Health insurance for seniors: how to choose the best insurance policy

For people over the age of 60, health insurance options have increased in recent years. However, there is always a trade-off between the affordability of the premiums and the benefits. Here’s how you can choose the best health insurance plan for your needs.

Health insurance options for the elderly have increased

If there was a time when virtually no insurer wanted to offer health coverage to seniors, the situation has now changed. “A few years ago it was almost impossible to think about purchasing health insurance once a person was 60, but the insurance landscape has changed over time. Older people can get coverage in old age to cope with the rising cost of medical treatment, which is most common among older people, ”says Indraneel Chatterjee, co-founder of RenewBuy, a brokerage firm. insurance.

You can get health coverage despite comorbidities

Often, an existing illness was reason enough for health insurers to reject clients’ new policy requests. When it comes to people over the age of 60, a large part of this segment suffers from one disease or another. This is why insurers have in the past been reluctant to offer health insurance to this segment. However, things have changed. “Insurers are increasingly sophisticated in the management of these chronic diseases. In general, if you have moderate health conditions that are well managed, the insurer will issue you insurance, ”says Kapil Mehta, co-founder of SecureNow Insurance Broker.

Common co-morbidities like diabetes or high blood pressure are covered by a number of special policies for seniors. “There are insurance companies that allow health insurance for people over the age of 65 with comorbidities such as diabetes and BP. Although they may have to pay loading costs or bear a period of waiting for a certain period of time for their pre-existing illnesses to be covered “, explains Naval Goel. , Founder and CEO of PolicyX.com, an insurance comparison portal.

Watch out for these limiting factors

Although insurers have started offering health plans for the elderly, there are, however, many limitations. “Most of these plans have some common characteristics in terms of the benefits provided. Some exceptions in the case of health insurance for the elderly include the cap on the sum insured, a longer waiting period and pre-existing clauses,” explains Chatterjee.

One of the shortcomings of many of these plans is the sickness waiting periods. “Regular Mediclaim insurances tend to have only one waiting period for pre-existing conditions, while senior plans often list waiting periods by illness. These higher restrictions make it easier to issue insurance to elderly people with health problems, ”explains Mehta. Likewise, many plans also have disease-specific sub-limits, which means that they will not cover if expenses exceed those sub-limits for a specific disease.

Standard plan with a higher entry age or a special senior plan?

There are many new standard plans that have started offering a higher age of entry so that older people can purchase these policies as well. Given the two choices, how should a senior decide which diet will work best?

Where the special policy for seniors marks: being personalized according to the requirements of old age, the special plans for the elderly tend to tick more appropriate boxes for the elderly. “The basic coverage of the plans for the elderly includes the costs of hospitalization before and after, the costs of an ambulance, the costs of intensive care, the fees of a surgeon, etc. There are also plans for the elderly which cover the costs of the elderly. organ donation and transplant costs, ”advises Chatterjee.

The choice will mainly depend on the amount of health insurance you already have. If you were primarily dependent on your business plan and didn’t purchase an individual plan, the Senior Special Plan may be a better option. “In case an elderly person has not applied for a health insurance policy after age 60, it is suggested that they go for plans based on the elderly. Indeed, many benefits of the insurance plan illnesses for older people are related to their age. In addition, older people can continue to renew policies until old age, which is not the case in a comprehensive health plan, ”says Chatterjee.

If you already have or have a higher risk of developing a chronic disease, then a senior special plan would also be a better choice. Pricing, pricing and benefits are geared towards these seniors, ”Mehta explains.

When the Standard Policy May Work: There are many standard policies that have a higher entry age and offer long term coverage which may be a good option for seniors. “Over the past 2-3 years, insurers have turned to regular products where the entry age can exceed 65 years. Fewer plans are administratively easier to manage for insurers, ”explains Mehta.

Standard plans offer broad coverage at a relatively higher premium. “Standard health insurance plans mainly have features and benefits. And there is no co-payment in standard health insurance plans. While there are a few co-payments plans, payment remains very marginal in standard health insurance plans up to 20 years. % “said Goel.

To opt for the co-payment or not?

Most special senior plans offer a lower premium than the standard plan, but that comes with a tradeoff. “In senior plans, the premium is lower than in standard health insurance, but there is a co-payment option in these plans as well as a fixed sum insured, as the sum insured is paid within the limits. diets for the elderly, ”Goel explains. Each time you make a claim, you will have to pay part of it as agreed under the co-payment clause. Some plans give you the option of paying a higher premium so that you don’t have any co-payment obligations.

So how do you decide whether to opt for a cost-sharing plan? “It depends entirely on the financial capacity of the policyholder. Health insurance without co-payment costs a little more than the co-payment. If the premium does not weigh heavily enough on the policyholder’s pocket, he has to pay it. take without the co-payment, because paying a higher premium is always cheaper than paying a heavy hospital bill, ”Goel explains.

There are also conditions under which the insurer will only issue a policy if you accept the co-payment, especially in cases of pre-existing illness. “A co-payment is a good option if you have chronic illnesses. Insurers are more willing to issue insurance if they know you will pay part of a possible hospital bill. The copayment completely aligns the insurer and your interest. . For example, you would also want to minimize your hospital stay if you have a co-payment because you are paying part of the bill. If there hadn’t been a quota, you have less incentive to leave earlier, ”explains Mehta.

So, if you don’t have a chronic illness, a no-co-pay plan may be a better option. “If you are in good health, it is better to go for a plan without co-payment for the obvious reason that the entire hospital bill will be paid by the insurer. Keep in mind that even when there is no co-payment there there are certain items such as administrative costs and toiletries that the insurer will not cover. These costs can represent between 10 and 15% of the total bill, ”explains Mehta.

If affordability is an issue, then having a co-payment plan is better than having no plan at all. “There is another reason why you can opt for co-payment and that is to keep the premium low. Co-payment plans are cheaper. Some insurances offer you the option of paying a higher premium later and waiving the co-payment. This is useful because you can buy an affordable plan now and later when you can afford to pay more, take the co-pay off, ”Mehta explains.