When to Make the Switch from an Individual Plan to a Senior Citizen Health Plan

Posted on: Jan 23, 2025 | 3 mins | Written by: HDFC ERGO Team

When to Make the Switch from an Individual Plan to a Senior Citizen Health Plan

Imagine you are all set for your life post-retirement and have decided what hobbies you will pursue and how you will spend time with your family members and friends. To ensure that there are no health issues that may derail your plans by introducing hefty medical bills, you revisit the coverage of your health insurance plan. You figure out that you need to increase the scope of your coverage. You contact your insurance provider and find out you will have to pay a significantly higher premium. On further exploration, you learn that your age plays a significant factor in determining the premium and that you should now switch to a senior citizen healthcare plan.

What is an Individual Health Insurance Plan?

An individual health insurance plan is a type of insurance policy that covers the medical expenses of a single person. Unlike a family floater, the sum insured cannot be shared among other family members but is dedicated to the policyholder solely. Individual health plans are ideal for people with chronic illnesses or the elderly who require extensive coverage. You can customise the plan as per your health needs.

What is a Senior Citizen Health Insurance Plan?

A senior citizen health insurance plan is specially curated for the healthcare needs of people above 60 years of age. With age, senior citizens become vulnerable to illnesses and injuries that may require immediate or regular medical care. With medical services getting more expensive by the day, any hospitalisation (emergency or planned procedures) can drain their lifetime savings. Having senior citizen insurance ensures their savings remain intact and they receive the best medical care without worrying about the costs. It provides them financial security against a range of age-related medical conditions and treatments common at this age. It offers several benefits, such as coverage for pre-existing diseases and chronic illnesses, preventive health check-ups, AYUSH treatments, etc.

When Should You Move from an Individual Healthcare Plan to a Senior Citizen Health Plan

Switching to senior citizen insurance when you enter the golden age is advisable because such plans are specially designed for people aged 60 and above. After you turn 60, the immune system becomes weak, your medical needs increase, and you may require regular medical care and attention. Spending your lifelong savings on hospital bills is not a wise idea, as your savings can get wiped out in a few hospitalisations due to rising healthcare expenses. So, when a senior citizen health insurance plan can take away your financial burden, why not make a switch at the right time? These plans are also tailored to cater to age-related health risks.

Factors to Consider While Switching to a Senior Citizen Health Insurance Plan

While switching to a senior citizen health insurance policy, you must focus on the following factors to ensure adequate protection –

1. Comprehensive Coverage

Look for plans which offer comprehensive coverage, including hospitalisation, pre- and post-hospitalisation, emergency ambulance cover, daycare procedures, domiciliary care, preventive health check-ups, AYUSH treatment, etc.

2. Network hospitals

Opt for an insurance company with a wide network of hospitals to avail of cashless treatments. Check for network hospitals in your location to receive quick medical help during emergencies.

3. Sum insured

This is the maximum amount you will receive from your insurer during a policy year. As senior citizens are prone to illnesses, you must buy a policy with a high sum insured to cover your health risks.

4. Premium

Senior citizen healthcare plans usually have higher premiums because of the increased health risks. So, you must compare various plans offered by different insurers and choose the one which offers good coverage at affordable premiums.

5. Waiting periods

As with all health insurance plans, senior citizen healthcare plans also come with a waiting period for pre-existing medical conditions and specific illnesses. Ensure you have checked the waiting periods, and if possible, opt for a reduction or waiver of the waiting period; however, remember that this comes with an additional cost.

6. Co-payment

Make sure you check the co-payment clause of the policy while comparing plans. The co-pay is the amount or percentage of the claim amount you must pay while the insurer covers the rest. The co-payment clause varies from insurer to insurer.

7. About the brand

This is a significant factor to consider. The brand must have a good performance record, high claim settlement ratio, and good customer service. Comparing plans based on existing customer reviews and ratings will help you find the best insurance provider.

Conclusion

The best time to switch to a senior citizen insurance plan is when you touch 60. However, before buying the health plan, you must research and compare various plans based on coverage, cost, benefits, inclusions, exclusions, network hospitals, etc., which will help you pick the most suitable plan.

Disclaimer: The above information is for illustrative purposes only. For more details, please refer to the policy wordings and prospectus before concluding the sales.

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