Health Insurance at the age of 60

Yes, you do. Health insurance companies offer senior citizen health insurance plan. These plans provide health insurance coverage at the age of 60 and above. The coverage under these plans is similar to normal health insurance plans. However, there are some features which make senior citizen plans a tad bit different. So, here’s a quick look at the salient features of senior citizen health insurance plans:

Pre-entrance medical check-ups

This might surprise you but senior citizen health insurance plans do not, usually, require pre-entrance medical check-ups. Yes, you heard me right! You can buy the plan without undergoing any medical check-ups. A word of caution though – while many senior citizen plans do not insist on a medical check-up, there are some plans which might require you to undergo a medical check-up based on your medical history. So, look for the pre-policy check-up clause when you are looking at senior citizen health plans.

Sub-limits and coverage restrictions

The Sum Insured under senior citizen health plans is restricted in terms of the level offered. You would find such plans to have the maximum coverage of Rs.10 lakhs. Moreover, there are sub-limits on various coverage features. For instance, you might find a sub-limit on room rent. These sub-limits are usually expressed as a percentage of the Sum Insured. Higher the Sum Insured higher would be the limit you can avail. Some common heads on which sub-limits are imposed are room rent, doctor’s fees, surgeons fees, nursing expenses, etc. There is also a limit on cataract and eye treatments. These limits are also expressed either as a percentage of the Sum Assured or as an absolute amount. Robotic surgeries and technologically advanced surgeries might also have a restriction. These sub-limits should be kept in mind when you are buying senior citizen health plans. Read the policy carefully to understand these sub-limits and restrictions.

Co-payment ratio

A unique clause in senior citizen health insurance plans is co-payment. Co-payment, also known as co-pay, signifies the portion of claim which is payable by you. Co-pay is expressed as a percentage and the co-pay amount is calculated on the claim amount. So, if your policy states a co-pay ratio of 20%, 20% of the claim amount would be borne by you. The insurance company would bear 80%. A higher ratio is bad for your pockets and so you should try and select a policy which has a lower co-pay requirement.

Pre-existing waiting period

This feature is a very common clause in all health insurance plans. Ailments, which you already suffer from at the time of buying the policy, are called pre-existing ailments. These ailments are excluded from the scope of coverage for a few years. These years are called the waiting period. Being a senior citizen, you might have pre-existing illnesses. Know that complications arising out of these existing ailments would not be covered in the plan’s waiting period. So, check your policy for its waiting period.

All the above-mentioned points talk about the precautions which you should take. But, what about the coverage features? Do you know what coverage benefits you can avail under senior citizen health plans?

There are universal coverage features and also those features which vary across plans. Some common coverage benefits are as follows:

• In-patient hospitalization
• Pre and post-hospitalization
• Ambulance charges
• Day care treatments

Moreover, based on the plan’s features, you might also find coverage for the following:

• Organ donor expenses
• AYUSH treatments
• Free health check-ups, etc.

A senior citizen health insurance plan gives you the much-needed cover when you are aged 60 years and above. As such, these plans prove to be a blessing for seniors. All major coverage benefits are extended by senior citizen health plans though there are some features which should be checked thoroughly. Check out for these precautions before you buy a plan and get the most out of a senior citizen health insurance plan.

Choose wisely!