What Factors Affect the Premium of My Family Health Insurance Plan?


A family health insurance plan provides coverage to the entire family under a single sum insured. When it comes to medical insurance for family members, it is easier for everyone to be covered under one single plan rather than get an individual health plan for each family member. Perhaps, the best aspect of health insurance plans for family is that the coverage is provided for all family members under one single premium. Understandably, the premiums of a family plan are higher than those of individual health insurance plans. These premiums are decided based on several factors.

In this article, we explore the major factors that affect the premiums of health insurance plans for family.

  1. The age of the members insured

Individual health insurance plans also consider the age of the insured individuals as a primary factor in deciding the premiums. However, in a family with multiple members of different ages, how is the premium to be decided? Here, the major determinant is the age of the eldest member of the family covered under the plan. This is because older people are more likely to get sick or diagnosed with major illnesses and raise a claim. The ages of the other members covered are also taken into consideration. A family health insurance plan with two 30-year-old adults and one dependent child would most likely incur lesser premiums than a plan with two 40-year-olds and a senior member of 60 years of age.

  1. The lifestyle of the family members 

The lifestyle of each family member influences the family health insurance premium to a great extent. Those who live healthier lifestyles and follow healthy practices can benefit from low premiums as the chances of them getting sick and getting diagnosed with diseases are lower. Similarly, those with unhealthy lifestyle patterns would incur high premiums. If any member of the family is prone to smoking, then that would mean higher premiums for the plan. The occupation of the family member may also be taken into consideration, as some risky professions would mean higher chances of claims. If a family plan has a spouse who is a homemaker, that might affect the premiums in a positive way.

  1. The size of the family  

The number of people you choose to cover under your plan definitely affects the premium rate for the family health insurance. Simply put, including more family members under a single plan would see you incur higher premiums. The premiums of a health insurance plan for a family of 3 would be lower than that for a family where 5 members are insured.

  1. The medical history of each family member

If any of the family members suffer from pre-existing illnesses, there will be an impact on the premiums. If several insured members of the family have pre-existing conditions, then the premiums would be considerably higher. You would need to check the coverage for pre-existing illnesses in the family health insurance plan and also ask if there is any waiting period applicable.

Do note that premiums would also depend upon individual health insurance companies and their guidelines. Do seek the advice of a professional before going ahead with any decisions.

We hope this article has increased your understanding of family health insurance plans and their premiums.

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