After a life dedicated to a career or caring for the family, during your golden years, you deserve to be indulged. Your life should be all about pursuing a more relaxed daily routine with enjoyable hobbies and rejuvenating vacations from time to time. In the event that you need medical treatment, it should be a comforting, nurturing experience, without any concerns about affordability. Having health insurance makes that possible.
Missed the bus?
In their younger days, a number of people tend to commit the oversight of not purchasing their own health insurance policy since they are insured by their employer. This culminates in a situation where, after they retire, they do not have health insurance cover when they need it the most.
Fortunately, the IRDAI has instructed insurance companies to permit the purchase of a new senior citizen health insurance plan up to the age of at least 65 years. It also insists that if a senior citizen’s health insurance proposal is rejected, the company is bound to offer valid reasons for the rejection in writing. Further, the insurance sector regulator has advised that an insurance company cannot decline the renewal of any senior citizen health insurance scheme except in on the grounds of misrepresentation, moral hazard or fraud. It has also insisted on certain allowances for senior citizens, such as the option to alter their TPS anywhere feasible.
Making the right choice
Against this backdrop, almost every company in the health insurance industry has a policy crafted for senior citizens. So, how do you decide what policy is best for you?
Here are five factors that you should pay attention to while purchasing senior citizen health insurance…
- Coverage: Ideally, the higher the coverage you opt for, the better. However, there is a direct correlation between the premium that you have to pay and the coverage that you receive. However, some companies will offer to cover more than the basic hospitalisation and pre-and post- hospitalisation expenses. They offer you a consumable allowance, allowance for a companion, domiciliary hospitalization, dialysis cover, and other add-ons. So, ensure that you get the best value for your money.
- Flexibility: Some policies allow you to recharge the sum insured, up to 100% of the original SI if the amount gets exhausted. At a different level, some companies allow you to purchase a policy for a tenure of 1-3 years. Look for such options that build useful flexibility into your plan.
- Co-Payments: Senior Citizen health insurance policies usually have a co-payment clause. This means that the insured has to bare a portion of the claim amount (as specified in the policy). While IRDAI has stipulated that at least 50% of the pre-insurance medical investigation cost must be reimbursed to the senior citizen, look for a policy that gives you the best deal.
- Maximum Age to Renew: This differs from issuer to issuer but there are companies that offer ‘Lifelong renewal’. When you choose an insurer, look for such options.
- Pre-existing illnesses and waiting periods – This may be the most important factor to consider since most companies have a waiting period before they cover pre-existing illnesses and some do not cover them at all. Naturally, the lower the waiting period the better and in case you do have pre-existing illnesses, as defined in the policy, ideally they should be covered, at least eventually.
- Simple Claim Process – This factor is relevant, irrespective of what age you are. Make sure you understand how the claim process works, in advance, so that you do not lose time or effort following up on a claim.
(Disclaimer: Writer is Anuj Gulati, MD & CEO, Religare Health Insurance. Views expressed are a personal opinion.)