Senior citizens should buy health plans with lifelong renewability option

Buy a plan with a short waiting period for pre-existing diseases and low co-pay

Once a person retires, he ceases to get the benefit of a group health insurance coverage offered by his office. Buying a normal health cover becomes difficult at an advanced age. The chances of contracting ailments, meanwhile, rise at a time when one’s regular cash-flows have stopped. Health care costs tend to spiral at around twice the consumer price index-based inflation rate. One option for those who have crossed 60 and are without a personal health insurance plan is to purchase a cover specifically designed for senior citizens.

Age-related ailments covered

Senior citizen plans are specially designed to include coverage for ailments more prevalent among the elderly.

“These products usually cover age-related illnesses like cataract, osteoarthritis, and joint replacement surgeries. They also cover pre-existing diseases that require recurrent admissions and medications regularly,” says Raghavendra Rao, chief distribution officer, Future Generali India Insurance Company.

These plans offer benefits, such as preventive health checks, for the early detection of diseases.

“Many insurers, such as HDFC ERGO Health, Care Health Insurance, and Niva Bupa Health Insurance, provide free annual medical health check-ups,” says Naval Goel, founder and chief executive officer, PolicyX.com.

Niva Bupa’s Senior First health insurance plan offers health check-ups from Day One and does not require mandatory pre-issuance medical tests. Buying a health cover makes senior citizens eligible for tax breaks.

“Senior citizens can avail of tax deduction up to Rs 50,000 on their health insurance premium,” says Rao.

Differently designed

These plans have a different design, compared to regular health insurance plans.

“They come with a co-payment (mandatory or non-mandatory) requirement, which helps to keep the premium rate under control. Regular health insurance plans usually don’t have this requirement. Senior citizen plans also have a waiting period for pre-existing diseases during which claims are not paid,” says Goel.

While regular health insurance plans come with lifelong renewability, this may not hold true for all senior citizen plans. 

“Some insurers provide covers with lifelong renewability,” says Aatur Thakkar, co-founder and director, Alliance Insurance Brokers.

Buy adequate cover

While deciding on the amount of cover, senior citizens must take into consideration both their health and the affordability.

“Given the way health care expenses are rising, a senior citizen must buy at least Rs 5 lakh of sum insured per individual. This should be complemented with a good super top-up plan,” says Thakkar.

Key checks to run

Many insurers have imposed restrictions on the entry age in their senior citizen plans, citing higher loss ratios. It is 65 in some, higher in others.  Check if you are eligible before you apply. Compare the waiting period for pre-existing diseases across plans. The shorter the waiting period, the better.

All senior citizen health covers may not offer lifelong renewability. Thakkar emphasises that this is a key criterion that must be checked. Also make sure that the major hospitals in your city, which you are likely to be admitted into, are included in the insurer’s network, so that you are able to avail of the cashless facility.  

Choose the senior citizen plan with the least co-payment requirement, so that the burden of sharing the hospitalisation bill is minimised.

“The co-payment requirement shouldn’t exceed 20 per cent of the total bill,” says Goel.

He adds that since older people may require medical assistance more frequently and continuously, the plan should cover outpatient department and home-care treatment.

Thakkar adds that besides buying a comprehensive health insurance plan, senior citizens should also purchase a critical illness cover for protection against the risk of dreaded diseases, which usually impose a high financial burden.

Finally, disclose all pre-existing ailments, medications you are currently on, and past treatments fully. Failure to do so could lead to problems at the time of claim settlement.