Things To Remember Before Buying Health Insurance For Senior Citizens
The rising cost of healthcare in India is a fact, and adequate health insurance coverage for you and your family is the need of the hour. Having health insurance is even more important for senior citizens.
As one age, the chances of carrying diseases and going on hospital visits increase. Even when seniors are covered under family health insurance, that cover might not be enough for them. So, it is important to buy separate health insurance for senior citizens.
Health insurance for senior citizens
Health insurance for senior citizens is for people of age 60 years or above. An insurance plan is a standard contract between the insurance company and the policyholder. While the senior citizen pays a premium to the company, the company pays for expenses incurred by the insured such as pre- and post-hospitalization, daycare, etc.
The premium for a senior citizen health insurance is much higher than that for a younger individual. Know about choosing the best health insurance for senior citizens here.
Remember these 6 things before buying health insurance for senior citizens
1. Look for in-patient hospitalization and sub-limits
Insurers offer in-patient hospitalization coverage against seniors’ medical expenses when they are admitted to the hospital for over 24 hours. In-patient hospitalization covers hospital expenses like doctor and specialist fees, nurses expenditure, medicine cost, etc.
Many health insurance policies for senior citizens limit certain expenses with sub-limits. Thus, in-patient hospitalization is covered, but there are sub-limits on costs like doctor fees. As the number of hospital stays for a senior citizen might get higher, it is essential to buy a senior citizen health insurance policy that offers maximum in-patient hospitalization coverage.
2. Check the benefits offered against the premium amount
The premium amount for senior citizen health insurance is way higher than policies meant for young individuals. So, while comparing different senior citizen health insurance policies, look for a policy offered at the lowest premium but with the most benefits.
Again, some insurance companies allow a monthly premium payment option so that you don’t have to make a huge payment in one go.
3. Check post-hospitalization expense limitations
As a policyholder, senior citizens get reimbursement of expenses incurred after being discharged from the hospital. The post-hospitalization expenses are directly attributed to the illness or injury for which the policyholder was admitted.
Generally, the post-hospitalization eligibility is around 60-90 days. But, the post-hospitalization period is shrunk down for many health insurance policies for senior citizens. Many senior citizen plans also offer post-hospitalization coverage as 7 to 10 per cent of the total claimed amount. So, check the applicable terms and conditions before making the purchase.
4. Check for restrictions on the number of day-care hospitalizations
Certain medical procedures like cataract, dialysis, chemotherapy, etc. take less than 24 hours at the hospital to get completed. While most health insurance for senior citizens covers daycare facilities, some plans even restrict that number. The number of daycare facilities might be as low as 8 to 10 for some plans. Before buying any health insurance plan, check for restrictions on daycare facilities under the policy.
5. Check for terms and conditions on pre-existing illness
Senior citizens may have a couple of pre-existing illnesses. So before buying a health insurance policy for them, check for the terms and conditions regarding pre-existing illnesses. Check whether pre-existing disease are covered or not, what is the waiting period for covered pre-existing illnesses, co-payment clauses, etc. before buying a policy.
6. Check the plan’s co-payment, exclusions, waiting period, etc. factors
While buying a policy for senior citizens, read policy wordings to understand co-payment, waiting period, exclusion, sub-limits, etc. terms and conditions.
- Sub-limits: Sub limit is the cap on the amount a policyholder can claim for a particular procedure. Most senior citizen health policies come with sub-limits. For example, for cataract surgery, there might be a specific sub-limit per eye. There are sub-limits for kidney dialysis, knee-cap surgery, etc. Read policy terms and conditions to understand the procedures with sub-limits and other conditions for each of them.
- Co-payment clause: Co-payment clause is where you are required to pay a share of the claim from your pocket. Particularly while buying health insurance for senior citizens, consider these two things: Most senior citizen health insurance plans come with co-payment clause and the clause is in relation to the waiting period offered in the plan. So, if the waiting period goes down, the co-payment portion goes up and vice versa. Read the policy document thoroughly to know about the co-payment clause and waiting period. In general, for health insurance plans for senior citizens, the co-payment percentage is around 10 to 30 per cent.
- Waiting period: The waiting period is like a hibernation period when no claims are admissible. The clause is applicable for pre-existing illnesses. For any health insurance policy, the waiting period is from two to four years. However, insurance companies have brought down the period to as low as a year for senior citizen health insurance. The reason for the decrease in the waiting period’s duration is that senior citizens often require immediate hospitalization. So, lower the waiting period, better the plan.
- Exclusions: Many health insurance plans for senior citizens come with exclusions. They are healthcare expenses or medical conditions not covered by your health insurance policy. Read the fine print of the health policy to understand the diseases that are excluded from the policy. Go for a policy with no or minimum exclusions.
Conclusion
These are the 6 things you can contemplate before you choose the best health plan for senior citizens. Research around these 6 points to narrow down your search.
Apart from these points, several other factors can be termed crucial while buying a health policy for seniors like enhancing sum insured, OPD expenses, room rent allowance, etc. Consider these points as well, but know that these 6 factors are the most essential while buying health insurance plans for the elderly. Contemplate these five points and then prioritize your plans based on other benefits that are offered.
Health insurance is the best gift for anyone, especially for your parents. Make sure you buy the best health insurance for them.
