It’s impossible to plan one’s retirement without factoring in the bottomless pit of medical expenses that go hand in hand with old age. Out of all age groups, the elderly are most likely to be impacted by health and lifestyle diseases.
An unannounced calamity like COVID-19 - which also impacted senior citizens the most - has been a wake-up call for everyone to realise the prudence of a financially sound health cover. As per the Centers For Disease Control and Prevention, hospitalisation for COVID-infected elderly people is much more probable than the younger age groups. Yet, news reports affirm that India has a meagre percentage of 18% senior citizens being covered under health insurance.
There could be several factors at play here. Traditionally, a lot of people used to bank on their children for old-age support. Other times, they might not have adequate financial buffer by this stage to afford the best insurance plan. However, with an increasing number of empty nesters who desire self-dependence, we are now slowly growing past this scenario.
If you are looking for a health insurance plan for your elderly parents but not sure how to navigate your way through it, here are some factors to weigh in -
Go for a plan with comprehensive coverage
You wouldn’t want to invest in a policy only to discover later that it doesn’t provide protection against certain ailments, accidents or critical illnesses. Health issues are unpredictable, so, it’s important to choose a policy that ticks the maximum number of boxes on your checklist. For instance, certain cases don’t require hospitalisation but the OPD expenses or day-care procedures can cost a fortune.
There are many plans that are specifically available for senior citizens. However, they are usually recommended for people with pre-existing conditions because these plans might come with certain limitations, like compulsory co-payment. The co-payment clause requires the policyholder to pay some percentage of the total hospital bill. Also, the limit of the sum insured is up to Rs 10-20 lakhs in these plans, while regular plans have a sum insured up to Rs 1 crore. If possible, it’s advisable to go for a regular health plan to have more features and flexible options.
Higher sum insured
More than anything else, health insurance should serve its primary purpose of covering hospitalisation bills in the hour of need. Sum insured - the maximum amount paid by the insurer to the insured in the event of hospitalisation - should cover all the costs adequately. With growing age, the likelihood of contracting diseases tends to go up and recovery slows down. It is important that the policy should cover the cost of a longer hospitalisation or repeated hospitalisation if the condition demands so. The cost goes further up for metropolitan cities. There are several plans from insurers like Max Bupa Health Insurance or Care Health Insurance that offer a cover of up to Rs 1 crore with a premium ranging from Rs 6,000-8,000 per month for a 65-year-old male and 60-year-old female in a metro city depending on terms and conditions.
Bear the waiting period in mind
The waiting period refers to the time policyholder should serve before their actual coverage begins. If the policyholder happens to have any pre-existing conditions or comorbidities, the waiting period could go up higher to 3-4 years. If there’s a possibility of hospitalisation arising out of any such condition, one needs to plan way ahead. Even though health issues arrive unexpectedly, preparing ahead could help pass the waiting period and prevent your savings from eroding in the face of rising medical inflation.
However, there are some plans available that also cover pre-existing illnesses from the very first day or have a waiting period as low as 30-40 days. Read your policy documents thoroughly to understand its terms on the waiting period.
When opting for a policy for the elderly, look out for additional features like coverage of check-ups, pre and post-hospitalisation and ambulance charges among many others. Depending upon the case, there might be a need for repeated hospitalisation or multiple check-ups and tests. In case of a medical emergency, the policy should be able to take care of these additional charges as well. Also, look for plans that offer coverage for alternative medicine as well, like Ayurvedic or Unani treatment. Keep these additional features in mind when choosing a policy.
Domiciliary treatment coverage
Domiciliary treatment refers to the patient’s treatment at home when they require hospitalisation according to a medical practitioner. This usually happens due to the unavailability of the hospital room or the severity of the patient’s condition. We have just gotten past the second COVID wave where the whole country witnessed a serious shortage of hospital rooms. The situation could grow even more grave in the case of senior citizens where their condition might not allow them to be moved to a hospital. Therefore, it’s best to purchase a policy that covers domiciliary treatment expenses as well.
Also, it’s best to purchase a plan separately for your elderly parents rather than making them a part of your regular family floater plan. Not just for handling medical emergencies, the insurance plan also helps senior citizens with tax benefits under section 80D of the Income Tax Act.
The author, Amit Chhabra, is Head- Health Insurance at Policybazaar.com. The views expressed are personal
(Edited by : Anshul)
First Published: IST