How to Choose the Best Health Policy for Senior Citizens?

Different senior citizen health insurance policies cover a varying range of medical complications. Hence, it is crucial to consider which health insurance policies cover a wider spectrum of illnesses, events, and also to what extent.

To make it easier for you to research, we have compiled a list of components which you should consider when purchasing a senior citizen health insurance policy:

1. Look for the Critical Illness Benefit in Policies

Critical illnesses include cardiovascular diseases, cancer, paralysis, kidney failure, etc. Medical expenses for these illnesses are considerably higher compared to costs related to other types of illnesses.

In addition, senior citizens are more prone to certain critical illnesses such as cardiovascular complications, kidney failure, Alzheimer’s disease, etc. Hence, ensure to look for health insurance policies that provide coverage for critical illnesses.

Note: Digit provides 25% additional sum insured for critical illness-related hospitalization under their senior citizen health insurance policy. 

2. Go for Insurance Plans with Domiciliary Care

In some cases, geriatricians might prescribe treatments at your parents’ home, due to their inability to move or because such treatment requires prolonged and individualised care.

Under the facility of domiciliary care, insurance companies provide coverage for expenses that arise out of home treatment. As this form of treatment is fairly common among the older population, you should consider going for a senior citizen health insurance policies that cover such expenses.  

3. Psychiatric Care is Important

Did you know that more than 50% of individuals above the age of 60 suffer from depression?

On that account, you should consider health insurance policies that cover expenses arising out of hospitalisations due to any form of psychiatric illness.  

4. Check if AYUSH Treatment Costs are Covered

AYUSH stands for Ayurveda, Yoga, Unani, Siddha, and Homeopathy.

In case your parents prefer seeking an alternative method of treatment, hospitalisation expenses related to the same would be covered under this facility.

5. Check Coverage Policies on Pre-existing Diseases and their Waiting Period

What are pre-existing medical complications?

As far as insurance policies are concerned, health complications which an individual has already been diagnosed with before the purchase of a health insurance policy are considered pre-existing diseases.

For instance, if your father is diagnosed with diabetes before you have purchased a health insurance policy, it shall be considered as a pre-existing medical condition by such insurance company.

In most cases, insurance companies stipulate a waiting period before coverage is provided towards expenses related to pre-existing medical complications.

Ergo, when you are looking for senior citizen health insurance policies, consider plans which have the shortest waiting period, as chances of being hospitalised for pre-existing health complications are significantly higher. 

6. Look for High Sum Insured at Affordable Premiums

As mentioned earlier, medical costs for treatment of aged individuals are considerably higher. Hence, in order to bridge the disparity of costs, look for a higher sum insured value provided with health insurance policies.

Therefore, it is quintessential to look for senior citizen health insurance plans that provide a higher sum insured at reasonable premiums. Tally among different sum insured and premium combinations, to compare which plan would be ideal to your parents’ needs.

Given the rising medical costs in India, you should not settle for a lower sum insured just to pay lower premiums.

Digit Insurance provides you with the facility of sum insured refill, which essentially means that you can refill the sum insured in case you exhaust the existing amount in a particular year.

7. Check Policies with Coverage for Bariatric Surgery

In India, approximately 5% of the population is affected by obesity. Although, obesity can occur at any age, it is more prevalent among the elderly population due to physical inactivity that follows the post-retirement phase.

And don’t think is a problem only in itself. It comes with other health implications as well such as chances of a person contracting cardiovascular diseases jacks up when one is obese.

Ergo, it is imperative to choose a senior citizen health insurance policy for yourself or your parent that covers treatment costs pertinent to Bariatric Surgery. 

Know more about Health Insurance that Covers Bariatric Surgery

8. Find Policies that cover Day-care Procedures

Most senior citizen health insurance policies do not cover expenses related to day-care procedures.

What is day-care procedure?

Hospitalisation for less than 1 day or 24 hours is considered as daycare procedure. In case of most health insurance policies, hospitalisation of at least 1 day is necessary to claim reimbursement against such expenses.

Regardless, under certain circumstances, prolonged hospitalisation might not be necessary but expenses related to it might be enough to put a dent in your pocket. Hence, seek out policies that cover such expenses.

For instance, Digit Insurance covers expenses arising out of hospitalisation for less than 1 day or 24 hours. 

9. Look for Insurance companies that have Network Hospitals in your nearby areas

You had to admit your father in a hospital due to a medical emergency, where you did not find the time to procure necessary finances for the treatment.

Upon initial check-up, the hospital authorities tell you that total treatment costs, including medication, might amount to Rs. 5 lakh.

Now, if you have admitted your father in a hospital which is under the network hospitals of your insurance company, you do not need to look for finances and can avail the facility of cashless settlement.

But, what is cashless settlement?

In case of a cashless settlement, the insurance company directly pays treatment costs to the hospital authorities without you having to pay a single penny from your pocket.

Hence, when you are looking to purchase a senior citizen health insurance policy, check its network hospitals beforehand. The more the number of network hospitals, the better.

Also, consider the location of such empanelled hospitals and whether they fall within convenient vicinities before deciding.

10. Enjoy Complimentary Health Check-Ups

With Complimentary health check-ups, the insured person can enjoy annual health check-ups at renewal.  

11. Avail Tax Benefits with a Senior Citizen Health Insurance Policy

Under Section 80D of the Income Tax Act 1961, premiums paid for senior citizen health insurance policies can get a tax exemption of up to Rs. 50,000. 

Know more about Income Tax Benefits for Senior Citizens.

12. Check whether Zone Upgradefacility is available

As is popular knowledge, seeking treatment in different cities in India bears varying medical expenses. Based on this variance of medical costs, cities or regions have been categorised under different zones.

To account for this variance, insurance companies provide the facility of Zone upgrade. With Zone upgrade people residing in Zone C cities can avail an insurance policy at a lower premium than that for Zone A and Zone B cities.

Further, if these individuals residing in Zone C cities want to seek treatment in Zone A or Zone B cities, they can do so by paying a marginally higher premium.

Further, with this upgrade, the insured person will not have to pay the copayment amount that is usually levied under such circumstances. 

Know more about Zone Based Health Insurance.

13. Compare the Co-payment clause of different Policies

Most senior citizen health insurance plans include a co-payment clause.

But what is co-payment?

Co-payment is a clause where the insured individual has to pay a part of his/her medical expenses while the rest is covered by the insurance provider.

The amount stipulated for co-payment varies from one insurance company to another. On that account, when you purchase a senior citizen health insurance policy check which policies stipulate the lowest co-payment amounts.

With Digit Insurance, you can avail a zone upgrade cover and enjoy zero co-payment liability, which means you do not have to pay a single penny when you raise a legitimate claim against such policy. 

Know more about What is Copayment in Health Insurance..

14. Look for different Cumulative Bonus Policies

Cumulative Bonus is a form of reward which policyholders earn on every claimless year. This reward is offered in the form of a higher sum insured at the same premium. The rate of the increased sum insured, in this case, varies from one insurance company to another.

Before you purchase a health insurance policy for your parents, look for the Cumulative bonus terms offered by different companies on their plans. It will allow you to maximise your benefits from a health insurance policy. 

Know more about Cumulative Bonus in health insurance.

15. Look for No Cap on Room Rent/ ICU Room Rent Cap

Since the chances of senior citizen individuals requiring long term care or getting admitted in the ICU is higher, it is best to look for policies that do not impose a cap on room rent, as long as it remains under the total sum insured. This way one can choose the room of their choice without financial constraints.

Further, since ICU room rent is much higher than that of normal rooms, seeking prolonged treatment becomes easier for senior citizens without the room rent cap. 

16. Claim Settlement Ratio

Claim settlement ratio is the ratio between the number of claims an insurance company has received and the number of such claims settled by it.

Comparing the claim settlement ratios of different companies would allow you to seek a policy for yourself or your parents with the least chances of rejection of legitimate claims.

These are a few factors you need to consider before purchasing an insurance policy for your parents or if you yourself are above 60 years.

However, it is easier said than done. There are umpteen options available in the market and researching each and every point shall be daunting.

But, then again, it is your responsibility to choose what is best for you or your parent’s and not simply take the easy road, especially when it concerns health.