Things To Remember While Buying Health Insurance For Senior Citizens

As people age, the list of ailments increases and risk of repeated hospital visits are more. Now, even if your parents are covered under your group health policy, it might not be enough. Hence, it makes perfect sense to buy a separate health insurance policy for them.

We will tell you how you should go about choosing the best health insurance for your parents. Here are the 6 things you should consider while buying medical insurance for senior citizens.

Coverage for in-patient hospitalisation:

In-patient hospitalisation coverage is given by the insurer for the medical expenses incurred by the policyholder when he/she has been admitted to the hospital for more than 24 hours. It should cover all hospital expenses, nurses expenditure, doctor and specialist fees, medicine etc.

For some senior citizen mediclaim policies in the market, there are sub-limits for certain expenses. For example, for some plans in-patient hospitalisation is covered, but there are sub limits on doctor fees. Since the number of hospital stays might be higher for a senior citizen, it is crucial to look for a senior citizen mediclaim that gives you maximum in-patient hospitalisation coverage.

Limitations on post hospitalisation expenses:

This is the reimbursement of any expenses incurred by the policyholder after being discharged from the hospital, which are directly attributable to the illness or injury for which he/she was admitted. Typically, the post hospitalisation eligibility is 60 -90 days. However, for many health insurance for senior citizens, the post hospitalisation period has been shrunk down. There are plans that say, the post hospitalisation coverage would be about 7 to 10 percent of the claimed amount. Check the term applicable, before making the purchase.

Restrictions on the number of day-care hospitalisations:

There are procedures that can be completed in less than 24 hours at a hospital. For example, cataract, dialysis, chemotherapy etc. Though most health insurance for senior citizens does cover day care facilities, some plans restrict that number. For some plans, the number of day care facilities might be as low as 8 to 10. Before buying any health plan, ensure that you are aware of the number day care facilities available under the policy.

Terms and conditions regarding pre-existing illness:

Your parents might have one or two pre-existing illnesses. So while buying a policy, check for the term and conditions regarding pre-existing illnesses i.e. whether certain pre-existing illnesses are covered, waiting period for each of them, co-payment clauses etc.

Examine the plan's waiting period, co-payment, exclusion:

While buying a policy for your parents, ensure to read the policy wording to understand waiting period, co-payment, exclusion and sub-limits.

• Waiting Period: It is a kind of a hibernation period during which no claims will be admissible. This clause is applicable if you have any pre-existing illness. Normally, for any health insurance policy the waiting period is between two and four years. For medical insurance for senior citizens, many insurance companies, however, have brought down the waiting period to as low as one year. This is solely because for senior citizens the need for immediate hospitalisation is usually more. As a rule, lower the waiting period the better it is.

• Co-payment clause: Co-payment is a clause where you have to pay for a share of the claim from your own pocket. While buying health insurance for senior citizens, there are two things to ponder about this clause. First most senior citizen mediclaims come with a co-payment clause. Second, the co-payment clause is related to the waiting period offered in the plan. Of course, there is nothing called a free lunch. If the waiting period goes down, the portion of co-payment will go up. Make sure to read what the policy says about the waiting period and co-payment clause. For senior citizen mediclaim, the percentage of co-payment for the policyholder is between 10 to 30 percent.

• Exclusions: Similarly, many medical insurance for senior citizens come with exclusion ? medical conditions or healthcare expenses that are not covered by your health plan. Again read the fine print of the policy to understand which diseases are excluded from the policy. Go for the policy which has no or minimum number of exclusions.

• Sub-limits: A sub limit is a cap of how much a policyholder can claim for a particular expense/procedure. Several senior citizen mediclaim policies come with certain sublimits. For example, cataract surgery might have a specific sub-limit per eye, knee-cap surgery, kidney dialysis etc. Read the policy wordings to understand which are the procedures/treatment that have sub limits, and what are the terms as conditions for each of them.

Compare premium amount versus the benefits offered:

For health insurance for senior citizens, the premium amount is much higher than policies meant for a younger individual. So while comparing health insurance for senior citizens, do not look for the policy that is offered to you at the lowest premium, but the policy that provides most benefit for a low premium amount.

*Source: ETMoney