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What to know before buying health cover for senior citizens

Look for a policy that has a co-payment clause so that you get the best deal

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Anuj Gulati

Updated: Nov 15, 2017, 07:25 AM IST

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After dedicating the golden years of their life to career and family, they deserve to indulge later. Life, for senior citizens should be all about pursuing a more relaxed daily routine with enjoyable hobbies and rejuvenating vacations from time to time. And, if in case they need medical treatment, it should be a comforting, nurturing experience, without any concerns about affordability. Having health insurance makes that possible.

Missed the bus? It has been commonly seen that most Indians in their younger years, tend to oversee the importance of taking a health insurance policy of their own. This is primarily due to two reasons, firstly because they feel it would not be required since they are hail and hearty and secondly - those who are working professionals find coverage offered by their employers sufficient. This culminates in a situation where in their golden years or post retirement - when the need of health insurance is the most, they don’t have a cover.

Keeping this in mind, a lot of insurance companies offer health insurance plans specifically designed for senior citizens. Enrollment for such plans is usually allowed at least till 65 years; however some insurers put no restriction on entry age thereby making it easy for senior citizens to access quality healthcare.

Making the right choice - With almost every company in the health insurance industry offering a policy for senior citizens, it can be a daunting task to narrow down on one.

Here are five factors that one must pay attention to while purchasing a senior citizen policy -

Coverage: Ideally, the higher the coverage you opt for, the better it is. However, there is a direct correlation between the premium that you have to pay and the coverage you receive. However, some companies will offer to cover more than the basic hospitalisation and pre-and post- hospitalisation expenses. They offer you a consumable allowance, allowance for a companion, domiciliary hospitalisation, dialysis cover and other add-ons. So, ensure that you get the best value for your money. Furthermore, some insurance providers offer coverage ill even Rs 10 lakh.

Flexibility: Some policies allow you to recharge the sum insured, up to 100% of the original SI if the amount gets exhausted. Additionally, some companies allow you to purchase a policy for a tenure of one to three years and offer discounts for choosing a longer tenure. Look for such options that build useful flexibility into your plan.

Co-payments: Senior citizen health insurance policies usually have a co-payment clause. This means that the insured has to bare a portion of the claim amount (as specified in the policy). Look for a policy that gives you the best deal in this regard.

Maximum age to renew: Every insurer specifies a different maximum age till when they can stay for enrolled in their plans however there are some companies that do not put any restriction on this i.e. once enrolled the insured can stay covered throughout lifetime. All they have to do is timely renew their policy.

Pre-existing illnesses and waiting periods – This may be the most important factor to consider since most companies have a waiting period before they cover pre-existing illnesses and some do not cover them at all. Naturally, the lower the waiting period the better. There are companies that offer to cover these after a wait-period of just two years thus making such policies extremely relevant for a senior citizen keeping in mind they might be already ailing from certain illnesses. Do check the wait-period when you choose an insurer.

Simple claim process – This factor is relevant, irrespective of what age you are. Make sure you understand how the claim process works, in advance, so that you do not lose time or effort while filing your claim.

Coverage apart from the usual cover – Few senior citizens plans offer recharge of sum insured if it gets exhausted, that too without having to pay any additional premium. While this may be just one of the features offered a in health insurance plans, it particularly is of great significance for senior citizens since they are more likely to have multiple claims in a year wherein the first claim exhausts the sum insured. In such situations, recharged amount can be used to pay for subsequent claims.

HEALTH — THE REAL WEALTH

  • Look for a policy that has a co-payment clause so that you get the best deal
     
  • Some insurance companies offer a consumable allowance, allowance for a companion, domiciliary hospitalisation, dialysis cover and other add-ons
     
  • Make sure you understand how the claim process works, in advance, so that you do not lose time or effort while filing your claim.

The writer is managing director and CEO Religare Health Insurance

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