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Senior citizen health insurance: Buying mediclaim for those above 60 Lesser known facts
Financial Express, February 15, 2019

The cost of treatment in private healthcare sector is very high, especially when a person gets admitted to a private hospital. Moreover, the rate of inflation in the healthcare industry is also very high, which makes health insurance a must for people.

While the cost may not be a matter of concern for the wealthy people, but that is not the case with the poor. Thankfully, the Ayushman Bharat scheme has been launched to provide Rs 5 lakh insurance cover to the poor. But, with no such cover, middle class people have no choice, but to take healthcare policies to bear the exorbitant expenditure at the time of hospitalisation, or put their employment at risk to stand in long ques of government hospitals time and again.

Although health insurance policies are not very cheap and, unlike life insurance, premiums continue to rise as policyholders move to higher age blocks, but proper planning may be done to save the amount of premium, which is a known figure, rather than facing the uncertainty of paying high and unknown amount at the time of hospitalisation, putting all the savings at risk.

Ideally, people should take health insurance at young age, when the health condition is good, to ensure that no exclusion is there on the basis of pre-existing diseases or conditions like co-payment or capping or waiting period are imposed or higher premium is charged while taking the policy.

Although, at young age, probability of hospitalisation is less, but taking a policy early would also result into accumulation of no-claim bonus. Moreover, paying insurance premium may be taken as a social cause, as it will help a needy person at the time of suffering to get some financial assistance through settlement of his/her insurance claims.

Even if a person fails to realise the importance of taking health insurance early, he or she may still get a health cover after retirement when they realise the importance of it through sufferings.

However, senior citizen health insurance policies have some limitations, like –

Compulsory pre-policy health checkup: Apart from disclosing current illnesses, it is must for senior citizens to undergo health checkup before taking a policy, so that insurers may assess the risk involved in covering the person and put conditions and charge premium accordingly. Although cases of senior citizens are considered leniently, but in case of high risk, insurers may refuse to provide health insurance cover to an applicant.

Higher premium: Even if extra premium is not charged, the regular premium of senior citizen policies are generally higher than a regular policy for policyholders of same age.

Cap on amount of cover: Health insurance companies generally don’t provide high insurance cover to senior citizens and limit it mostly up to Rs 3 lakh or at max Rs 5 lakh. On the other hand at lower age, a person may take cover up to even Rs 50 lakh, depending upon his/her premium paying capacity and eligibility and continue it for life long.

Co-payment: Most insurance policies of senior citizens come with co-payment clause, where the policyholder need to pay a certain percentage of the hospital bill. Opting for higher co-payment reduces the amount of premium to be paid by the policyholder.

Capping: Most of the health insurance policies of senior citizens come with capping on amount to be paid on room rent or for operations related to old-age conditions like knee replacement, organ transplant etc.

Apart from the above, there may be many more restrictions, which may, in case of some ailments, defeat the purpose of taking the insurance at old age. So, it is essential to take a policy at a younger age before onset of any illness.

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