HYDERABAD: Many people think that insurance companies are not keen on providing health insurance cover to senior citizens, owing to increased risk, but quite to the contrary, there are several options available for them. While some health insurance policies come with an entry age limit, there are policies that don’t, and are best-suited for senior citizens.
“Typical health insurance plans in the market have underwriting requirement (medical examination and decision by insurance firm) for above a certain age, and medical questions regarding present or past illnesses. Very few plans can be obtained without the need for a medical examination, but comes with certain terms and conditions such as compulsory Co-Pay and sub-limit on many procedures,” said Vaidyanathan Ramani, head (product & innovation), policybazaar.com.
There are factors that a senior citizen should keep in mind while buying a health plan — such as Co-Pay, waiting period, and restoration benefit.
Co-Pay is the portion of sum that one has to pay out of his own pocket. In some plans, Co-Pay is inbuilt and some companies give the option of choosing this in their policy. Co-Pay will definitely reduce the premium, but will add an extra burden at the time of hospitalisation. Therefore, one must carefully look through this feature.
“Policyholders should examine the waiting period while buying a health insurance policy. Normally, all health insurance plans have an initial waiting period of 30 days. For specific illnesses, this extends up to two years and for pre-existing diseases, it can go even up to four years. So, one must look at this factor carefully and choose a plan that has a lower waiting period for pre-existing diseases, as at the older age, a person is more vulnerable to diseases,” said Hanu Yedluri, financial adviser & CEO of fintech company InstaEMI.com.
Another feature to look at is the capping on room rent. Most plans have room rent sub-limits. This is the percentage of sum insured that the insurance company would pay towards room charges. For instance, if the room rent is capped at one per cent of the sum insured for a policy of Rs 5 lakh, then the rent of room that you can avail is restricted to Rs 5,000 or below. It is also advisable to have higher limit or no restriction on room rent, as the overall bill reimbursement will also depend on the room rent capping.
“If a senior citizen’s sum insured gets exhausted during treatment, the insurance company restores it, but there is a catch. If the sum insured is Rs 10 lakh and one is undergoing a treatment that goes up to Rs 15 lakh, then the restoration benefit will not kick-in as it can be only applied for subsequent claims. If one has already undergone treatment for a similar illness, there is again no benefit of restoration as it only applies in case of an unrelated illness,” Ramani said.