Points to Ponder while Choosing a Health Care Policy for Senior Citizens
The Indian health insurance market for senior citizens has grown and there are many companies that offer policies. Before deciding to buy a policy, you should know what you want from your insurance cover. Whatever the outcome, taking a policy for health is a great investment for elderly.
Medical insurance for senior citizens provides such individuals with financial benefits besides offering monetary help in case of unforeseen medical emergencies. A health insurance policy empowers an elderly person to go for health check-ups, financial help during emergency health problems as well as long-term medical treatment. The policyholder enjoys tax benefits for premiums up to a certain level under Section 80D of the Income Tax Act. A good number of insurance companies in India are trying to overcome the challenges concerning the senior citizens.
All the available options will have to be studied and evaluated to choose the most suitable policy.
This is a very important factor to be considered while buying a senior citizen policy as even the best features have no value if a person cannot avail it due to advanced age. Insurers in the public sector offer plans for senior citizens in the bracket of 60 – 80 years. Many insurers don’t have any maximum entry age.
It is best when the insurer is ready to enroll a person even at an advanced age. This advantage is with a policy, which has long coverage tenure and will be most suitable. The renewal age, i.e. the age until when the policy can be renewed is sometimes until 80 years though some companies allow renewal for longer periods.
As a person grows older, the health risks increase making it important for senior citizens to have a higher health care protection. It is best to choose a policy with adequate health cover.
Another important factor is to choose a policy, which will cover a wide range of illnesses including critical illnesses. The exceptions will need to be reviewed and also the pre-existing conditions which are not covered. The best plans will cover a maximum number of illnesses with only a minimum number of exceptions.
Pre-existing Medical Conditions:
There is a waiting period for claims regarding pre-existing illnesses, this is of utmost importance as the danger of illness and hospitalization due to pre-existing medical conditions grows with advancing age. The shorter waiting period is a definite advantage.
Broad Hospital Network:
A senior citizen’s health insurance policy should cover a broad network of hospitals ideally in their immediate neighborhood. This should include emergency care and hospitalization. The plan should include a wide network of good hospitals.
The premiums charged to senior citizens are usually high due to high risk levels. There are other factors which affect the premium rates and they are family history, lifestyle and overall health. An extra premium is usually charged for pre-existing disease – this is to cover the additional risk. It is best to consider all options and premium rates offered by various companies before deciding on a health plan with affordable premiums.
A co-payment clause means that the insured has to share a part of the medical expenses they incur. These policies have this clause and it varies from insurance company to insurance company.
Listed below are some good health insurance plans for senior citizens:
- Reliance Life Super Golden Years Term 10 Senior Citizen Plan
- Heart Beat (Silver) Policy - Max Bupa
- New Jeevan Nidhi Plan– LIC
- Varishtha Pension BimaYojana– LIC
- Optima Senior Plan - Apollo Munich
- Silver Health Plan - Bajaj Allianz
- Senior Citizen Red Carpet Health Insurance Policy - Star Health
Insurance Plans for Senior Citizens:
Senior citizens need a great amount of care and protection. Their worry is about the increasing medical expenses for ailments, which are unavoidable. Most of them are now financially dependent which makes it all the more important that they buy the right policy and gain security.
Options for Senior Citizens while Buying Health Insurance:
Health insurance after the age of 60 is very important as a person becomes very vulnerable and it is very important for the elderly to have adequate health cover and be able to avail medical assistance as and when required.
How to Choose a Health Plan:
The Premium amount should not be the sole criteria while shopping for a health care plan. Options like hospitalization expenses, critical care and the number of network hospitals are equally important. It would be an added advantage to pay a higher premium if it could keep you protected in all the important criteria. The sum insured should be a high amount as the medical expenses are spiraling. The plan should have a low waiting period for ailments which come under the pre-defined time frame. A lifelong renewable health plan ensures that a person can be covered with health insurance for as long as they needed it.
Two additional Sum Insured Options namely Rs.7.5 lacs and Rs.10 lacs were introduced:
- Cataract limits revised
- On-line purchases – 5% discount on premium
- Outpatient consultation in network hospitals
Protects the insured for in patient hospitalization expenses for a minimum of 24 hrs. These expenses include room rent, nursing and boarding charges, Surgeon, Anesthetist, Medical Practitioner, Consultants, Specialist Fees, Cost of Medicines and Drugs up to the limits specified.
Senior Citizen Mediclaim Policy:
Senior citizens can enroll in New India Assurance’s Senior Citizen Mediclaim Policy as it covers the age category of 60-80 years. The premiums are considerably priced and vary between Rs 3850 – Rs 5150. In case of renewal, it can be extended up to 90 years.
To enroll for this policy, it is a must to undergo a prescribed pre-acceptance health check at one’s own cost for identifying the pre-existing diseases. In case one has an existing mediclaim insurance with the company, the health check is waived off.
This policy covers hospitalization expenses incurred for the treatment of illness or injury, pre- and post-hospitalization from 30 to 60 days, with ambulance charges paid. Pre-existing conditions like hypertension, diabetes mellitus can be covered after 18 months.
Diabetes is among the most common of illnesses and it severely affects most of the organs. Heart disease is a life-threatening disease and needs to be monitored on a regular basis. Overweight and obesity are other problems faced by the aged people. Cancer, influenza and pneumonia are few of the top 10 causes of death among senior citizens.
It is very important that senior citizens have medical insurance as most of them do not have any established income to be encumbered by hospitalization. Covered by health insurance, a person can benefit by good health care during his later years without the worry of medical bills due to ill health which a person cannot afford. Expensive medical treatment is available under health care policies.
New guidelines have been laid down by the IRDA according to which health insurance providers will need to cover an individual up to an age of 65 years with lifetime renewability.
As per a senior citizen health insurance policy, an individual can even enter into the policy at an age of 99 years. These plans cover the hospitalization charges, room expenses, doctor’s fee, medicine costs, ambulance charges and pre and post hospitalization expenses. The features of any policy vary from one insurer to the other.
Comparative Rate Chart
|Bajaj Silver - 55 yrs & above||Star Medical Classic - 2 to 80 yrs||Star Red Carpet - 60 to 69 yrs||National Varishtha - 60 yrs & above|
|Max. entry age||70||75||69||70|
|Max. exit age||75||80||Lifelong||90|
|Pre-existing waiting period||1st year for 50% S.A||4 years||2nd yr with 50% co-payment||1st claim free year|
|Non network hospital treatment||Co-payment of 20%||No charges||No charges||No charges|
|Room Rent||No room rent||2% of S.A up to Rs. 4000/-||1% of S.A||1% of S.A|
|Buying policy process||Too many medical tests and inflexible process||Abundant restrictions, many test but, simple issuing||Easy to buy and no medical tests||Easy issuing but lower cover|
- Policies / Schemes - (https://www.india.gov.in/people-groups/life-cycle/senior-citizens/policiesschemes)
- Health Insurance ofr Senior Citizens - (http://www.healthinsuranceindia.org/senior_citizen_health_insurance.asp)
Latest Publications and Research on Senior Citizens - Comparison Chart of Policies
- Survey of Customers Requesting Medical Information: Preferences and Information Needs of Patients and Health Care Professionals to Support Treatment Decisions. - Published by PubMed
- Patterns of Health Care Utilization and Medication Adherence Among Youth with Systemic Lupus Erythematosus During Transfer from Pediatric to Adult Care. - Published by PubMed
- Is obesity a risk factor for readmission after acute myocardial infarction? - Published by PubMed
- Bidirectional association between alopecia areata and major depressive disorder among probands and unaffected siblings: A nationwide population-based study. - Published by PubMed
- Containing or shifting? Health expenditure decomposition for the aging Dutch population after a major reform. - Published by PubMed