Health insurance options for senior citizens, choose wise

You must be bombarded with the n number of options available in the sector of health insurance; however, when you cross 50, the options gets limited and an individual finds himself compromising with his requirements. Here, most insurers are not ready to cover you against the sky rocketing frequent medical requirements.

In this regard, the Insurance Regulatory and Development Authority (IRDA) has asked general insurance companies to keep at least 65 years as the maximum entry age for a health insurance policy, after which you will not be able to buy a plan or get your existing plan renewed. In addition, you will have to undergo some self-funded medical tests (the older you are, the stricter the tests get) to prove that your conditions allow you to buy a policy with all available covers.

In this case, you will have to opt for the specifically designed senior citizens' policy. The common features of these policies are:

1.       Diseases covered: These plans cover those diseases which are more common in aged people like that of heart attack, cardiac diseases, renal complications and surgeries.

2.       Age of entry: Generally, age of entry or renewal age is fixed at a maximum of 60 years in individual policies. However, in senior citizen policies, the age of entry is higher and can go up to lifetime. The examples of lifetime renewal policies are Star Health Red Carpet, which lets you enter at a maximum age of 65 years and renewal till lifetime.

3.       Domiciliary treatment: The medical treatment taken at home, if the patient is not in a condition to travel to hospital, is called domiciliary treatment. The expenses incurred during domiciliary treatment are usually reimbursed under senior citizen policies but not under individual health policies.

4.       Special discounts: These plans do offer special discounts on disclosure of vital information. Discounts are offered on premiums are offered, if the certificates of ailments are produced. These ailments include BP report, sugar and blood urea report and other such reports. A discount of up to 10 per cent is given to senior citizens.

5.       Pre-existing diseases: Usually, health insurance plans cover pre-existing diseases only after the completion of 3 or 4 policy years. But in senior citizen plans, the waiting period is usually 1-2 years.

6.       Critical illnesses covered: One of the major advantages of senior citizen policies is that they cover the critical illness and individual does not have to buy a separate critical illnesses policy or rider for it.

Comparative analysis of the cost structure

An individual senior citizen of 64 years takes a policy for 1 year term. Following are few senior citizen plans available in the market to choose from. 

Disadvantages

1.       Senior citizen policies are expensive as their premium is higher and therefore are little unattractive.

2.       Also, the sum assured seems to be inadequate to cover medical costs that could prove more expensive for elderly.

3.       Though the waiting period in these policies is smaller but it is still long for senior citizens as they are prone to diseases.

4.       Exclusions would include non-allopathic treatment. However, elderly usually trust and go for non-allopathic treatments, amounting to expenses incurred by individuals.  

5.       Co-payment is the part of expenses that the insured person has to pay out of his pocket as a contribution towards health expenses incurred by him. Co-payment is higher in case of senior citizens. Since claims are bound to happen in case of senior citizens, insurers want to make sure that over-spending is not being done at their cost. To be safe, they raise the co-payment ratio in these policies to make the insured responsible for his health and expenses there on.

Despite these disadvantages, senior citizen plans come to your rescue when all other health plans decide to leave you in lurch when most required. These plans care for you when all others back out. So, it is good to invest in these plans as soon as you are eligible, so that by the time you actually need their services, the waiting period is already over.