Rising healthcare costs are a major concern for everyone. With the massive increase in lifestyle-related diseases, hospitalizations seem to be inevitable for everyone. The increasing healthcare costs, weakened immunity and the vulnerability of elderly parents to their medical conditions can have a financial and emotional effect on the whole family. Especially, elderly people especially need good healthcare and medical facilities to give them comfort and ease in times of illness. A good health insurance policy will assure you of that.
If you are looking to buy health insurance for your elderly parents, our checklist will be a good starting point. Our article lists important tips and tricks to help you choose the best health insurance policy for senior citizens. So, let’s begin!
As there are many different types of health insurance policies available for senior citizens, it is important to look for an individualised coverage plan that addresses various needs in old age rather than just the affordability of the premium.
Health insurance policies are a great way to meet your medical expenses. They cover a host of illnesses and treatments while also giving you benefits like daily cash benefits, daycare treatment coverage, attendant expenses, alternate treatment coverage and many more.
A good health insurance policy is necessary to ensure that you are able to give complete attention to your ailing parents and not worry about the financial part of it all.
1. Coverage offered by the Plan
A health insurance policy is a legal agreement. The insurer is required to pay for the expenses of medical treatment, as laid down in the agreement. They are also not a liability to pay you anything that is not part of the agreement. So you should make sure that your policy covers most treatments and costs associated with elderly healthcare. The medical needs of an elderly person are different from that of the younger generation. So make sure that the policy is suitable for your elderly parents.
2. Consider the Health History of your Parents
Naturally, when getting a health insurance policy for your elderly parents, you will be required to mention their complete medical history. This allows the insurer to generate an accurate health cover policy that covers their existing illnesses. This also helps you to get the appropriate cover in case of future medical treatments for their illnesses.
Most health insurance policies have a waiting period on existing illnesses. You have to know the terms for existing illnesses so that you are able to process the claims quickly.
3. Check the Co-Payment Clause
In a health insurance policy, the customer is required to bear a percentage of hospital expenses. The share is based on various conditions, which must be clearly understood by the policyholder when buying the policy. The share of approved claims may vary from 10% – 50%, which may become a burden at times. It is good to be on top of such information so that you are not in for any surprise at the time of claims.
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4. Waiting Period
This is another important clause in every health insurance policy. All health insurance policies have a stipulated waiting period on pre-existing illnesses and a few other ailments. The waiting period is mostly 2 years for pre-existing illnesses. But for senior citizens, the insurer may give a lower waiting period. It is better to get a policy with a minimal waiting period so that elderly parents get immediate medical attention.
5. Coverage for Out-Patient Treatments
With advancements in medical technology, many procedures are now being done as out-patient treatments, which are generally not covered in health insurance policies. But health insurers have come up to speed and started covering most of the treatments that are now done as out-patient treatments and do not require hospitalization. More than 50 such outpatient treatable ailments are covered in health insurance these days. Ensure that your policy covers these.
As mentioned earlier, it is very important to know what is and what is not covered under your policy. You can then match it with your requirements to see if you are getting complete coverage. Health insurance policies have something called ‘Exclusions’, which means they do not cover certain illnesses or conditions. For example, congenital illnesses, like body part deformations, or heart diseases are not covered. Dental expenses and plastic surgery is also excluded in many health insurance policies. So, knowing what is excluded from your policy helps you to plan for the expenses accordingly.
7. Know the Deductibles
Though your policy covers most treatments and medical expenses, they do not pay for certain expenditures. These are called deductibles. For example, your policy will pay for operation theatre and anaesthetist fees but will not pay for some of the surgical items used there, like rubber gloves or cotton pads or syringes. This differs from insurer to insurer. So, before applying for a claim, find out what the deductibles would be.
8. Learn more about pre and post-hospitalization coverage
Most health policies pay for expenses incurred before and after the medical treatment. These expenses should be related to the said procedure or surgery you underwent and shall be reimbursed upon producing all relevant bills and prescriptions. Most health policies shall pay for 30 days of pre-hospitalization and 60 days of post-hospitalization expenses. This again differs from insurer to insurer. So check with your insurer before raising your claim so that you can get the amounts reimbursed.
9. Find out the sub-limits
We would mostly go for a family health policy where we can include our elderly parents; this is called a family floater policy. In such cases, find out the sub-limits, or the number of times a policyholder can claim for a particular illness/treatment in a given policy year.
For example, the policy might allow only one cataract surgery per year, or a specific percentage of the sum insured towards a kidney transplant, or only a certain number of kidney dialysis allowed per month. You need to ensure that the policy gives adequate coverage to meet your needs.
10. Full Disclosure
This is very important in terms of health insurance. When buying health insurance or while registering a claim, ensure that you give accurate information and genuine documentation. Any incorrect or fraudulent information could lead to rejection of the claim and ultimately termination of your health insurance policy. Insurers have a panel of doctors and medical professionals who will scrutinize your claim before approving it. It is always wise to provide only correct information on your policy and your claim application.
Health insurance policies can be advantageous because they cover a variety of medical bills for our elderly parents. Ensure to pay extra attention to the claim procedure for senior citizens' health policy, since the policy features of the senior citizens' health insurance are likely to vary. Read your policy document carefully and understand all the terms clearly before purchasing it. This makes sure that your claims are not rejected.
- Are senior citizens’ health policies costlier than regular health policies?
Definitely yes, because elderly people are more prone to health issues compared to the younger generation. So the premium is accordingly higher for them.
- Are there health insurance policies specifically designed for elderly parents?
Yes, there are many in the market. Some leading senior citizen health insurance plans are - Star Health Red Carpet, National Insurance Varistha Mediclaim, Oriental Insurance HOPE, Bajaj Allianz Silver Health, New India Assurance Health Insurance and more.
- Do senior citizen policies have more exclusions than normal policies?
That doesn’t seem to be the case. Senior citizens’ policy would also list the same type of exclusions as any other normal health insurance policy. It is always better to check with the insurer in this regard.
- What are the entry and exit ages for senior citizens to get a health insurance policy?
People over the age of 60 are considered senior citizens and the maximum entry age for such policies would be around 70 years. Some insurers even allow till 80 years of age.
- Is a minimum 24-hour hospitalization required to raise a claim?
No, that is not necessary. If the procedure was just an OPD procedure, and it is covered under the policy, you can raise a claim without the 24 hours’ hospitalization.