Health Cover in the Golden years
Insurance is a product which cannot be purchased, when you really need it! Sounds confusing? We will not listen to our insurance agent, when he meets us during our active life. But when we are diagnosed with some health problem, we really wish that we could have taken a policy! At that time, no insurance company will offer insurance to you. Health insurance is all the more fit into the above story, because living without a health cover is going to be almost impossible in advanced ages. Thanks to the ever increasing medical costs and the incidence of lot of life style diseases and the increasing longevity. So, it is in our own interest, to ensure that we are having a health cover, when we are healthy. Go for a policy which offers life time renewals.
But, if you have not bought a health cover and are already into your 60s, or if you are having parents in that age group, you can still go for the limited edition offer – Senior Citizen’s Health Plans. IRDA has mandated insurance companies to keep the entry age upto 65 in health policies. Today, such senior citizen’s policies are offered by National Insurance Company, Oriental Insurance Company, New India, Star Health and Bajaj Allianz General Insurance.
These are similar to the normal health cover but with certain limitations. Entry age is limited to 60 – 70 in most cases and are renewable upto age 75 or 90. Most of them are having a limited sum insured range between 1 lakh and 5 Lakhs.
Another restriction in these policies is the co-payment clause. In simple words, you have to share a portion of the bill, while the balance only will be paid by the insurance company. For example in the case of Star Health’s Red Carpet Policy, 50% co-payment is applicable for pre-existing diseases and 30% for all other claims.
|Name of the Company||Oriental||New India||National||Bajaj Allianz||Star Health|
|Policy Name||HOPE||Senior Citizen policy||Varistha Mediclaim||Silver Health||Red Carpet Policy|
|Entry Age||60||60-80||60 -80||46-70||60-69|
|Renewal allowed upto||lifetime||90||90||75||beyond 69 with loading as per claim|
|Sum assured||1lakh – 5 Lakhs||1lakh – 1.5 Lakhs||1lakh – 2 lakhs||50000 – 5 Lakhs||1 lakh – 5 lakhs|
|Extra Features||Pre existing diseases are not covered.||Pre. existing diseases cover after 18th month||50% cover to pre. existing diseases from 2nd year.||Pre. Existing diseases covered from 1st year with 50% Co-pay.|
Please study the exclusions before taking the policy. Pre – existing ailments are covered generally from the 2nd year with certain conditions. In most of the health policies, certain ailments are totally excluded and certain ailments fall under the pre existing category. We have to see the fine print to understand which ailments are covered from which year. Most of these policies will not cover cataract, knee replacement etc. in the first 2 years while dental treatments are excluded totally.
Loading on renewal:
Most companies will load the premium based on the claim experience in the policy. Please check the insurance companies loading mechanism before buying the policy. Some companies charge higher premium initially and will have less loadings on renewal. Most of the companies are charging premium based on age bands. When you move from one age band to the next, the premium increases sharply. Look out for premium in your next age band, while analyzing the policy.
Most policies have sub limits for certain ailments. If your sum insured is 2 lakhs, and if knee replacement surgery is having a Cap of 70%, you will get only 1.4 Lakhs even if you spend more than that for the treatment. Most policies will have a sublimit of 1% for room rent. Look for policies with less sublimit.
What to do?
Companies like Apollo Munich and Max Bupa offers policies which are having life time renewal facility and without much sub limits. You can go for these policies if you are below 65. The premium will be bit higher compared to the PSU companies. But if you can afford, these policies offer value for money. Don’t just look at premium only while selecting the policies. Look for exclusions and sub limits and lifetime renewal facility.