SENIOR CITIZEN HEALTH INSURANCE
After a life dedicated to a career or caring for the family, during your golden years, you deserve to be indulged. Your life should be all about pursuing a more relaxed daily routine with enjoyable hobbies and rejuvenating vacations from time to time. In the event that you need medical treatment, it should be a comforting, nurturing experience, without any concerns about affordability. Having health insurance makes that possible.
In their younger days, a number of people tend to commit the oversight of not purchasing their own health insurance policy since they are insured by their employer. This culminates in a situation where, after they retire, they do not have health insurance coverage when they need it the most.
Fortunately, the IRDAI has instructed insurance companies to permit the purchase of a new senior citizen health insurance plan up to the age of at least 65 years. It also insists that if a senior citizen’s health insurance proposal is rejected, the company is bound to offer valid reasons for the rejection in writing. Further, the insurance sector regulator has advised that an insurance company cannot decline the renewal of any senior citizen health insurance scheme except in on the grounds of misrepresentation, moral hazard or fraud. It has also insisted on certain allowances for senior citizens, such as the option to alter their TPS anywhere feasible.
Against this backdrop, almost every company in the health insurance industry has a policy crafted for senior citizens. So, how do you decide what policy is best for you?
Ideally, the higher the coverage you opt for, the better. However, there is a direct correlation between the premium that you have to pay and the coverage that you receive. However, some companies will offer to cover more than the basic hospitalization and pre-and-post- hospitalization expenses. They offer you a consumable allowance, allowance for a companion, domiciliary hospitalization, dialysis cover and other add-ons. So, ensure that you get the best value for your money.
Some policies allow you to recharge the sum insured, up to 100% of the original SI if the amount gets exhausted. At a different level, some companies allow you to purchase a policy for the tenure of 1-3 years. Look for such options that build useful flexibility into your plan.
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). While IRDAI has stipulated that at least 50% of the pre-insurance medical investigation cost must be reimbursed to the senior citizen, look for a policy that gives you the best deal.
This differs from issuer to issuer but there are companies that offer 'Lifelong renewal'. When you choose an insurer, look for such options.
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 and in case you do have pre-existing illnesses, as defined in the policy, ideally they should be covered, at least eventually.
This factor is relevant, irrespective of what age you are. Make sure you understand how the health insurance claim process works, in advance, so that you do not lose time or effort following up on a claim.
A lot of medical policies for parents do not pay for Day-care procedures. To claim the insurance, hospitalization is compulsory for 24 hours. Due to modernization today, there are a lot of procedures that do not require any hospitalization. Hence, it is wiser to opt for a policy that covers the highest amount of daycare procedures.
While an emergency at any age requires immediate medical assistance, its importance is even more for senior citizens. It only warrants for a person to check how wide an insurer’s network hospital strength is. It is advised to go for an insurer that covers the highest number of hospitals across a wide range of cities.
At a progressed age it is common for an individual to undergo a series of diagnostic tests & routine check-ups that involve doctor consultation costs etc. To support this Health Insurance policy must cover expenses incurred before hospitalization as well. These are called Pre-Hospitalization expenses.
It is to be noted that since health insurance plans for senior citizens tend to be expensive, experts recommend individuals who are looking for health insurance for themselves & their parents to take separate policies.
There is no upper limit of age when it comes to availing health insurance for parents as an adult.
You can avail a tax benefit of up to Rs. 50,000 if you buy senior citizen mediclaim policy for your parents or for yourself.
Parents who are aged 65 years or above, may be deemed ineligible for a dependent status on the health insurance plan.
Various IRDA approved general insurance providers also offer a mediclaim policy for senior citizens in this country who have a niche and customized products to offer to this special segment in our society.
Disclaimer: Please read the brochure and prospectus to know more about our health insurance plans cover as conditions may vary.
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