Why Do You Need Health Insurance Coverage After Retirement?
Retirement is the best time of your life to enjoy the rewards of all the hard work you have put into your career. 😌 You will make plans for how to spend this stage of your life as retirement draws near.
But alongside the excitement, it’s natural to feel some financial worries, especially about healthcare. The fear of expensive medical treatments eating into your savings is a common concern, making it essential to have a solid financial backup.
That’s why health insurance after retirement is a must for those over 60. It provides peace of mind, ensuring you get the best medical care without the stress of heavy expenses. Read this article to understand how health insurance helps after requirements.
What is Health Insurance Coverage After Retirement?
Post-retirement health insurance coverage guarantees full health-related financial coverage, including hospitalisation, in-patient treatment, diagnostic test costs, critical illness coverage, and yearly check-ups.
According to Global Data of Life Expectancy, India's life expectancy rose to 68.2 years in 2024 (1). Thus, it is important to make advance plans to pay for your healthcare needs in the future.
Why is Health Insurance Important for Retirees?
Apart from the monthly expenses and lifestyle requirements post-retirement, health insurance is an essentiality that one must have to ensure financial security and peace of mind, especially at that age.
Here are some reasons highlighting the significance of having health insurance coverage after retirement:
Medical science and technology advancements have successfully increased life expectancy. It is expected to increase by 56 million for elderly persons in 2031 (2). Hence, we have a longer span of post-retirement golden years, during which we are more susceptible to illnesses and injury. Here is when health insurance becomes essential.
A national survey by the NGO HelpAge India has shown that as many as 47% of elderly people are economically dependent on their families for income (3). Since most senior citizens rely on their dependents, medical emergencies might not be affordable for them. Hence, health insurance provides a financial cushion for these medical expenses.
Senior citizen health insurance gives you the financial security you need to access advanced healthcare. Not just that, most health insurance plans provide annual health check-ups and other preventive care that can help you detect and manage health issues early on. Thus, having medical insurance after retirement is of utmost importance.
5 Reasons to Get Health Insurance After Retirement
Buying health insurance after retirement is essential as it ensures you have access to quality healthcare without worrying about financial constraints. Here are the top 5 reasons why you should consider purchasing medical insurance after retirement:
Rising Healthcare Costs
Healthcare costs are increasing every year, and it's essential to have insurance that can cover these expenses. A comprehensive health insurance policy saves you money on doctor visits, medications, and hospital stays.
In the retirement stage, it becomes more important to have a financial cushion for covering medical costs since you have a limited income source and more probability of adverse health situations at that stage.
Access to Better Healthcare
With health insurance, you may have access to a broader network of healthcare providers and specialists. This ensures you receive the best possible care and treatment for your health conditions. Also, health insurance plans often provide access to preventive care services and complimentary health check-ups.
Handle Unexpected Medical Emergencies
With health insurance coverage in place and by paying a predetermined premium in a planned manner towards a healthcare policy, retirees can better manage those unplanned medical situations, especially chronic illnesses or injuries, that can otherwise devastate their lifetime savings.
Peace of Mind
For retirees who are often on fixed incomes, health insurance can be a major factor for peace of mind. With health insurance up your sleeve, you are confident of affording necessary medical care if needed. It also provides access to affordable, preventive care with which you can be aware of your body's health.
Financial Security
Given medical inflation and the requirement for routine medical care in old life, your savings will quickly run out if your retirement money is used to pay for hospital costs. You can deal with medical emergencies worry-free if you have health insurance.
How to Select the Best Health Insurance After Retirement?
Selecting the right health insurance after retirement is crucial for financial security and quality healthcare. Here is a step-by-step guide to selecting the right medical insurance after retirement:
Step 1: Consider Your Healthcare Requirements
Take some time to think about your healthcare needs, both now and in the future. This can help you determine what type of insurance plan is best for you.
For example, if you have chronic conditions that require regular care, you may want a plan with low co-pays to help with out-of-pocket costs. Look for plans that cover regular and chronic conditions that require long-term care.
Step 2: Check if the Pre-Existing Conditions are Covered
As we age, the risk of developing pre-existing medical conditions increases. Waiting for years for your pre-existing conditions to be covered by insurance is not an option at this senior age. Hence, select a plan that covers these pre-existing conditions and does not have any waiting periods for coverage.
Step 3: Check for Domiciliary Care Option
Domiciliary hospitalisation, also known as home care, is a form of care provided to individuals in their own homes by trained caregivers or healthcare professionals.
As a senior citizen, you might require personalised care and attention to maintain your physical and emotional well-being. Hence, it is one of the major features to look for in your health insurance policy.
Step 4: Evaluate Your Cost in All Aspects
Research and compare different kinds of policies from different insurers. Not just the premium, also consider deductibles, co-pay, coinsurance and out-of-pocket maximums to get a better sense of the total cost of the plan.
Knowing what each option covers and what you are eligible for can help you make informed decisions.
Step 5: Choose an Insurer with a Vast Number of Network Hospitals
If you have preferred healthcare providers or specialists, ensuring they are on your health plan's network hospitals list is always a good idea. Out-of-network care can be much more expensive and may not be covered at all.
Also, pay utmost importance to an insurer having many cashless hospitals. During a medical emergency, you do not want to worry about arranging for cash. Choose a health insurance plan that provides cashless hospitalisation facilities to ensure a hassle-free experience.
Step 6: Hassle-Free Claim Process
The importance of a hassle-free experience in a health insurance claim cannot be overstated, especially for senior citizens who are mostly not tech-savvy and may face difficulties in filing claims online.
A good health insurance policy should have a simple and straightforward claim process that is easy to understand and navigate, with clear instructions on how to file a claim. A dedicated team to assist senior citizens in filing claims and provide them with a hassle-free experience would be the icing on the cake.
Step 7: Consider Add-ons and Riders
Other riders can be purchased in addition to health insurance coverage. Riders such as the critical illness rider or consumable cover add-on should be considered essential to prevent excessive costs and receive a lump sum payment upon retirement.
What is the Eligibility Criteria for Getting Health Insurance After Retirement?
Retirees looking for health insurance must meet certain eligibility criteria set by insurers. However, the eligibility criteria might differ from one insurer to another, here are some general criteria that a retiree should have to avail health insurance after retirement:
Which Government Programs in India Provide Retirees with Health Insurance?
Several senior citizen health insurance plans initiated by the government of India provide retirees with access to health insurance. Some of such government-initiated programmes are listed below:
PMJAY or Pradhan Mantri Jan Arogya Yojana
A government-run health insurance program called the Pradhan Mantri Jan Arogya Yojana (PMJAY) offers free coverage for medical procedures, hospital stays, operations, and prescription drugs. Seniors who are below the poverty line can apply for this.
SCHIS or Senior Citizen Health Insurance Scheme
One government-sponsored health insurance program that covers medical costs involved during hospitalisation is the Senior Citizen Health Insurance Scheme (SCHIS). Seniors who are 60 years of age or older and do not have access to other health insurance coverage are eligible for it.
RSBY or Rashtriya Swasthya Bima Yojana
A government-sponsored health insurance program called the Rashtriya Swasthya Bima Yojana (RSBY) covers hospital stays, domiciliary hospitalisation and medicines. It offers a coverage of Rs. 30,000 per family in a year on a family floater basis by paying a premium of just Rs. 30 per annum.
CGHS or Central Government Health Scheme
High-ranking employees of Indian Railways, Supreme Court judges and other important workers under the central government can benefit from this plan. CGHS is available in 82 Indian cities, covering more than 42 lakh government employees and pensioners.
ESIS or Employees' State Insurance Scheme
A government-run health insurance program called the Employees' State Insurance Scheme (ESIS) covers expenses incurred during hospitalisation. While the plan was initially restricted to Kanpur and Delhi factories only, it has since been upgraded to support more than 7 lakh factories across India.
Factors to Consider When Buying Health Insurance After Retirement
To get maximum coverage after retirement, it is important to check your health insurance policy thoroughly before buying. When selecting appropriate health insurance plans for senior adults, take into account the following factors:
Every retired person or senior citizen must sign up for a high sum insured in health insurance policy because age raises the risk of contracting certain illnesses and infections. Consider purchasing a policy that will pay for anything from regular checkups to hospital stays.
There are certain waiting periods in health insurance policy. To find out about the coverage that takes effect for serious diseases, pre-existing conditions, etc., you must carefully read the policy wording. The coverage in the particular policy will not be effective until the waiting period is over.
Every health insurance policy's coverage amount is determined by its exclusions and inclusions. Therefore, it is advised to check the exclusions in the health insurance policy before selecting coverage.
Check if your existing health conditions (diabetes, heart disease, etc.) are covered because as you age, you get more prone to getting any illness. PED in health insurance is only covered after the waiting period.
Ensure the policy covers a wide network of hospitals for cashless hospitalisation. Confirm if your preferred hospitals are part of the insurer’s network.
Many treatments (dialysis, chemotherapy, cataract surgery) do not require more than 24 hours of hospitalisation. So, look for a plan that covers outpatient expenses and daycare procedures under the health insurance policy.
Some policies require you to pay a percentage of medical bills (co-payment, usually 10-30%). Choose a policy with a low or no co-payment clause to reduce out-of-pocket expenses.
Look for policies that offer NCB, which increases the sum insured for every claim-free year. This helps in getting higher coverage without extra cost.
Consider a critical illness rider if you have a history of diseases like cancer, stroke, or heart problems. Other top-up plans can be used to increase coverage at a lower cost.
To Sum Up:
Everyone deserves a stress-free lifestyle post-retirement where you can spend more time with your loved ones, engage in hobbies, and not have to worry about medical expenditures in the case of hospitalisation after working for 35 - 40 years of your life. 😌
Therefore, to eliminate the financial strain in retirement, consider purchasing a health insurance policy in advance.
FAQs About Health Insurance Coverage After Retirement
Can I Keep My Employer-Sponsored Health Insurance After I Retire?
It depends on the employer's policy. Some employers may allow retirees to keep their health insurance but with higher premiums or reduced benefits. It's essential to check with your employer to determine the available options.
What Are the Different Types of Health Insurance Plans Available for Senior Citizens in India?
There are several types of health insurance plans available for senior citizens in India, such as:
- Individual health insurance plans
- Family floater health insurance plans
- Senior citizen health insurance plans
- Critical illness health insurance plans
- Top-up health insurance plans
Can I Still Purchase Health Insurance After Retirement?
Yes, you can purchase health insurance after retirement in India. However, the insurance cost may be higher than what you paid while employed.
Are There Any Tax Benefits to Purchasing Health Insurance After Retirement?
Yes, there are tax benefits to purchasing health insurance after retirement in India. Premiums paid for health insurance policies are eligible for tax deductions under Section 80D of the Income Tax Act. Also, this deduction limit for Senior Citizens is ₹50000/-
If I Find a Better Option, Can I Switch Health Insurance Plans After Retirement?
Yes, with portability, you can switch health insurance plans after retirement if you find a better option. However, there may be restrictions on when you can make changes, so it's essential to check with your insurance provider or agent.
How can I buy health insurance after retirement?
To select the most cost-effective choice that works for you, you can compute premiums and compare the prices of several policies. After that, you can apply for insurance coverage and get a quote by contacting the insurance provider or visiting their website. You may be required to provide identification, proof of income (pension or savings), and personal and medical information.
What is the process of paying for health insurance after retirement?
Here are some ways of how you can pay for health insurance after retirement:
- Apply for appropriate coverage that can be easily affordable after retirement.
- After that, you might be required to provide identification, proof of income (pension or savings), and personal and medical information.
- After selecting and applying for a top policy, you must pay the premium to activate your finest health coverage.
Does my senior citizen health insurance cover dental and vision care?
The particular senior citizen health insurance plan you are considering purchasing will determine dental and vision coverage.
Dental and vision care may or may not be covered as part of the total coverage under some policies. Therefore, before acquiring senior citizen health insurance, it is essential to carefully examine the policy's terms and conditions and comprehend the coverage.
What is the cost of health insurance for seniors?
Various things affect the cost of senior citizen’s health insurance. It includes the person's age, medical history and the kind and extent of coverage they desire. As older people are more likely to have health problems and require medical attention, senior citizen health insurance rates are often higher than those for standard health insurance.
What happens to my employer-sponsored health insurance when I retire?
When you retire, your employer-sponsored health insurance may end, but some employers offer retiree health benefits. Check with your HR department to understand your options and any continuation of coverage.
Can I keep my current doctor after buying Health insurance for my retirement?
Yes, you can keep your current doctor even if you buy health insurance for your retirement. You can also opt for a cashless claim under your health insurance if your doctor is included in the network hospital of the insurer.
How do I choose the right Health insurance plan for me before retirement?
To choose the right health insurance plan before retirement, you must:
- Consider your healthcare needs, budget, and preferences.
- Compare the benefits, costs, and coverage of different insurance companies.
- Check all the network hospitals of the company for undergoing cashless treatment.
- Look for additional benefits such as consumable cover, AYUSH hospitalisation, etc.
- Finalise an appropriate sum insured and premium amount as per your budget.
What should I do if I have a pre-existing condition and I am nearing retirement?
You should buy a plan in advance to avoid the pre-existing waiting period. The waiting period for PED is between 2 -3 years. To get coverage for your pre-existing disease in your retirement, you must buy the plan early.
How do I manage healthcare costs after retirement?
To manage healthcare costs, consider choosing a plan with lower out-of-pocket expenses, preventive care services, higher coverage, enough sum insured, and additional coverage. This will help you avoid financial burdens during your retirement.