Should I include my elderly parents in our family floater or buy a separate health insurance policy for them?
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 parents. It is vital for good health regardless of age and also reduces financial stress.
In the current market in India, there are quite a few plan options available for elderly people. This could lead to the dilemma of deciding which is the best plan to avail for maximum benefit.
Family Floater Health Insurance Plans or Individual policies for elderly parents?
A family floater insurance 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 mediclaim policy can be a good choice when your folks 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 policies.
Having family floater health insurance can be economical. The cost of medical insurance for senior citizens is slightly higher than insurance for non-senior citizens. However, such plans for relatively young parents are not extremely expensive and can easily be managed with appropriate financial planning.
A family floater health insurance 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 plan.
Some of these plans impose entry age limits (60-65 years) on insured members,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 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 plan. Purchasing separate health insurance plans for parents , especially when they are at an age above 50, means a separate sum insured and not worrying about paying for their treatments.
To avoid the stress of not having your ageing parents' health requirements adequately covered, it is recommended to buy an independent policy for them. Fortunately, India has numerous health insurance plans that cater specifically to senior citizens. Moreover, the premiums are eligible for tax benefits in India – at 60 years and above, the tax benefits are up to Rs. 50,000.
Certain factors to consider in senior citizen health insurance plans are:
Sum Insured Amount: Senior citizens at age above 60 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 buy a quality plan for them.
We invite you to visit our portal, sana.insure for comprehensive information on best family floater health insurance plans in India, factoring your 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! Our Health Insurance Experts will be glad to assist you with additional information. Please get in touch with us via WhatsApp chat (8278271818) or via phone call (1800 202 8118).
Wish you a healthy and happy life!
Q- Who cannot be covered under family floater policy?
Ans-A family floater policy typically covers self, spouse anddependent children. Most plans also cover parents under the same floater plan. Other relatives such as brother, sister, grandparents, in-laws, uncle, aunt etc. may not be covered under the family floater policy. Instead, they could be covered under individual health insurance plans. These conditions differ between insurers and plans;therefore, it is important to read the policy wordings or customer information sheet for details.
Q- Should I buy separate health insurance for parents?
Ans-If your parents are above 60 years of age, it is recommended to take separate i.e. individual senior citizen health insurance for them. Reason being, such plans take care of elderly people’s healthcare needs with lower waiting periods. It would be best to go for higher sum insured for them considering their medical requirements might be more frequent with age.
Q- Can I convert individual health insurance to family floater or vice-versa?
Ans-A family floater plan can be converted into individual health insurance plans or vice versa by informing the insurer that you wish to do so and following their guidelines or process to convert the policy.
Q- How does individual health insurance work?
Ans-Individual health insurance is a plan that covers an insured member and takes care of the policyholder’s medical requirements as per the terms stipulated in the policy. The insured member has to pay a premium amount every year in order to keep the plan active and to continue enjoying the benefits offered without any break. Some of these benefits include cashless hospitalization, day care procedures coverage etc.