Here’s the second part of the guide to health insurance plans for senior citizens, by Rita. She looks into the fine prints and reminds us what to be check, when dealing with such policies for the elders, in the weekly column, exclusively for Different Truths.

With numerous senior citizen health insurance plans available today, comparing and choosing the best one can be a daunting and cumbersome task. To make sure you pick the best policy, it is imperative to evaluate all options and essential aspects and make a well-informed decision thereafter.

Important factors to consider while selecting senior citizen health insurance plans

1. Age

Entry age: A critical aspect in senior citizen health insurance plans is the age factor. Even the best features are far from useful if one cannot avail the health insurance plan in the first place due to age exceeding the limit permitted by the policy. Some insurers, especially in the public sector, offer health insurance plans for senior citizens in the 60-80 year age group. Certain other insurers have health insurance policies without any maximum entry age.

The best senior citizen health insurance plans are those that allow entry even at the age of 80. Pick a plan that provides the longest coverage tenure, allowing entry at any age, along with a medical cover that goes on for a longer period.

Renewal age: This is the age or time until when the health insurance policy can be renewed by the insured. Certain health insurance plans allow renewal only till 80 years of age, following which the policy cannot be renewed. This age limit for renewal varies between companies, so pick a plan that suits your requirements.

2. Waiting period

Health insurance comes with an initial waiting period, a waiting period for pre-existing diseases and for specific illnesses. The initial waiting period is generally the first 30 days from the date of the policy being issued, except in the case of accidental injuries or hospitalisation.

In the case of pre-existing diseases, most insurers have a 2-4 year waiting period, whereas, for illness-specific diseases, the waiting period is around 2 years.

3. Sum Insured

The sum insured or health cover is another vital consideration when selecting a senior citizen health insurance plan. With advancing age, health risks increase and therefore senior citizens need higher health cover protection. It’s important to consider the right face value–higher the face value, higher the final coverage provided.

4. Coverage

It is essential to ensure that the best senior citizen health insurance plans cover a broad range of illnesses, particularly critical illnesses, as chances of such incidences increase with progressing age. You must also thoroughly review all terms and conditions concerning exceptions, i.e., the illnesses that the policy does not cover, especially the pre-existing medical conditions.

Hereditary medical conditions such as diabetes, hypertension, must be watched out for. The best health insurance plans for senior citizens offer maximum illnesses coverage with minimum exceptions.

5. Pre-Existing Medical Conditions

Defined in the health insurance policy itself is the waiting period before a claim can be made for a pre-existing medical condition. This is a critical factor because the threat of illness and resultant hospitalisation due to a pre-existing medical condition increases with age and is hence higher for senior citizens.

6. Broad Hospital Network

A senior citizen’s health insurance policy should ideally have a broad network of hospitals, including the good ones in their immediate vicinity. This is particularly helpful when senior citizens need emergency medical care and/or hospitalisation. It is, therefore, necessary to opt for a health insurance plan that includes a wide network of hospitals specialising in a broad range of treatments.

7. Premium

Premiums are another important consideration when comparing health insurance policies for senior citizens. Because senior citizens are at higher health risk levels, insurance companies usually charge higher premiums.

Senior citizen insurance policy rates vary as per age. Other factors affecting the rates of such policies are lifestyle, family history, overall health, etc. Healthier senior citizens get better coverage at lower premiums.

Choose wisely by comparing the various senior citizens’ insurance policies that different insurance companies offer at varying premium rates. Keeping in mind the above-mentioned criteria, these comparisons/evaluations make it easier to choose a good health insurance plan with affordable premiums.

8. Co-Payment Clause

Health insurance policies for senior citizens have a co-payment clause that varies from insurer to insurer. A co-payment clause means that the insured has to share a part of the medical expenses they incur.

9. Medical Check-up

One needs to provide the insurer, accurate information about existing health ailments of the individual. Upon submission of the proposal form, the insurance company would go through the medical conditions and would schedule a medical check-up where 11-13 tests would be conducted, based on the health condition of the individual. These tests would include sugar, urine, lipid profile, blood routine, liver function, kidney function, serum creatinine, sonography (for women) and PSA (for men).

Benefits of Senior Citizen Health Insurance

• Daycare costs: Costs for procedures like dialysis or chemotherapy, or for using particular types of medical equipment.
• Pre and post hospitalisation medical costs: The number of days covered varies from one insurance policy to the next.
•  Ambulance charges: Though ambulance costs are covered, these costs could be subject to a maximum limit.
• Hospitalisation charges: If hospitalisation is more than 24 hours, expenses like doctor fees, room charges, nursing fees and cost of medicines are covered.

Policy Exclusions in Senior Citizen Health Insurance

The following is the list of some of the exclusions generally seen in a senior citizen health insurance policies:

• Pre-existing diseases or injuries
• Self-inflicted injuries
• Diseases that are contracted within 30 days of availing the policy
• Treatment of AIDS
• Costs of lenses or spectacles
• Dental treatment (unless the treatment has arisen due to an accident)
• Cosmetic surgery
• Injuries caused due to the act of a foreign army or war
• Expenses which are as a result of drug abuse
• Treatments like joint replacement, etc. are covered upon the completion of 2 years of availing the policy
• Non-allopathic treatment

Popular Health Insurance Plans for Senior Citizens

Listed below are some of the more popular health insurance plans for senior citizens available in the market:

• Reliance Life Super Golden Years Term 10 Senior Citizen Plan
• Heart Beat (Silver) Policy–Max Bupa
• New Jeevan Nidhi Plan– LIC
• Varishtha Pension Bima Yojana–LIC
• Optima Senior Plan–Apollo Munich
• Silver Health Plan–Bajaj Allianz
• Senior Citizen Red Carpet Health Insurance Policy–Star Health

Source: www.policybazaar.com

©Rita Bhattacharjee

Photos from the internet.

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Rita Bhattacharjee

Rita Bhattacharjee is a communications consultant with extensive experience in managing corporate and internal communications for companies across diverse industries, including non-profit organizations. She is the co-founder of Mission Arogya and Arogya HomeCare and has recently relocated from the US to India to channel her skills towards social entrepreneurship to increase awareness and reduce disparity in public health. She also writes poetry, some of which have been published in reputed international journals.

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