What senior citizens should check before buying health cover 


Senior citizens usually avoid buying health insurance due to the complex procedure involved and cannot comprehend what they need from what is being offered. They often miss read the clauses in fine print, which may lead to problems while filing the claim as health insurance for senior citizens involves various clauses. Therefore, it is essential to read and understand the entire plan before deciding.

Naval Goel, founder and chief executive, PolicyX.com, said, “Selecting suitable health insurance for senior citizens help get complete coverage at the time of emergency. Primarily the health insurance policy for senior citizens must have the maximum entry age and lifetime renewal so that they have uninterrupted medical assistance.”

“The method to select a policy for senior citizens is to go for a comprehensive health plan that can cover existing health conditions and acute diseases. The plan must offer the least waiting period and lowest co-payment to avoid expenses from own pockets. As they may require constant checkups and treatments, the policy should have OPD and domiciliary benefits as inbuilt for continuous medical support,” said Goel.

Let’s understand some of the critical things that you need to keep in mind when buying health cover in detail.

Know the sub-limits and coverage capping: Sub-limit is the monetary cap put in the form of a limit on the claim amount for specific medical procedures or expenses.

“Sub-limits can help you save money on your premiums, but on the other hand, they may also affect your claim. It is not advisable to go for a plan with sub-limits for senior citizens because you should ideally have a plan that approves your claim in full,” said Jayan Mathews, co-founder and chief product officer, Vital, an insuretech firm.

There are different waiting periods: Depending on the policy you choose and the health conditions, every insurance policy has a different waiting period which can vary from one month to four or five years.

Also, there is a separate waiting period applicable for pre-existing conditions before the cool-off period, which is around 1-4 years. However, if you go for a higher premium, a few insurance companies can offer a policy with no waiting period.

Select a combination of individual plans and top-up plans: Mathews said, “Considering the health condition of senior citizens and the increasing medical cost, availing a policy with maximum coverage is crucial. Therefore, opt for a combination of policies that offer different sums with super top-up plans to guarantee maximum coverage while still having a chance to control your premiums.”

Get a clear understanding of the policy inclusions and exclusions: As one age, they become more susceptible to health problems requiring frequent hospital visits.

Since the health risk increases, senior citizens’ health insurance comes with many terms and exclusions. It is essential to read the policy documents to understand the coverage and exclusion of specific health conditions.

Pre-existing health conditions: Any chronic illness or condition diagnosed in the preceding 48 months before buying a health insurance policy is known as pre-existing disease. While insurance coverage is available for many of these conditions like diabetes, heart conditions, hypertension, etc., providers are cautious about approving coverage.

Mathews said, “A pre-existing cover for an elderly person grows the risk manifold, making it even tougher to get a policy. Be prepared to undergo medical screening tests, pay much higher premiums and undergo a waiting period of 3-4 years if you are buying a plan for your parent who also has a chronic condition. You can, however, go for policies with day one cover, but you can expect those premiums to be exorbitantly high.”

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