Mediclaim for Senior Citizens
Dec 07, 2010

Author: PersonalFN Content & Research Team

In recent years, life expectancy has been increasing thanks to medical advancements. With inflation however, these medical advancements have also been becoming more expensive.

As it is not uncommon to find that as senior citizens, we are often no longer in the pink of health, hence it is important to assess the opportunities available to save on medical costs, by way of taking health insurance.

Mediclaim policies can be an effective tool which can save you from spending hard earned money by covering the hospitalization expenses resulting out of illnesses.

As a senior citizen, a major question in your mind would be “Can I buy health insurance at this age?”

And the answer is Yes, you can.

Mediclaim for senior citizens is certainly not as easily available nor is it as comprehensive (as a policy) as mediclaim for someone who has not yet crossed the age of 60, but it is still available. Certain insurance companies such as National Insurance, Oriental Insurance, New India, United, and others do offer health plans for senior citizens.

These plans are limited and fairly restricted when compared to regular health insurance plans, so it is important to read the policy document very carefully, so you understand exactly what the policy offers you, and exactly what it does not offer you.

Here are some of the main features associated with the policies offered by these companies:

Entry Age:

Most of the PSU companies are providing Mediclaim for senior citizens between the ages of 60-80 years. It means that if you have not taken this policy and have crossed 60 years of age then you can still approach PSU Mediclaim insurers and get yourself insured. However some companies limit entry age to 69 years of age i.e. once you cross 69, you are not eligible to take the policy.

Renewal Age:

Renewal age is the time till which you can renew your Mediclaim policy. This age limit is generally 90 years but it might differ from one insurer to another.

Pre-Existing Diseases:

Pre-existing diseases are those diseases which you might already be suffering from; such diseases are typically covered after 1 or 2 years from the date of taking up of the policy (differs from company to company). However, certain policies, such as National Insurance’s Varistha Senior Citizen Policy categorically states that it will never cover a pre-existing critical illness, under its critical illness rider, it will however cover hospitalization expenses under its health insurance cover.

Premium:

The most important factor which comes to your mind before taking up the policy is the premium which you have to pay out of your pocket. The premium for such policies is generally high as the age of the life to be insured is above 60 years and if there is any pre-existing disease then the insurance company will charge an extra premium to cover that particular disease. The additional premium is to compensate for the additional risk taken on by the insurance company to cover a policy holder who has a pre existing disease.

Sum Assured:

Sum Assured is the amount of insurance cover you get at the time of taking the policy. Mediclaim for senior citizens are providing coverage of about only 1 or 2 Lakhs which is pretty low keeping in mind the increasing medical cost.

Co-payment:

Co-payment means the fixed percentage of total bill which you have to pay in case of a claim. This percentage is already defined in the policy document while taking up the policy. Co-payment clause is around 10% or 20% for such policies.

Tax Benefit:

The premium paid by you for such policies are deductible from your income u/s 80 D of Income Tax Act, 1962.

No Claim Bonus:

If you buy this policy and do not claim anything during the year than in your subsequent renewal of the policy your sum assured will be increased by 5%, upto a maximum limit of 50% or 30% (differs from company to company).

What should you do?

As a senior citizen looking for a health insurance policy, you currently have the following options:

INSURANCE COMPANY	POLICY NAME
Bajaj Allianz General Insurance Co. Ltd	Silver Health policy
National Insurance Company Ltd	Varistha Mediclaim for Senior Citizens
Star Health and Allied Insurance Company Ltd	Senior Citizen Red Carpet policy
New India Assurance Company Ltd	Senior Citizen Mediclaim policy
Oriental Insurance Company Ltd	Senior Citizen Specified Disease Insurance
United India Insurance Company Ltd	Senior Citizen Policy

It is up to you to decide which policy best suits you, depending on your current health and specific health requirements.

For example, there are certain policies which will cover things such as ambulance charges up to a certain limit, or which will provide you a critical illness cover as a rider to your health insurance. But you should note that there is a limit on ambulance charges (up to Rs. 1,000) and that it is only the specified critical illnesses that will be covered.

You can also opt for a health insurance which will cover certain specified diseases (Oriental Insurance: Senior Citizen Specified Disease Insurance), such as knee replacement, cardio vascular disease, stroke and so on, but keep in mind that while you are paying a premium for the full sum assured, you will only be eligible to receive a part of the sum assured in case of certain specific diseases, under this policy. Additionally, pre existing diseases are only covered after the policy has been in force for 2 continuous years.

In cases of some policies, such as National Insurance Varistha Mediclaim for Senior Citizens, pre existing diseases will never be covered under the Critical Illness rider that it offers, however it will cover your hospitalization expenses, under mediclaim cover. Additionally, while critical illness policies typically pay you a lump sum upon diagnosis, this policy does not. It will however reimburse you for the expenses incurred.

It is vitally important to go through the details of the policy before you opt for it. You might find that the feature of the policy that appeals to you the most is restricted to a certain limit or has certain clauses attached to it which make the policy itself infeasible.

Conclusion

Before you opt for any policy, be sure to read the fine print and ask your insurance agent as many questions as you can. Having a Mediclaim policy in place for your age beyond 60 years is important, but it is equally important to have a policy that is beneficial to you specifically.

If you need assistance with your Insurance, or with knowing how much insurance you require from a Financial Planning or tax planning perspective, please do contact us at info@personalfn.com or simply call us.