As people grow older, their health becomes more fragile and vulnerable to diseases. This means frequent hospital visits and unsaid medical expenses. During the golden years as the source of income remains limited, the question arises is how to maintain a balance between the outflow and inflow of the finances.
A health insurance policy for senior citizens can surely help in balancing the two if the plan is chosen wisely. Hence, considering a few factors before choosing the policy will play a major role in getting the right coverage. The factors that can be prioritised when choosing the best health insurance for parents or the elderly in your family will be listed in detail as we move forward in this article.
There are multiple factors to keep in mind while purchasing a mediclaim policy for senior citizens. The top 10 features that you should look for while you are comparing policies in the markets are:
This is the time when no claims will be registered. Waiting periods are usually applicable to pre-existing diseases and vary from insurer to insurer from 2 to 4 years. For health insurance policies for senior citizens, choose a plan which has a minimum waiting period. In Care Senior Citizen Health Insurance, there is a waiting period of 2 years covering the named ailments. The list of named ailments is exhaustive and includes almost all major possible illnesses of old age.
Since you are looking for an exclusive plan, lifetime renewability is a huge advantage that will prevent your budget from going haywire once your parents are above 60 years. Most general health insurance for parents above 60 has a high premium cost with medical check-ups, etc. However, a plan with lifetime renewability and an entry age of 61 years is the best way to have coverage as long as you live at a manageable premium cost. Care for Senior Citizens plan is renewable for a lifetime, and you do not need to look for separate plans once you or your parents reach 65 years and then subsequently 70 years.
A co-payment is a clause that most senior citizen insurance policies have where insured pay a share of the claim as an out-of-pocket expense. It is usually related to the waiting period offered in an inverse manner. When the waiting period goes up, the co-payment amount goes down. For any health insurance for senior citizens, the co-payment varies from 10-30%. Under Care Senior Citizen plan, there is a co-payment of 20% for all claims. However, you can opt for a co-payment waiver clause where seniors aged 61 years and above can buy or renew a policy with or without co-payment. There is no co-payment involved for the zone of treatment. Although the premium is charged as per the zone of your residence, any treatment taken in a higher or lower zone does not incur any co-payment charges.
Sub-limits are a ceiling of expenditure on certain procedures like cataract treatment, knee replacement surgery, cardiovascular treatment, renal conditions and cancer treatments. You need to read and be aware of the details of sub-limits and their terms and conditions and check whether they suit your health requirements.
There are some treatments which require hospitalisation for more than 24 hours and some which can be treated within 24 hours. In case you need admission for more than 24 hours, in-patient hospitalisation covers your expenditures. Any good health insurance for senior citizens should have exhaustive in-patient coverage, including nursing expenditures, doctor’s fees, and medicine. But there are plans where the sub-limits for chosen expenses are room rent, ICU charges, etc. Hence, this impacts the cost of treatment as the number of days of hospital stays is usually higher in the case of senior citizens.
For daycare treatments like dialysis, chemotherapy and cataracts, hospitalisation is required for less than 24 hours. Though most health insurance for senior citizens has daycare facilities, the number provided might be insufficient. You need to check for the exhaustive list under the plan. Care for Senior Citizens offers 541 procedures for daycare treatments, up to the Sum Insured amount.
No claim bonus is the reward that insurers provide to the insured for maintaining good health. If no claim is filed within a policy year, there is a percentage benefit passed on to the insured person, which is added to the sum insured during renewal. In Care Senior Citizen health insurance, base policy SI is increased by 10% on renewal if no claim was filed in the previous policy year. There is also an optional benefit of NCB Super where this percentage goes up to 50% in a year, and in two consecutive years of no claim, the sum insured doubles.
Recharge of the sum insured involves upgrading the sum insured amount with an equivalent amount every year, automatically by the insurer in case of sum insured exhaustion. This can be again utilised during further hospitalisation claims in the same policy year. In the Care for Senior Citizens plan, there is even no waiting period of 45 days if you want to claim the recharge amount for the same person and same disease.
Hospitalisation is the ultimate care required, but before that finding the root cause of illness requires diagnostic tests, x-rays, ultrasound, blood tests etc. Any of the best medical insurance for parents in the market will have extensive coverage for these out-of-hospital expenses.
You need to check the exclusion list to avoid any unwanted surprises during the claim. Some common exclusions include eye check-ups, dental treatments like RCT, cleaning, cost of instruments, food supplements, cosmetic surgery etc. This is an important factor to note as most get overwhelmed by the benefits and offers and ignore this part.
It is a fixed amount which is to be paid by the insured as a part of the total claim. These are small expenses that a lot of insurers do not cover. For example, if you have an operation, the policy may cover the operation theatre cost, anaesthetist expense, and surgeon expense but may not cover surgical items, cotton pads, disposable gloves, masks or even syringes.
Health insurance for senior citizens must have a smooth, seamless claim process. As an aging person, neither the patient nor the patient has the capacity to keep visiting insurance offices to follow up on claims. Claim Genie app of Care Health Insurance is an excellent tool for uploading and tracking all claims. It is handy and user-friendly and quickly resolves any issue that may arise during processing.
If you trust alternative medicines like Ayurveda or Homeopathy, pick a plan which covers these treatments as well. AYUSH coverage is one of the USPs of Care Senior Citizen plan.
These points will help you understand the importance of a separate cover required for senior citizens:
Once ageing sets in, it is usual have some pre-existing chronic conditions like diabetes, high blood pressure, cholesterol, hypertension and arthritis. Hence, it is crucial to have a plan that caters to pre-existing and complicated illnesses and covers advanced treatments.
With lower immunity and a less active lifestyle, old age requires long-term and consistent medication or treatments. The recuperation time is much longer than normal. And earnings dwindle as you retire and may not be actively working. Health policy for senior citizens brings in the needed financial relief where you do not need to depend completely on your income or savings.
No matter how much you save for your hay days, life always has unexpected turns. Moreover, with inflation forever on the rise, the value of money is never the same when you earn and when you retire. Hence, once you factor in inflation, additional financial support always helps, especially with advanced medical treatment.
The best health insurance for senior citizens will always have all benefits under one roof. A comprehensive plan will cover pre-hospitalisation, in-patient treatment and post-hospitalisation care at home, along with pre-existing illnesses, tele-consultations, regular health check-ups and many more.
With an extensive network of hospitals having cashless benefits, you are made aware of the best treatment possible and have the option to choose from hospitals countrywide.
For the elderly, complete recuperation is a long-term affair. Hence post-hospitalisation treatments or follow-ups are crucial to prevent a recurrence. A plan that includes coverage beyond hospitalisation, regular tests and diagnostics and doctor consultation is apt for a senior citizen. A floater coverage may not suffice the requirement and an exclusive plan is the way to go.
These are just a few factors that help you avoid confusion while selecting the best health insurance for senior citizens or the elderly in your family. You further must check if these factors fit in your or your family’s health insurance requirements, as can be seen, the significance of having a separate plan for the elderly cannot be emphasised enough.
>> Also Read: How to Choose the Right Health Insurance for Parents?
Disclaimers: All plan features, benefits, coverage, and claims underwriting are subject to policy terms and conditions. Kindly refer to the brochure, sales prospectus, and policy documents carefully.
Published on 11 Dec 2024
Published on 10 Dec 2024
Published on 10 Dec 2024
Published on 10 Dec 2024
Published on 9 Dec 2024
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