As per the news report of Economics Times, health insurance plans for senior citizen are more restrictive than the regular health plans. Medical expenses in India are growing as much as 20% percent in every year. The amount is two times greater than the overall inflammation in the country. Health insurance policies are extending their network to cover up everyone who wants to have a proper support when a worst situation comes. The need for health coverage is not restricted to the working class people, but it is also equally important for those who retire from their works. Senior citizen health plans are to protect their demands in terms of having the best coverage benefits. But the policies have some restrictions in their offerings.
Senior citizen health plan is designed solely for ageing people who want to keep themselves away from high medical costs during hospitalization. They need to pay the premium every year to renew the policy and ensure that the companies will take care of their medical expenses.
The Premium and Age Cap
As per the general policies, the premium for senior citizen health insurance plan depends on the age of the insured. It is observed by the market researcher that the premium for a certain age group is more or less similar in companies. Only exception is the Star Health insurance where the premium is same for 60 to 65 age groups, and it depends only on the amount of the sum insured.
As per the IRDAI regulation, every company must follow their mandate of the entry age limit and companies must offer renewability for lifetime to policy holders. This is why companies are bound to keep the entry open for minimum 65 years of age. When it comes to senior citizen, it must allow high age limit to include the maximum people.
For existing policy holder
Those who have purchased a regular policy before 60 years, they no need to switch the policy from general health insurance to the senior citizen health insurance. They are eligible to renew the policy as per the terms of the companies after crossing 60 years age. It is always advisable to retain in the regular health insurance plan rather than switch to the policies strictly designed for the senior citizen. In your regular plan, you will get better benefits and coverage terms.
Restrictions in Senior citizen health plan
In senior citizen health plan, restrictions are common things that you need to face. The numbers are also greater than the regular health plans follow. The below are a few things that you should keep in mind.
Nearly every company has a co-payment term for the policyholders in senior citizen. The expenses are shared between the insured and the insurers. The lump-sum part will be taken care of the companies and a bit portion has to be attained by the policyholders.
Sub-limit on hospital expenses
Sub-limit is the amount decided by the companies for different expenses spent hospitals, such as doctor’s fees, surgery operation charges, medicine cost, room rent, and more. You have to have exact knowledge about the limit.
Waiting period follows tougher rules in a senior citizen plan. Remember that every policyholder has 30 days waiting period after the commencement of a policy. In between, they are eligible for claiming the amount. The exclusion from this term is accidental coverage. Besides this, some diseases have also certain waiting period limit as per the companies’ term and conditions.
You have to be cleared on the pre-existing ailments coverage. You have to cross waiting limit to get coverage for pre-existing diseases.
The cost of Medical test
Senior citizens need to go through certain medical tests as insurer wants. The costs of the medical tests are generally borrowed by the company itself, especially when it is done in the empanelled hospitals. You need of have a clear idea on this also.
Whenever you purchase a senior citizen plan, you must check all terms and conditions stated by your chosen companies. Such plan is typically for those who are 60 years or above. So, if you have crossed the age limit of a regular insurance, you can opt for this plan. Otherwise, it is better to stick to the regular plan only.