the plan, see the number of days they are willing to provide daycare treatment under the plan. Some procedures just need a day of hospitalization.
Some of these treatments, which are included in daycare procedures, are dialysis, cataract surgery, radiotherapy for cancer, and many more. Depending on your present health condition, you can ask for a medical policy that covers most of the daycare treatments.
6. Specific Diseases & Treatments
Another important aspect that you have to consider while buying health insurance for your family is whether it covers some specific diseases and treatments. Moreover, if you have any pre-existing condition or are looking for some specialized treatment, check if they provide that.
Most of the insurance companies impose a waiting period of almost 3 years. They often make people wait a while before approving cataract surgeries or joint replacement. So, it is necessary that you understand the coverage of these treatments.
7. Claim Settlement Process
Before you choose any family health insurance, make sure to know about its claim settlement procedure. With family, you can not take any chances of delays or rejection in claims during a medical emergency.
That is why it is essential to choose an insurance provider that has a straightforward claim process and provides support throughout the claim process.
Benefits Of Buying Health Insurance For Family
- No Financial Stress: The biggest benefit of family health insurance is that you and your loved ones would not have to face a financial crunch in the face of medical emergencies.
- Access to Healthcare Services: Purchasing family health insurance provides timely access to healthcare services. You and your family can avail of services such as preventive check-ups and hospitalisation, if needed.
- Family Coverage: Another significant benefit of family health insurance is that it provides comprehensive coverage for all insured family members under a single plan.
Family Health Insurance With TATA AIG
Now you know how your family size impacts your family health insurance costs. However, buying health insurance for a family is more affordable than purchasing individual plans for each family member, especially if you want coverage on a budget.
If you are planning to buy a family health insurance plan, consider the TATA AIG MediCare plan.
The insurance plan is a comprehensive family insurance plan that offers features such as inpatient treatment, daycare procedures, second opinion coverage, hearing aid coverage, bariatric surgery coverage, and coverage for pre- and post-hospitalisation expenses.
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