Senior Citizen Health Insurance: Here’s all you need to know

Updated: June 25, 2019 3:57:11 PM

With the rise in lifestyle-related issues, it becomes extremely challenging for the human body to maintain optimal health as it ages. This is where health insurance for senior citizens becomes crucial.

health insurance, Senior Citizen Health Insurance, Family Floater Plans, Pre-existing Diseases, Co-payment clauseThe sooner you buy health insurance for senior citizens the better it is in terms of the coverage and insurance premium.

It is said that age is just a number. This thought is productive from a motivational point of view. However, from a practical point of view, one must look at age more analytically. The Human body is subject to deterioration. As the body ages, its immune system becomes weak. And with the rise in pollution, lifestyle-related issues, and other such hazards, it becomes extremely challenging for the human body to maintain optimal health as it ages. This is where health insurance for senior citizens becomes crucial. It lends financial cushioning in case of health issues. Read ahead to know more about health insurance for senior citizens.

Types of medical insurance for senior citizens

● Employee’s Group Policy
A lot of employers offer group health insurance for their employees. Medical insurance for senior citizens is also covered under such policies depending upon the nature of the policy. Employees can extend the benefits of such a policy to their immediate family. However, such a cover might not be sufficient for the elderly.

● Family Floater Plans
You have the option of going for a collective health insurance policy for your family. Such a policy is termed as a family floater plan. A claim can be raised if any insured family member faces an illness that is covered by the policy.

Including senior citizens in such a plan can increase the premium. One must note that if a claim involving a large amount is made under such a policy for one family member, it can leave others underinsured.

● Stand-alone Policy
You can buy health insurance for senior citizens as a stand-alone policy/individual plan. This is the most ideal type. Different insurance providers offer different coverages in such plans. A number of illnesses as well as additional benefits are covered in such policies.

Important aspects of medical insurance for senior citizens:

● Critical Illness Cover
This aspect can be looked at as a separate plan or as an addition to an individual plan. It offers insurance cover for a number of specific critical illnesses, for example – cancer. This plan is dedicated towards covering illnesses that can drain you financially due to their high treatment cost. As a result, the insurance premium for such policies is also on the higher side.

● Pre-existing Diseases
Most insurers that offer health insurance for senior citizens do not cover pre-existing diseases. Some insurance companies might cover such diseases after the completion of the waiting period. Such a period can be in the range of 24 to 48 months.

● Sub-limits of the policy
Insurance companies might have pre-decided sub-limits on the cover offered by their health insurance policy. As per such sub-limits, the insurance company provides the claim amount up to a certain limit. If the treatment cost exceeds the sub-limit, the insurance company does not cover it.

● Co-payment clause
As per the co-payment clause, the policyholder has to pay a certain amount of the expenses incurred for treatment. The insurance company will not settle the entire claim amount. This is mostly prevalent in case of high-value claims.

● Exclusions
Make sure to check the exclusions before you buy health insurance. Injuries that are self-inflicted, expenses incurred for cosmetic surgeries, medical condition due to drug abuse, etc. are not covered.

Make an informed choice

Certain terms and conditions regarding health insurance can be confusing. It is suggested to get all your doubts cleared before purchasing a health insurance policy. You can get clarity on your queries by calling the insurance company or sending them an email. The sooner you buy health insurance for senior citizens the better it is in terms of the coverage and insurance premium.

( By Biresh Giri, Appointed Actuary, Head of Product Development & CRO, Acko General Insurance)

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