As you grow older, your medical expenses tend to rise considerably. Therefore, having a health insurance policy in place assumes all the more importance, more so because of the absence of a regular income at this stage of life.
While there are some insurance companies in India that have specific products for senior citizens, most of them still prefer to service the under-60 segment.
Factors like premium charged, coverage amount, the co-payment clause, exclusions, pre-existing diseases? waiting period and other features offered should be analysed while choosing a policy.
Premium: The premium to be paid for a health policy is a significant factor as the income earned during this phase of
life is limited. State-run players like National Insurance and New India Assurance have policies with attractive premium rates. Private players, on the other hand, charge much higher premiums.
Coverage: Generally, higher health coverage is needed as you grow older. Most public sector players offer very low coverage to senior citizens. The maximum coverage offered is by United India Insurance (R3 lakh).
On the other hand, higher coverage is offered by private players like Star Health, Bajaj Allianz and Apollo Munich (up to R5 lakh). This is, however, still low compared to what is offered to the younger population. Max Bupa is one of the few companies that offers high coverage to senior citizens (up to R50 lakh on its Platinum plan option).
Waiting period: Generally, senior citizens already have some diseases when they opt for a health policy. All companies specify pre-existing diseases? waiting period. The lower this period is, the better it is. Policies by National Insurance, New India Assurance, Star Health and Bajaj Allianz have a lower waiting period, while it is higher for policies by United India Insurance, Max Bupa and Apollo Munich.
Co-payment: Unlike policies for the young, all senior citizen plans come with a co-payment clause. This means that the policyholder will have to contribute a part of the claim made. Understandably, it is better if this proportion is lower. Policies by New India Assurance and National Insurance require 10% co-payment; Bajaj Allianz, United India Insurance and Max Bupa require 20% co-payment, while Apollo Munich requires 30% co-payment. Co-payment is the highest for Star Health?s policy at 50% for pre-existing diseases and 30% for all other diseases.
Other features: In addition to the basic features, some policies like those offered by Max Bupa and Apollo Munich provide value-added services like a discounted value of health services and products or free second opinion from a medical panel.
Usually, such benefits mean a loading on the premium. Thus, you must assess the benefits you receive against the premium you pay. Like other policies, some senior citizen policies also come with a cumulative bonus clause, which results in an increase in coverage amount on completion of a claim-free year. Policies offered by United India Insurance, Bajaj Allianz, New India Assurance and Apollo Munich offer a small discount in premium charged if any family member is included in the policy.
Policies by National Insurance and New India Assurance are attractively priced, but have a very low coverage. These policies may thus be individually insufficient due to the mounting medical expenses in today?s world. If you do not mind paying a higher premium, you can consider policies by Star Health and Bajaj Allianz for a slightly higher coverage.
Pre-existing diseases are a critical determinant of which policy you choose. Sometimes, companies don?t issue a policy if there is a pre-existing disease. As an applicant, you must always ask for a rejection in writing from such an insurance company. This can be used for filing a complaint to Irda or when you use the Right to Information Act.
If you don?t have any pre-existing disease, you can also look at health policies offered by nationalised banks, which come at a low premium and generally have a high renewal age. Some nationalised banks (like Punjab National Bank, Oriental Bank and Indian Bank) offer policies with a high entry age also.
If your children are working, you as a senior citizen parent can benefit if they have a good cover from their employer. This is because most corporate health schemes cover parents with pre-existing diseases. However, it is always better if you have a secondary cover as well.
As you can see, all health plans for senior citizens come with several conditions and restrictions, and are more expensive compared to other health policies for the same coverage amount. You can, therefore, work around this by either splitting the cover, choosing policies by nationalised banks or by getting coverage in your child?s company policy.
n The writer is CEO, BankBazaar.com