What Is It and Who Is It For?
For people who want help with eligible hospital expenses. Compare your family's needs, existing cover and the hospitals you use.
Individual Cover
One person has their own sum insured. The proposer applying for the policy may be different from the person being insured, subject to eligibility.
Family Floater
Eligible family members share one sum insured. A claim by one member uses part of the cover available to the others.
What Does It Usually Cover?
- Eligible hospital treatment, including doctor fees, medicines and room charges.
- Listed day-care procedures that do not need a full day's hospital stay.
- Related expenses before and after hospitalisation, within the policy's stated periods.
- Ambulance and other benefits where included, subject to limits.
These are general examples. Benefits, eligibility, limits and exclusions depend on the policy you choose.
Key Terms, Simply Explained
- Sum Insured
- The cover amount available under the policy. Sub-limits and other conditions can still apply.
- Waiting Period
- Time you must wait before certain benefits or conditions become covered. Check initial, specific illness and pre-existing disease waiting periods separately.
- Pre-Existing Disease (PED)
- A health condition that meets the policy's definition of a pre-existing disease. Disclose your medical history accurately when applying.
- Room Rent Limit
- The room amount or category your policy allows. Choosing a higher category may affect payment for room charges and related expenses.
- Co-pay
- Your share of an admissible claim. A 10% co-pay on an eligible ₹1 lakh claim means you pay ₹10,000, before considering other deductions.
- Cashless and Reimbursement
- Cashless means an approved amount is paid directly to the hospital. Reimbursement means you pay first and submit a claim. Both are subject to policy terms.
What Should You Check?
- Check nearby hospitals and the insurer's cashless process.
- Compare waiting periods, room eligibility, co-pay and treatment limits.
- Check whether maternity, OPD, consumables or dental treatment are included or need an add-on.
- Read restoration and bonus conditions before relying on extra cover.
Common Limits and Exclusions
- A treatment or illness still within its waiting period.
- Expenses listed as non-payable, unless specifically covered.
- Routine outpatient or cosmetic treatment unless the chosen policy includes it.
A Simple Example
One shared family cover
A family has ₹10 lakh of floater cover. An eligible ₹3 lakh claim may leave ₹7 lakh of the base cover for that policy period. Restoration or bonus benefits work only as stated in the policy.
Illustrative only. This is not a quote or a promise of claim payment.
Details and Documents to Keep Ready
- Proposal details, age proof and identity documents.
- Medical history and any reports requested by the insurer.
- For claims: hospital bills, discharge summary, prescriptions and claim forms as required.
The insurer may ask for additional information depending on the application or claim.
Frequently Asked Questions
Can I insure a parent without insuring myself?
An eligible proposer may apply for another person. Share the insured person's name, relationship, date of birth and medical history so YFB can check suitable options.
Is every hospital bill paid in full?
No. Co-pay, deductibles, exclusions, room restrictions and benefit limits can leave part of the bill payable by you.
Are existing illnesses covered immediately?
Do not assume immediate cover. The insurer must assess the application, and waiting periods or special terms may apply.
Does cashless mean I pay nothing?
No. Approval covers the admissible amount. Non-payable expenses and your applicable share may still be collected by the hospital.
Get Help from Your Financial Buddy
YFB helps you understand options, organise documents and follow up on claims. The insurer assesses applications and decides claims under the policy terms.
References and Information Notes
General educational information reviewed on 6 October 2026. Insurer examples explain concepts and are not a recommendation of a specific product. Always read the current policy wording and benefit illustration where applicable.