Business Other News 23 May 2016 Worry not: Sixty and ...

Worry not: Sixty and without health insurance?

Published May 23, 2016, 12:44 am IST
Updated May 23, 2016, 12:44 am IST
As a senior citizen, living without health insurance is risky.
 As a senior citizen, living without health insurance is risky.

Health is wealth, goes the adage. Your life and career’s successes would mean much less to you and your loved ones if you don’t have good health to enjoy them. True, medical care has improved over the years and it affords us a greater life span, but the associated medical costs have also increased. The best way to safeguard against medical crises is to buy health insurance. But what if you are above 60 years of age and have never had health insurance? Luckily, you can still opt for health insurance in your sunset years but buying this coverage will require paying a higher premium and passing a battery of tests.

Why is it so difficult to buy health insurance at a ripe age? It is because with age, the chances of having a medical crisis increase exponentially. A 30-year-old healthy male is  less likely to suffer from a serious health ailment like coronary artery disease compared to a 60-plus individual. As a person nears the age of 60, a sedentary lifestyle, reduction of physical activity, the chances of having a pre-existing disease, all combine to increase his medical risks.

What are your options?

As a senior citizen, living without health insurance is risky. To offset your risks, you have two options. One, get covered with your children’s group plan. If you are still working, you can be part of your own employer’s group coverage. But if you’re retired, you can ask your children to add you to their group coverage. However, both these measures are quick fixes. A loss of employment for you or your children could leave you vulnerable. Two, opt for a personalised health cover. This is the better, more pragmatic, and a stabler option of the two. To avail this, you will naturally pay a higher premium but it would be worth every rupee in any medical crisis requiring hospitalisation.

How to pick a health plan:

Many insurance providers sell health plans to the elderly. You must pick the one best suited to your health profile. Here is a checklist to help you make a choice.

Know the co-payment clause:

Unlike health plans for the young and healthy, health insurance for the elderly comes with a co-payment clause, which lightens the insurance company’s risks, with you paying a fixed percentage of your medical expenses out of your own pocket. For example, an 80:20 co-payment clause will set your liability at 20 per cent. The higher you agree to co-pay, the lower is the risk of the insurance company and therefore the lower will be your annual premium. You may opt for a higher co-payment percentage as per your financial capacity. This will lead to a win-win situation for both the insurer and the insured — a lower premium for you and lower risks for the insurance company.

Watch out for the insurance sub-limit:

Most health insurance plans for the elderly come with an insurance sub-limit for specific diseases. This means the insurance company will not offer coverage over the pre-determined limit for that disease. Many people find this out only at the time of filing claims. To avoid such complications and surprises, it is better to compare the insurance sub-limits of various service providers and choose the one that pairs well with your personal health as well as with your family health history.

Don’t assume health coverage will include pre-existing diseases:

The waiting period for pre-existing diseases vary from one insurer to the other, but all insurers insert a minimum waiting period. If you have any pre-existing disease, you will also be paying a higher premium. Group insurance policies, however, offer coverage for pre-existing diseases. The best protection plan, therefore, is a combination of a personal health plan and a group insurance plan either of self or of your children.

Know the age limits of your policy:

Your health insurance will have an age limit. Usually, health insurance policies for the elderly can be in force till the age of 90. Recently, some companies have begun offering lifelong renewal policies. Know the age-limit of your policy and opt for the one that gives you the best protection for the longest term.

Check claim settlement ratio of the insurance firm:

You do not want to run from pillar to post to settle your claims. Check the claim settlement ratio, which is a percentage of claims honoured by the insurance company to the total claims received. Opt for a company with a higher CSR ratio. Buying health coverage for seniors may seem like a daunting task. But with the right amount of research and care, you will find the perfect insurance plan that would prove immensely helpful during a medical crisis.



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