Knowledge Centre

Choosing Right Health Insurance Plans For Different Life Stages ?

A recent study at one of the Fortune 100 Company shows, 80% of their employees’ intent to go with a health cover that did not match their needs for at least a year. That is the general policy term!

You can always select and upgrade your  health insurance  plan at each renewal, so think as short as 1-2 year when choosing a plan. Also, continuous renewals earn cumulative bonuses, reserve benefits, discounts, no more waiting periods and countless other perks, so think as long as lifetime, in parallel.

This reveals, people need simpler choices to nudge them towards buying health insurance plan that suits their needs.

At what life stage are you?

1. Young & Single in 20s

2. Hitched & Expecting in 30s

3. Family Man in 40s

4. Empty Nesters in 50s

5. Retired and Relaxing in 60s

The definition of good health will change for you at each stage of life. Reviewing your health cover with time and age can ensure you get 360-degree protection.

Young & Single in 20s

Ask yourself these 5 questions to determine the basis of your decision:

1. Am I staying with parents?

2. Can I afford a deductible plan?

3. My budget for health insurance premiums?

4. How often will/may I show myself at doc’s clinic in a year?

5. I prefer a particular doctor, hospital, or treatment (say, AYUSH).

#1 Footloose and fancy free individuals of up to 26 years of age

Is it time to head out on your own?

You have been on your parent’s plan so far and soon if not yet you will have to look out for yourselves. You are in your 20s that means good health, few liabilities, and advantage of time & long future. Maybe you are questioning the need of health insurance.

Don’t forget the low health risk at this age means big health cover in small premium costs. Also, your parents are getting old, you may need to swap roles with them and soon start taking care of them.

As soon as you settle into your first job, is the great time to consider buying an independent health insurance policy. Reasons exist in plenty, like tax benefits, Stay Fit rewards, hospitalization & emergency cover and others.

#2 Career focused individual at 26+ years of age

Well, current law makes this decision for you easier. As per current India laws, children of up to 26 years only of age can stay on parent’s health insurance plan. Your parent’s health insurance plan won’t cover you henceforth.

At this age you may be rising up your career ladder, changing teams, shifting jobs, paying your education loans, paying taxes, doing long exhaustive working shifts. There is no time to get sick, ignore health, and definitely not have your health cover up to date.

It can’t be without reason that 75% of youngsters  buy health insurance  to save taxes. But saving premium should not be primary here.

Remember, you can’t rely on your company cover as it ceases with your association with the company. You don’t have savings or a partner’s income to rely upon and meet rising costs of healthcare all at once. A high deductible plan may be cheapest but can you risk bearing the entirety of that deductible in one go? For a young solo soul, deductible health insurance plans are cheap only until they are not.

If you have a doctor or hospital you prefer for medical aid- Most health insurers have their own network of hospitals, check the network hospital & clinic lists you make an informed decision.  Then, choose a plan that includes your preferences or offers out-of-network coverage.

Hitched & Expecting in 30s

Ask yourself these 6 questions to determine the basis of your decision:

1. What are the benefits and drawbacks of combining our health insurance plans?

2. Does the network hospital list include mine & my partner’s doctor?

3. How often will/may I show myself at doc’s clinic in a year?

4. My budget for health insurance premiums?

5. Can I afford a deductible plan?

6. Are we willing to switch providers if some aren’t in the network?

#1 I'm getting married

Soon you will have someone to care & be cared from. As your priorities change from considering your personal health requirements to that of you and your partner, you should reconsider your health insurance plan. Consider your unique and combined needs, carefully.

If you and your partner prefer different doctors, may be you want to keep your individual plans for now, choose a doctor. This is great time to move to add a deductible plan to cover yourself and your better half. Choose the co-payment or deductible equal to the base sum insured of your primary cover to have sufficient cover for both of you.

Take time, compare to do cost benefit analysis as co-payment & deductible plans have higher premiums for family plans as compared to the individual plans.

#2 I’m expecting (or expecting to be expecting)

Maybe you will plan and have kids soon. Delivery expenses, regular diagnostic checks, preventive measures lie soon ahead for you. A family floater plan, and maternity benefit can now top your list of preferences at this stage. Maternity benefit comes with a waiting period generally, so make sure you plan with maternity benefit as soon as you start considering to have kids. As number of family members and people to be insured increases, your out-of-pocket expenses and premium costs will follow. High deductible plans may offer great long term value but it become cost-prohibitive with new expenses and responsibilities.

Some question why they even have health insurance; others may know they have prescriptions to fill on regular basis. And latter is the stage that comes for all. It’s time to consider and get ready for long haul. Children are more vulnerable to health risks in its early days.  With growing age will shrink your good health guarantee. So, it’s time to consider illness specific health insurance plans.

Predicting your health care needs, and comparing them to the available plans saving potential may help you make an easy call.

Family Man/ Super Dad in 40s

Ask yourself these 6 questions to determine the basis of your decision:

1. Is my child in college covered for specific healthcare needs?

2. Does the network hospital list include mine & my partner’s doctor?

3. How often will/may I show myself at doc’s clinic in a year?

4. My budget for health insurance premiums?

5. Can I afford a deductible plan?

6. Will I choose one family doctor or many?

Once you have kids, you may have a pediatrician for your kids, a primary care provider for yourself or even a specialist. The first consideration is to check all these doctors in the insurer network and choose a plan that gives you access to any doctor you choose.

If you kid is going for college, consider a health insurance cover with network hospitals in the close vicinity. Do your kids have any specific allergies, play sports, or study quite far from home, match coverage for unique situations and family needs to avoid emergencies.

If you do the math right and your insurer’s premium calculator may come as a handy tool in the process, you can save big and have an excellent healthcare for you and your loved ones.

Empty Nesters in 50s

Ask yourself these 5 questions to determine the basis of your decision:

1. Should I keep my child on my health plan?

2. Does the network hospital list include mine & my partner’s preferences?

3. How often will/may I show myself at doc’s clinic in a year?

4. My budget for health insurance premiums?

5. Can I afford a deductible plan?

Once your children turn 26, you can’t keep your kids your kids on your health insurance plan, even if you want to. Don’t worry! If not already, soon your children will start making their own living, head out and opt for their own plans.

As soon as the expensive  family health insurance plans  step off your door, it’s homecoming for your individual health insurance plans. Blood pressure, diabetes, allergies, critical illnesses have already knocked at least some of doors you know and you have seen the consequences. It’s time to gear up your health insurance so that you kids won’t have to compromise on their dreams. Also, you may seek medical care for different reasons at different places. If you have family history of diabetes you may need a diabetes health insurance plan.

By now, you may have a clear idea of your health care needs, the regular doctors you have visited for years. Closely look at you coming lifestyle plans, does your job require you to travel to different locations, or do you plan to spend a part of your winter upstate. Get a plan that covers you there where your life takes you.

With increase in age, increases health risks and quality medical care is getting expensive every day. This means your  individual health insurance plans  premiums will be higher than they used to. Going with above given 5 questions, you will see your medical needs have increased as well. Great coverage will sound better to a wise man’s ear than a cheap health insurance plan.

Get ready to go tough. While saving more was your priority when you were young, it’s not as important anymore. Just avoid picking the most expensive plan because it has the richest coverage. Don’t be over-insured. Don’t choose a low deductible or co-pay for high premiums if high deductible and low premiums will do for you right now. That is only if you are healthy and don’t incur many medical expenses.

Check your medical needs and choose a plan that covers you enough. In simple words, make sure you are not forced to take out from your retirement savings.

Retired & Relaxing in 60s

Ask yourself these 6 questions to determine the basis of your decision:

1. Should I keep my child on my health plan?

2. Does the network hospital list include mine & my partner’s preferences?

3. How often will/may I show myself at doc’s clinic in a year?

4. What health insurance premiums can I afford lifelong?

5. Which plan offers me the best cost to needed benefits?

Not every insurer will be willing to insure you in your 60s. You can buy health insurance plan only if you are below 65 years of age with  HDFC ERGO Health . The health insurance plan you choose at this point in life is the one that is going to be with you for the rest of your life, in good or bad, sickness and health.

Your retirement may cease your employer’s health insurance coverage. You may be living off your lifelong savings. Check out for senior citizen plans,  critical illness cover , disease specific policies, top-up plans, and decide upon a combination for the best coordination of benefits. Perform a cost to benefit analysis before you commit to multiple health insurance plans. If things go south, know what plans you can afford to drop without losing complete coverage.

For example, if you have a plan with high deductible and you end up consuming good part of your savings on a premium health insurance plan, you may not be able to pay the deductible and benefit from your health insurance cover when the time comes.

Keep close with your doctors, at this age it is inconvenient and as well as ill advised to switch from your regular doctors or specialist. Your doctors have your complete medical history and understand your needs just as good as you. So stick with the plan that has all your doctors’ in-network. Weight the financial savings vs. loss of convenience and ask for recommendations from your doctors, if you need to.

Top-of-the-line, expensive health insurance plans may not best suit the senior citizens.

Life expectancy has increased and adults are living longer and happier, of course with the effects of ageing like chronic ailments, weak vision and hearing ability, constipation, fluctuating blood pressure levels, diabetes, cholesterol, knee replacement surgery and similar. That means multiple prescriptions.

Bottom Line

Consider plan features and renewal benefits while buying or switching between health insurance plans at all stages of your life. The general list of things to consider includes cost-benefit analysis, choice of doctor, savings, or the level of complexity you can sail with.


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