As our parents age, they become more likely to fall sick. When thinking about their well-being, a major factor to consider is having excellent health insurance for your parents. Health insurance is vital for good health regardless of age and also reduces financial stress.
In the current health insurance market, there are quite a few plan options available for aging parents. This could lead to the dilemma of deciding which is the best plan to avail for maximum benefit.
Family Floater or Individual Health Insurance policy for elderly parents?
A family floater policy generally covers all the family members, including parents, spouse and children. It is a group insurance plan that has a fixed sum insured, which means that all family members are covered under a set amount.
When is a family floater plan a good option?
A family floater health care plan can be a good choice when your parents are young and do not have to worry about any pre-existing or age-associated ailments, say upto the age of 50.
Having one insurance plan for the family reduces the hassle of maintaining multiple health insurance policies.
Having a family floater can be economical. The cost of medical insurance for senior citizens is slightly higher than insurance for non-senior citizens. However, health insurance plans for relatively young parents are not extremely expensive and can easily be managed with appropriate financial planning.
A family floater plan coverage is not enough in the case of aging parents:
If senior citizens are included in the family floater, then the premium for the plan will be calculated based on the age of the oldest insured. Hence the overall premium amount will increase for the family floater plan.
Some family floater plans impose entry age limits (60-65 years) on parents beyond which they cannot be covered under the family insurance plan.
For every claim-free year, your health insurance company may reward you by increasing your coverage amount or decreasing your premium amount. Including senior citizens in the family floater plan increases the likelihood of filing a claim. This means that even if the rest of the family has no claims, such rewards will not apply.
When filing a claim because of illness/ injury to one family member, the sum insured amount for the entire family unit is reduced to that extent. This means there will be limited coverage remaining for the others insured under the same family floater plan. Purchasing a separate plan for your parents means a separate sum insured and not worrying about paying for their treatments.
To avoid the stress of not having your ageing parent’s health requirements adequately covered, it is recommended to purchase an independent policy for them. Fortunately, India has numerous health insurance plans that cater specifically to senior citizens.
Certain factors to consider in senior citizen health insurance plans are:
Sum Insured Amount: Elderly parents may require a higher sum insured so you can consider a cover of Rs 10 lakh- Rs 20 lakh, depending on the city your parents live in. As people age, the list of ailments increases and the risk of repeated hospital visits are higher. Therefore, having sufficient coverage is crucial.
Waiting Period for Pre-existing Diseases: Many insurance companies have decreased the waiting period for senior citizens to as low as one year. This is because the need for immediate hospitalization for elderly people is usually more. It is important to check that the plan has a lower waiting period, so that pre-existing diseases can be covered at the earliest.
Satisfactory Hospitalization Cover: You should check that the plan sufficiently covers the cost of hospitalization. Expenses to keep in mind when deciding a plan include room charges, doctor fees, nursing fees, cost of medicine etc.
Day-care Treatments: If your parents have health conditions that require special procedures like dialysis or cataract operations, make sure that they are covered by the specific plan.
Post-hospitalization Expenses: Post-hospitalization expenses are expenses that are incurred after you are discharged from the hospital. These expenses can be medicines, doctor’s consultations and diagnostic tests related to recovery. Post-hospitalization expenses are also covered only for a specific number of days, so it is important to confirm what expenses are covered and for how long.
Special Conditions to look out for:
Co-payment clause: Co-payment is a clause where a portion of the claim has to be paid from your own pocket. For senior citizen plans, co-payment is usually between 10-30 percent. Since most senior citizen plans come with a co-payment clause, it is ideal to look for a plan with a lower percentage.
Sub-limits: Sub- limits are restrictions on the amount you can claim for a particular expense/procedure. Several senior citizen policies come with sub-limits. For example, cataract surgery might have a specific sub-limit per eye, or limits on knee replacement surgeries. It is crucial to check the terms and conditions for sub-limits to know the amount of coverage available in a plan.
Trigger for reinstatement and coverage of same illness hospitalization for reinstated limits. Some plans offer reinstatement only on exhaustion of sum insured, while others offer after the first claim. Also some plans do not cover same disease re-hospitalisation under the reinstated limits. It is useful to have reinstatement triggered on the first claim and also same disease cover to have full limits available for all hospitalisations.
Exclusions: Many plans have medical conditions or healthcare expenses that are excluded. It is better to select a plan which has fewer exclusions to ensure comprehensive coverage for elderly parents.
Throughout your life your parents have taken care of you, now it is your turn to protect their health and well-being during their senior years. One of the best ways to ensure this is to decide on a quality health insurance plan for them.
We invite you to visit our health insurance portal, sana.insure for comprehensive information on various health policies available in India, factoring your family needs. SANA.Insure offers customized suggestions for health insurance plans, by analyzing your family details and medical needs as well as expectations. We make the whole process convenient in 3 simple steps of compare, select and purchase!
Wish you a healthy and happy life!