Investing in a family medical insurance plan reduces the pressure of health care costs on your household budget. (Credit: Shutterstock)
As you track and review the progress of your financial goals, it's good to check if you are prepared for unforeseen medical costs. Consider putting a portion of your savings into medical insurance should you dip into your emergency fund for urgent health issues.
A family medical insurance policy generally covers expenses for medical emergencies and diagnosis, and it may also include inpatient and day-patient treatments. In addition, it gives you access to quality private healthcare, including a network of hospitals, clinics and specialists.
Here's a guide to help you navigate the terrain of family medical insurance, what is covered and what to look out for when choosing one.
Who falls under family in medical insurance
Most family medical insurance covers your immediate family or household members. (Credit: Getty Images)
Family members eligible for insurance live within the same household. These include children who may not be your biological son or daughter. Some policies indicate the length of stay for eligibility as dependents. Clarify the age limit for kids with your provider.
What medical insurance covers
Most companies already have several types of medical insurance that cater to your needs, covering a range of symptoms, illnesses, injuries and specific types of treatment. The higher the premium, the more comprehensive your coverage.
Chronic vs acute conditions
Family health insurance usually covers unexpected illnesses or injuries and acute medical conditions developed after the policy's start date. Most policies do not cover pre-existing and chronic conditions, meaning diseases that can be managed but not cured, such as diabetes or allergies.
Inpatient vs outpatient
Medical care requiring a hospital bed, either overnight (inpatient) or just for the day (day-patient), is typically covered. But ask about outpatient treatments, such as consultations, diagnostic tests, scans and therapies. Some policies may offer this at an additional cost.
Ask your insurance agent about cancer coverage if it's a stand-alone policy or an add-on. For example, a critical illness protection plan may cover chemotherapy, radiotherapy, tests and therapies, surgery or reconstruction and other financial benefits.
Digital general physician service
Most family health insurance policies offer access to a digital general physician (GP) service, an asset during a pandemic, with appointments available 24/7.
The service usually provides phone or video consultations with registered GPs, medical advice, prescriptions and referrals for private healthcare if needed.
Policies vary, but the most common exclusions of medical insurance usually include:
- Routine pregnancy and childbirth, although you may be covered for complications
- Chronic conditions
- Cosmetic surgery
- Intensive care
- Kidney dialysis
- Screening and preventative treatment, like mammograms.
How much does family health insurance cost?
While it's not easy to gauge an average cost for a family, small or large, the following common factors come into play. They can influence your family's health insurance premium or the amount you pay each month or year for your policy.
- Whether you are a single parent or in a relationship
- Whether you want to pay annually or monthly
- Where you live and your occupation
- The level of cover (the more benefits your health insurance plan covers, the higher your premium is)
- How much excess you opt for (excess in insurance is the amount you must pay if you file a claim on your policy)
- The number of people covered
- Ages of the insured members (some policies set a minimum or maximum age of members)
- Medical history of each individual and any current and pre-existing medical condition that may restrict the coverage available to others
Having a profession at high risk of injuries or acute conditions might translate into a higher premium. Also, adding elderly family members will raise costs.
Factors to consider before buying medical insurance
Choosing a health insurance policy that provides adequate coverage can be difficult. Here are a few more factors that might help you choose the best option before buying.
Sum insured and co-pay
Sum insured means there is a cap on the maximum amount your insurance company is obligated to pay if you are hospitalised. You pay for the amount above or beyond the sum insured. Co-pay is an option that divides the expenses between the insurer and the policyholder.
Pre and post hospitalisation
What does the policy cover in pre- and post-hospitalisation expenses? For example, does it include consultation fees, x-rays, scans and follow-ups? These can significantly weigh on family finances.
Day-care procedures and treatments
Health insurance usually covers day-care procedures and treatments but always check what treatments are covered and for how many days. You may also want to look into the number of hospitals associated with the policy and where they are located before you buy it.
Claiming on your medical insurance policy will require you to:
- see a general physician who might refer you to a specialist.
- reach out to the insurance company and start your claim.
- get your treatment or therapy.
Benefits of medical insurance
Check the health benefits, additional features and claim settlement clause before buying medical insurance for the family. (Credit: Getty Images)
An emergency room visit alone can cost hundreds of dollars, and rising healthcare costs mean future medical bills will become increasingly expensive. Medical insurance protects your family against this type of financial hardship.
Medical insurance can provide preventive care services and quality treatment of health conditions. It could be a good investment if you are self-employed or working in a company that does not guarantee insurance or offers limited coverage.
Choosing the right coverage for your family can be daunting, but it's a great way to look after your loved ones while protecting your savings. Expert advice can help clear any doubts and answer your questions if you're looking for family medical insurance coverage. Get in touch with your local AIA office to explore your options and gain the confidence to choose the right solution for you.
Having the choice to live the kind of life you want starts with a strong financial foundation. In this episode of AIA Voices, finance expert Anna Haotanto shares the six steps towards financial success.
AIA Voices is a community of influential and educational voices from around Asia to talk about life, health and wellness. A platform to educate, motivate and inspire people to make positive behavioural changes on their health and wellness journey. Providing an opportunity for communities across Asia to connect, collaborate, and learn from each other. Designed to drive AIA One Billion, our ambition to engage a billion people to live Healthier, Longer, Better Lives by 2030.
III.org, Insurance Information Institute. 2022. Life Insurance. [online] [Accessed on 17 July 2022]
NIH, Asia-Pacific Journal of Oncology Nursing. 2016. Health Insurance for Cancer Care in Asia: Thailand. [online] [Accessed on 17 July 2022]