Can A Child Have Both Their Own Policy And Coverage Under Their Parent's Policy?

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Yes, it is possible for a child to be enrolled in their health insurance cover in addition to enjoying the same benefits under their parent’s family health insurance coverage. Many businesses frequently allow this, as long as the eligibility requirements and benefit payments are taken into account in accordance with the policy's provisions.


Parents may make this choice because of their desire to have more financial resources available for potential medical costs in the future.


Why Do Some Parents Choose Dual Coverage For A Child?


Being insured through two plans might be more financially beneficial in some instances. These instances include:



  • The child has continuing health requirements

  • High medical care fees in the city

  • The parents want to have more insurance overall

  • The child will require his own insurance in the future


Sometimes, having a separate plan while still young might enable the child to meet any required waiting periods.


How Does Coverage Under A Parent’s Policy Usually Work?


In general, children tend to be included in a family floater insurance scheme. A family floater plan involves dividing the sum insured between all members of the insured family.


Insurers permit dependent children to continue their insurance through the parents' policy plan until they reach a specific age limit, which varies from one insurer to another. Normally, that age limit ranges between 18 and 25 years, provided that the child is financially dependent and unmarried.


May include the following benefits:



  • Hospitalisation costs

  • Day care procedures

  • Pre and post-hospitalization costs

  • Emergency care

  • Cashless hospitals within a network


It depends on the insurance company and its policy terms.


What Is The Benefit Of Having A Separate Policy For The Child?


Another policy provides the child with a personal sum insured, which is not shared among other family members.


This can be helpful for the following reasons:



  • One of the family members has already exhausted the benefit available from the floater policy.

  • The child needs treatment that is more expensive than before.

  • The parents desire continuous benefits for their child.


Personal coverage may be helpful for the child once he or she becomes ineligible under the parent’s plan owing to their eligibility restrictions.


Can Claims Be Made Under Both Policies?


In certain cases, claims may have to be divided between two insurance plans where the expense amount exceeds the coverage of one insurance plan. This method is known as "contribution" or "coordination of benefits.


Example:






















Scenario



Possible Claim Approach



Hospital bill within one policy limit



One insurer may settle the claim



Hospital bill exceeds first policy coverage



The remaining amount may be claimed from the second insurer



Non-payable items under one policy



Another policy may or may not cover them



Proper documentation would be necessary in such instances from insurers.


One must remember that policyholders cannot claim more than what is actually paid for the treatment.


What Should Parents Check Before Buying A Separate Policy?


For instance, prior to buying another insurance plan for the child, one can consider the following points:



  • Age at entry

  • Waiting periods

  • Exclusions in coverage

  • Amount of premium

  • Conditions for renewal

  • Provisions regarding co-payments

  • List of hospitals covered


Parents must make sure that a separate declaration about the child’s health history is required.


Coverage and benefits depend on the conditions of the policy and insurance underwriting. Refer to your policy for detailed terms.


For many families, their parents’ floater policy would suffice during the initial years. But because of increasing healthcare costs, some parents like to purchase an individual policy for their children.