What’s the difference between individual and family health insurance plans?

27/02/2023

Individual and family health insurance plans

If you’re thinking about getting covered with a health insurance plan, it’s helpful to understand just how many different types of healthcare plans there actually are. Depending on your age, marital status, and whether or not you have children, a family plan can be the best option to help lower costs while obtaining health cover for more of your family members.

In this guide, we’re going to look at the main differences between individual and family health insurance plans, from how much each costs to what you’re entitled to on each plan. Let’s take a look!

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What is a health insurance plan?

A health insurance plan refers to an insurance system whereby you’re covered for private medical care if you fall sick or need medical attention in the future. You can obtain a healthcare plan with just the basic care covered (such as doctors appointments and in-patient care) while also having the opportunity to pay more for other supplementary services, such as dental care.

Different types of health insurance plans

As there’s no one-size-fits-all when it comes to healthcare and our bodies, there’s no one-size fits all when it comes to health insurance plans. Typically, you’ll be covered under one of the following types of health insurance plans in the UK:

  • Individual healthcare plan. This is paid for by yourself, and your monthly premium will be determined by your own age and some other factors, such as your postcode.
  • Family healthcare plan. A family health insurance plan will cover each family member, with each person having the same type of basic or comprehensive coverage. Family members that you can include on a health insurance plan include your partner (provided that you live together) and any children who live at the same address. Other relatives (such as grandparents and siblings) will need a separate insurance policy, even if they live at the same address. There are age limits in place for those children who have failed to leave the nest at 30.
  • Employer-provided health insurance. Certain companies now offer paid health insurance as one of their staff perks, usually with a basic coverage plan that gives you basic medical care for non pre-existing conditions (depending on the underwriting). Workplace health insurance is typically calculated by the average age of the employees, and the type of coverage offered will vary business to business.

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What does family health insurance cover?

Family health plans are still subject to the same terms and conditions as an individual healthcare plan. With a basic family healthcare plan, you can expect to receive the following care:

  • Cancer care
  • Inpatient care
  • Some outpatient care
  • Access to digital and telephone GP appointments

Your family health insurance plan typically won’t cover the following:

  • Gender reassignment surgery
  • HIV treatment Treatment for pre-existing conditions (depending on underwriting).
  • Pregnancy and natal care (although some providers do cover pregnancy complications).

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Benefits of family health insurance plans

To help you make an informed decision on what the best coverage plan is for you and your loved ones, here are some of the pros and cons of a family insurance plan:

Cheaper coverage per person

When you opt for a family insurance plan, you’re most likely going to end up paying less than you would have had you opted for an individual health care plan. This is because some insurers offer a reduced premium when there is more than one person on your policy.

Better care for babies and children

While family healthcare plans are still subject to the same terms and conditions of an individual healthcare plan, having private healthcare coverage for your children is highly beneficial for their development and wellbeing. Not only will you have access to quality care, but you’ll also get quick treatment for your child: this prevents any developmental or educational stalling due to prolonged school absences.

Plus, some insurers offer certain perks and benefits for parents who opt for a family plan. While terms and conditions may vary depending on your chosen insurance provider, some insurers will offer a newborn cash benefit, or parental accommodation if your child ever stays overnight in a hospital. Do remember that these perks are not universal, and policy benefits will vary from insurer to insurer.

Simplify the process

If you’re already on an individual healthcare plan, you’ll know how complicated the process can be. You’ll need to perform a full medical underwriting (or opt for a moratorium) while crafting a personalised healthcare plan suited to your needs. If you don’t have any particular health conditions and want to simplify the process for both you and your dependent family members, getting a family health insurance plan is your ideal option.

Disadvantages to family healthcare plans

While there are many benefits to obtaining a family health insurance plan, there are naturally some downsides, too:

Lack of personalised coverage

When you opt for a family insurance plan, everyone is going to be covered under the same policy, even if your healthcare concerns differ. This can mean that you’re unable to access specific supplementary healthcare on your plan without having to cover your entire family (which will be more expensive than simply adding extra care to your individual plan.)

What’s better for me, family insurance or individual insurance?

If you’re thinking about getting a health insurance plan, it’s a good idea to think about your personal circumstances. If you’re a young, single professional, it might make sense to stick to an individual health insurance plan.

However, for those living with a partner or with young children - a family health insurance plan can be a great way to simplify the process for health insurance, as you won’t need to apply for single individual cover for every member of your family. Getting a family health insurance plan is also likely to be much cheaper on an individual basis, especially if you’re including numerous children in your cover.

How many people can be covered under the same family health insurance plan?

There’s no limit to how many people can be covered under the same family health insurance policy, however only partners and children living at the same address can be included on the same policy.

How much does family health insurance cost?

The cost of your healthcare plan will depend on what type of plan you opt for, and if you add any optional extras (such as dental and full outpatient care) to your cover. In general, each family member will have their own premium cost, determined by the health insurance provider.

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