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Top 10 Factors to Consider When Buying a Senior Citizens Health Insurance Plan

According to a survey, only 18% of a sample set of 998 senior citizens between the ages of 60 – 70 years have health insurance in India. (Source: Indian Parental Care Survey) Due to the complicated process and inability to distinguish between what they want and what is being given, senior citizens often steer clear of purchasing a health insurance plan. People often fail to read the fine print, which might cause issues when making a claim as senior citizen health insurance has a variety of clauses. Therefore, before making a decision, it is important to read and fully understand the policy.

Why Should Senior Citizens Purchase Health Insurance?

A study published in 2017 found that less than 1% of senior citizens have health insurance in India. (Source: Times of India) As we age, our health also gets a little bit more fragile. This implies that medical problems might show up unexpectedly and subsequently may require expensive treatment, which can burn a hole through your finances. Additionally, critical illnesses might sneak into your life as you age.

With high costs due to inflation, it can be challenging to pay for medical expenses, and the elderly may not get the treatment they require. The simplest solution to this problem is to buy comprehensive health insurance or a critical illness insurance plan with a high sum insured, allowing prompt attention to any medical emergencies.

Understanding Senior Citizen Health Insurance Plan

Age is accompanied by deteriorating health, physical difficulties, and financial constraints. Therefore, having comprehensive health insurance is imperative to cover medical costs during the so-called “golden years.”

A Senior citizen health insurance plan delivers a one-stop solution to people 60 years of age or above. These plans, which provide health insurance coverage to anyone over 60, have been a blessing for a significant part of India’s elderly population.

Things to Consider When Purchasing Senior Citizen Health Insurance

1. Inpatient Hospitalization Coverage

When a policyholder is hospitalized for a period longer than 24 hours, the insurance company pays for their inpatient hospitalization and any associated medical costs. It pays for all hospital costs, including those for nurses, doctors, specialists, and medications.

A few senior citizen health insurance policies on the market have cost caps. For instance, certain plans include inpatient hospitalization but pose sub-limits on doctor charges. As the number of people requiring hospitalization for a senior citizen is getting higher day by day, it is crucial to look for a senior citizen health insurance plan that provides the maximum inpatient hospital coverage possible.

2. Restrictions on Post-Hospitalisation Costs

When a policyholder gets discharged from the hospital, he gets reimbursed for any costs incurred that are directly related to the illness or injury they had inflicted. Post-hospitalization eligibility often lasts 60 to 90 days. Nonetheless, the period after hospitalization is cut short for various senior health insurance plans.

3. Limitations on Day-care Hospitalisations

The hospital offers procedures, including cataract surgery, hemodialysis, chemotherapy, etc., that can be finished in less than 24 hours. Even though numerous senior daycare centers accept health insurance, specific plans have restrictions on how frequently these costs can be claimed. Depending on the plan, there might be eight to ten daycare claims available.

4. Conditions Regarding Pre-Existing Illnesses

When we get older, there’s always a chance of one or more pre-existing conditions. Therefore, when purchasing a policy, carefully read the terms and conditions about pre-existing illnesses. Determine which pre-existing diseases are covered, each condition’s waiting periods and any co-payment clause.

5. Compare the Premium Amount with the Benefits of the Plan

Compared to the policies curated for young people, the premium for health insurance for senior citizens is relatively higher. As a result, when searching for senior citizen health insurance, look for a plan that delivers more benefits for the premium you are paying rather than one that offers a lower cost.

Additionally, some insurance providers have started accepting monthly premium payments, easing the pressure of making one large payment at once.

6. Sum Insured

The sum insured under any policy should only be chosen after considering particular aspects, such as medical inflation and your current health. Since it is pretty challenging to increase the sum insured after the insurance has already taken effect, take your time determining the policy’s sum insured.

7. Select a Plan with a Low Waiting Period

Some pre-existing illnesses necessitate policyholders to wait it out. This implies that an individual might have to wait a bit longer to file claims for a specific disease. Since this is a crucial factor, you must conduct thorough research and compare insurance to determine the waiting period so that you don’t have to deal with any issues down the road.

8. Unlimited Sum Insured Restoration

Medical emergencies can happen to an older person at any time. As a result, you must have the option of restoring your insured sum as often as you’d like. These conditions could necessitate frequent hospitalizations. This will not only provide you peace of mind, but it will also safeguard your financial stability.

9. Check for Wide Network Coverage

Always remember to enquire if your insurance provider has a wide network of affiliated hospitals. In addition, make sure these hospitals specialize in providing medical care to senior citizens; if so, there is nowhere else to go. Finally, check that these hospitals provide cashless services.

10. Check for Deductibles

Although your insurance covers most medical procedures and costs, some expenses are excluded. They are referred to as deductibles. For instance, your insurance will cover the costs of the operation theater and the doctor, but not all of the surgical supplies used there, such as cotton pads, rubber gloves, or syringes. Each insurance company has different deductibles for different policies. Therefore, discover what the deductibles would be before submitting a claim.

Growing old doesn’t have to be all about being dependent on someone to take care of you! By choosing a senior citizen health insurance  plan, you can safeguard your life journey by ensuring your medical needs are met thoroughly. Also, keep this checklist in mind when choosing a plan that suits your needs.

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

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