A senior citizen health insurance plan is, undoubtedly, the best way to protect your life savings during a planned treatment or medical emergency. However, at times, the plan may not have enough coverage for complete financial protection. For instance, you develop a critical or life-threatening illness like cancer. The senior citizen plan will cover the expenses, but it will not be sufficient because of the exorbitant treatment costs of cancer. To meet the additional expenses, you must opt for critical illness insurance add-on cover. Apart from this, there are many other add-ons for enhancing insurance coverage.
A senior citizen insurance policy caters to the medical needs of individuals aged 60 and above. Post 60, our immunity and metabolism weaken, making us susceptible to health issues, infections, or injuries that require immediate or regular medical attention. Given the rising healthcare expenses, a senior citizen health plan can safeguard our life savings during medical emergencies or planned hospitalisations. Without a health insurance plan, your retirement funds can get wiped out in footing exorbitant medical bills.
Add-ons enhance the coverage of your standard health insurance plan. These offer additional protection or benefits you can opt for by paying an additional premium. The add-on comes in handy when your health insurance plan isn’t adequate to cover the expenses. Critical illness insurance, OPD cover, hospital daily cash allowance, room rent waiver, etc., are some add-ons that can be beneficial.
Senior citizens are more vulnerable to critical or life-threatening illnesses due to their age and weak immunity. These ailments require extensive treatments costing several lakhs, and a standard health insurance plan will be inadequate to meet the expenses. But, with critical illness insurance, you will be compensated with a lump sum amount if you get diagnosed with a covered critical illness, no matter what the actual expenses are. The insurer will not ask for any bills but only proof of the diagnosis. For instance, if you have a critical illness rider of INR 20 lakhs and get diagnosed with a critical ailment, the insurer will pay the full amount as compensation even if your total expenses come to INR 15 lakhs. You can utilise this amount for medical as well as non-medical expenses, such as paying off debts, day-to-day expenses, lost income, or children’s education. However, there is a survival period to claim compensation, i.e., the insured must survive a certain period after being diagnosed with a critical ailment like stroke, cancer, paralysis, kidney failure, etc.
Pre-existing diseases (PEDs) are those medical conditions you have been diagnosed with 48 months prior to buying a health insurance policy. Insurance providers impose a waiting period of up to 3 years for PEDs like diabetes, heart ailments, hypertension, etc., and if you raise any claim during the waiting period, the insurer is not liable to cover the expenses. It will be your out-of-pocket expenses. Some insurers offer the option of a waiting period waiver or reduction in the waiting period, but you have to pay a high premium. Considering the rising healthcare costs and that most senior citizens have PEDS, opting for this rider is necessary.
This rider allows you to choose a room with higher or no sub-limits without worrying about the additional costs. Health insurance plans have a cap or sub-limit on hospital room rent, and if your room rent exceeds the cap, you have to pay the difference. With this rider, the cap is waived off and the rent is applicable up to the sum insured.
While buying a senior citizen insurance plan, here are some factors you must consider –
This is the maximum amount you can claim during a policy year. Since senior citizens are at an increased risk of developing age-related illnesses, ensure the sum insured is sufficient to cover multiple hospitalisations in a year. A high sum insured will minimise your out-of-pocket expenses.
Look for plans with affordable premiums.
Check the waiting periods for PEDs and specific ailments. Opt for a policy with shorter waiting periods or waiting period waivers.
The more exhaustive the list of network hospitals, the better it is for you. Ensure there are good network hospitals close to your location so you can get immediate help during emergencies.
Look for a policy that provides extensive coverage for hospitalisation, pre- and post-hospitalisation, daycare procedures, domiciliary care, AYUSH treatment, free health check-ups, etc.
Before you go ahead with the purchase, don’t forget to check the reputation of the insurance company from customer reviews and ratings. This will give you an idea about the insurer’s performance. Also, check the insurer’s claim settlement ratio.
Add-ons or riders are particularly beneficial for senior citizens or those with chronic health conditions requiring regular medical care and attention. There are many add-ons you can buy based on your medical needs and affordability. However, it is recommended to choose only those which are crucial for senior citizens as riders come with an additional cost.
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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