With age, health issues and frequent medical visits become usual. Unfortunately, sedentary lifestyle taking a toll on our health, making it difficult to lead a healthy life and by the time one reaches his old age, the issues turn unmanageable. Not to forget, the healthcare expenses are getting expensive in India day by day, making it imperative to have a health insurance plan. As in post-retirement phase, people become more vulnerable to illnesses, it is essential to be covered with a senior citizen health insurance plan. However, minimum knowledge and some prevailing myths have prevented them from getting the much needed coverage they actually deserve. Let’s debunk a few health insurance myths and let them enjoy their golden years without going through the anxiety associated with the exorbitant cost of healthcare today.
There are a number of common myths with respect to health insurance for senior citizens. We will discuss these myths in this article and will logically contradict them:
This used to be a common reason for senior citizens not purchasing health insurance. Until recently, many health insurance companies had a maximum age for entry into their plans. However, as per new rules issued by the Insurance Regulatory and Development Authority of India (IRDAI) on April 01, 2024, the age cap for purchasing health insurance policies has been removed, thereby granting wider access to healthcare coverage. Now, age is no longer a barrier in purchasing a good health insurance policy for yourself.
Not purchasing a health insurance policy just because you feel that you are healthy is an extremely short-sighted view. You may be healthy today, but what is the guarantee that you will not fall ill tomorrow? As you age, your vulnerability to illnesses and injuries increases. A medical emergency may occur out of the blue and medical insurance is the only way to ensure that you get access to quality healthcare and also preserve your life’s savings for your golden years. A proper health insurance policy will cover not only your hospitalisation costs but will also reimburse you for your pre and post-hospitalisation expenses and ambulance expenses. It will also pay for domiciliary treatment and alternative treatment such as AYUSH.
Personal savings are your financial security in the golden years of your retired life when there is no or minimum source of income. You have created a corpus with a lot of financial planning and sacrifices. And even if you have planned to cover your health expenses with your personal savings, they may get wiped out or may even not prove to be enough in case of an illness or treatment requiring extended hospitalisation.
India’s medical inflation rate at 14 per cent, is the highest in Asia and higher than the average of the world, which is at 10.7 per cent for the equivalent period. Planning to see the rest of your life through based on your savings only is not a wise move, as you may be left with nothing to fall back upon. Financial problems and debt are not things you deserve to be burdened with at this stage in life. A comprehensive medical insurance policy with a proper sum insured in keeping with your medical requirements will safeguard your health as well as your accumulated corpus.
Health schemes sponsored by the government are, as the name suggests, basic in nature. You need a comprehensive health insurance policy with a sum insured and coverage personalised as per your health requirements. A basic government health scheme will not be enough to cover the exorbitant medical expenses and thus, leaves you underinsured at the time you need it the most.
There is no doubt that a comprehensive family floater plan with the proper add-on riders does provide you with good coverage. However, as you grow older, your immunity decreases, and you risk falling ill more often. The treatment is often one over longer periods and is expensive. A family floater plan provides health insurance coverage to all the members of your family, and the sum insured is shared among all members. Obviously, if one or more members of your family require hospitalisation, then the cover will get used up. In such instances, you may have to end up paying a major portion of your medical bill out of your own pocket. Also, as a senior citizen, you may need more medical care or even special medical treatment. All this will again exhaust the sum insured in your family floater. It is ideal that you have at least one separate policy for yourself as a senior citizen.
Note: The premium of a family floater policy is determined by the age of the oldest member covered. It is often more economical to have a separate health insurance policy for a senior citizen as the age factor may increase the premium for the family floater plan as the overall sum insured is higher there, and the underwriter will consider the entire sum insured from the point of view of the age of the oldest member of the family.
You may be covered by the group mediclaim policy provided by your children’s employer. The problems here are similar to those faced in a family floater policy. Most employer-provided group mediclaim policies have a fixed sum insured for all the members covered. In case you fall ill and exceed the limits of the policy, you or your children will end up settling the remainder of your medical bills out of pocket.
Note: There is one major advantage in adding senior citizens to an employer-provided group mediclaim policy. The senior citizens are added to the policy without any medical tests, which in the normal course of issuance of a policy could have led to the discovery of conditions leading to the underwriters increasing the premium or in the extreme case, even rejecting the issuance of the new policy. Also, the policy coverage becomes null and void immediately afters the employee leaves the organisation.
As you grow older, you are more vulnerable to age-related illnesses, and the premium for your health insurance policy may seem to be on the higher side. However, if you choose a comprehensive policy that is in line with your medical needs, you will save more in the long run. A sudden hospitalisation without a health insurance policy or with inadequate mediclaim coverage may cripple you on the financial front or, worse, bring you to a situation where you can no longer afford to pay for your treatment.
Care Health Insurance has Care Senior , a comprehensive health insurance policy with a zone-based premium. If you reside in Zone 3 as defined by the insurer, which covers a major part of the country, you will benefit from lower premiums.
A huge advantage offered by this policy is no co-payment in case of treatment at centres in higher zones. It also offers you the facility of a 100 per cent recharge of the sum insured once every year without the 45-day waiting period for multiple hospitalisations by the same person for the same disease or injury.
The policy also offers annual health check-up facilities, AYUSH coverage, up to 50 per cent increase in sum insured with No Claim Bonus (NCB) and optional add–on benefits of up to 150 per cent increase in sum insured with No Claim Super Bonus and Care Shield for coverage of 68 non-payable items.
Gone are the days when buying a health insurance policy felt like you were being forced to perform a major life task. Buying health insurance today is easy, and the process can be completed using your smartphone or your computer from the comfort of your home as well.
Pro Tip: Care Health Insurance offers you a discount of 7.5 per cent and 10 per cent on your premium if you pay for 2 or 3 years together respectively.
One of the most common misconceptions is that a health insurance policy for senior citizens will not cover their pre-existing diseases and conditions. This is incorrect. Pre-existing diseases and conditions are covered after the mandatory waiting period. You need to read the terms and conditions of your policy in detail to understand the waiting period applicable for particular diseases and conditions. The good news for senior citizens is that IRDAI has changed the rules for the waiting period for pre-existing diseases effective April 01, 2024, and has reduced the waiting period from 48 months to a maximum of 36 months.
Pro Tip: Care for Senior Citizens from Care Health Insurance offers you the optional add-on benefit to reduce the waiting period for pre-existing diseases to 2 years. This policy also comes with the feature of no pre-policy medical check-up.
This is probably the biggest misconception with regard to health insurance policies, especially those for senior citizens. It is crucial for you to go through and understand all the applicable terms and conditions of your policy both before and after purchasing it. Reading the fine print of the policy is extremely important. Every policy may differ in terms of inclusions, exclusions, coverage, limits, sub-limits, network hospitals and terms and conditions. It is always advisable to understand everything beforehand rather than regret the situation at the time of making a claim and facing delays or rejection.
Now that you have read about all the myths associated with health insurance policies for senior citizens and have also learned the truth behind them, you are in a position to make an informed decision while purchasing a policy for yourself or for your parents.
Make sure that you find the best fit in terms of your medical requirements and what is offered by the health insurance company. Purchase optional add-on benefits to customise the policy.
>> Also Read: How to Provide Best Healthcare Support to Your Parents?
Disclaimers: The above information is for reference purposes only. For more details about the health insurance plans and their benefits please refer to the sales prospectus, policy terms, and conditions.
Published on 2 Dec 2024
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