All You Need To Know About Health Insurance

With increasing years comes the need for increased medical care and attention. Yet, health insurance is an oft ignored product, especially in our country. As we grow older, the need for health insurance becomes more prominent, what with frequent check-ups and visits to the doctor. However, less than 10 per cent of the country’s population has life insurance, and health and medical insurance are generally taken when an employer is offering them. Having health insurance is very important because unexpected health emergencies and surgeries can dry up your financial resources very quickly. Health insurance schemes are definitely available for senior citizens too, with various special features, such as cashless hospitalisation, critical illness coverage, specific coverage for diseases, such as cancer, stroke, etc. A good policy for senior citizens should ideally go beyond just hospitalisation and hassle-free settlement of claims is important. Keep in mind that health insurance can literally be a life-saver when a huge medical emergency strikes. Smaller, regular medical needs can always be planned for and attended to. In an emergency, access to funds and hassle-free processes become key.

How do you choose a good health insurance plan?

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1.Never let the premium amount act as a deterrent. As you age, your premium amount increases, but this is a necessary expense that can save you from spending in six figures when you need medical aid.

2.It is not true that people over a certain age cannot get medical insurance. The only thing — as you age, the number of tests you need to undergo can increase significantly. This too is a one-time effort, well worth the outcome.

3.Check for the network of hospitals covered. The more in number they are, and the more convenient they are for you to visit, the better the plan for you.

4.It is estimated that healthcare costs go up each year by about 15 per cent.

5.Consider this inflation before deciding on the sum assured. A larger sum assured will not always increase the premium exponentially.

6.Whenever possible, opt for a lifelong plan that covers you for the rest of your life. Senior citizen plans are designed to cover preexisting illnesses as well. Check the details before you sign up.

Some Benefits To Look For

As per norms set by Insurance Regulatory and Development Authority (IRDA), health insurance is to be provided to all people who apply, until they are 65 years old, and for as long as they wish to be enrolled in such a plan. There are some additional benefits that some health insurance plans offer:

1.A list of pre-defined critical illnesses can be covered for an extra premium.

2.For pre-existing illnesses, there is usually a waiting period of up to 4 years after which these illnesses are covered in the plan. Some policies offer a lower waiting period of 1–2 years.

3.For surgeries, such as cataract, you can choose to set a limit on how much the insurance company will pay. You can then allocate the rest of the amount to emergencies.

4.If you agree to co-pay some of the amount and expenses, you may be able to get a lower premium

5.Most policies offer complementary medical checkups every year at network hospitals and diagnostic centres.

We spoke to Mr. Sharad Gupta, an expert who has been working in the field of insurance for many years, about how seniors should think of insurance and he had some very valuable suggestions. He says, “There are four things a senior citizen should keep in mind. One, get insured as early as possible. Once you get a disease, the coverage for that pre-existing condition will become expensive and in some cases may not be available at all. Two, make sure you declare your medical condition as explicitly as possible at the time of buying a policy. Any attempt or mistake to hide a pre-existing condition will give the insurance company reason to deny the claim. Three, consider co-pay and deductible options which tend to reduce the insurer’s risk and, thus, the premium, but will give you coverage for any big expenses — which is when most people really need a helping hand. Four, consider critical illness covers which are available for most major conditions. If you do not have that condition already, then you may be eligible for the cover. Since critical illness covers are usually paid only one time by the insurer, immediately when that illness is detected, the premium tends not to be too high.”

There is some insurance jargon that may seem confusing, so it is good to be aware of what they mean.

Co-pay: When you agree to co-pay, you and your insurance provider will split the medical bills at an agreed ratio. So, if you agree on a 70:30 ratio, when you need medical aid, and the bill comes to 1 lakh, you will pay 30,000 and the insurance company will pay 70,000

Deductible: This is usually paid only at the beginning of the policy period. If your deductible amount is `5,000 and the medical bill you incur in this period is `10,000, you pay only `5,000 and the insurance company pays the rest.

Exclusions: This is a list of diseases, conditions, surgeries and procedures that the policy doesn’t cover. Advanced eye surgery for cataract and cosmetic procedures are some examples

Lifelong plans: Most insurance plans have an entry limit of 75 years. However, you can choose a plan that has an entry limit but also covers you for as long as you live. Premiums are usually higher for such policies.

Pre-defined illness: This is a disease or disability that is often critical and included in a policy.

Pre-existing illness: This is an illness or condition that you already have at the time of taking the policy. Premium amount is decided based on the severity of this illness.

Premium: It is the amount you pay at regular intervals to the insurance company. The total premium you pay is almost always less than the total amount you are covered for. However, most health insurance plans do not offer maturity benefits.

Maturity: The period of time after which the insurance plan ceases to cover you. Do remember that plans can also lapse upon non-payment of premiums.

Be Aware of the Fine Print

In a country as vast as India, insurance is often a matter of signing on a few papers. No one cares to explain the minute details of a policy unless we ask them to. Also, bogus insurance companies are aplenty, and they make money of the more gullible people by offering too good-to-believe offers. With apathy and lack of awareness, on the one hand, and poorly trained agents on he other, it is very easy to fall for a health insurance trap. Here are a few things to look out for:

1. Sometimes, the policy itself could be fake. What this means is that the person offering it pretends to be from a real company and signs you up for a monthly or annual payment. You will be paying insurance till the time you want to claim it, only to realise that it is a scam. How can you avoid this? Always choose a policy from a well-known company. It is not a bad idea to visit their office at least once. If you haven’t heard the name of the company before, do an internet search to check what others have to say about the policy.
2. Always make premium payments only in the name of the insurance company and never in the name of any individual or agent. Ask for payment receipts or policy statements.
3. If the person offering the policy is incessant in their quest, and repeatedly calls you for personal information, think twice! As a customer, you can instinctively make out the difference between a really good salesperson and someone desperate to just push their goods. Anyone who is this desperate to sell a policy may actually be doing something outside the purview of the law.
4. Health insurance deals often don’t expire at very short notice. If an agent claims that your deal is about to expire very soon, then there is something fishy
5. If your choice of insurer is not paying your medical bills promptly stating reasons that are not included in the policy you need to consider your options.
6. Do remember that no insurance company is exempt from IRDA norms, and if someone claims that they are able to offer special benefits as they don’t have to register with IRDA, it is a scam. All in all, be sure to read the fine print of your policy very carefully. If you have questions. Do not hesitate to ask your agent until you are satisfied.

Travel Health Insurance

This is beneficial for people of all age groups. If a sudden illness strikes when you are in another country, the medical costs may often be prohibitively expensive. In such cases, a travel health insurance covers you and pays your medical bills.

Most travel agents and portals offer travel insurance when you purchase tickets. Be sure to read the fine print and compare your cover amount with average medical expenses in the destination country. You can use websites, such as policybazaar.com, to compare how much you are paying versus how much cover you get. Remember, most travel health policies only cover the person insured. So, you will need a separate policy for each traveller. In some cases, travel agents may be able to provide a group policy for large groups of people.

It’s a simple procedure that can give you immense peace of mind as you set off to see new places.

The Benefits Of A Group Policy

Group health insurance is often offered by organisations that have a certain number of members. This is most commonly seen in case of organisations that cover all their employees and sometimes, their dependent family members as well.

1. Since the insuring company gets members in bulk, they are more willing to offer discounts and incentives that are absent in individual policies, such as a discount on the boarding fee.
2. Group plans enable you to make the transaction at hospitals cashless and seamless, as they usually come from various reputed agencies
3. Some policies can also cover pre- and post-hospitalisation fees, which is a huge advantage.
4. Even for day surgeries, you won’t have to look beyond such a policy.
5. Such policies may offer you a better cover in case of terminal illnesses, such as cancer.
6. If you pay extra premium, a group policy may be able to accommodate existing illnesses as well.

For these benefits and more, group policies are often preferred. Would you be interested in getting a group policy for yourself and your spouse?

To further help you in picking out the right health policy for you, mentioned below are some of the best senior citizen health policies available in the market right now(as per turtlemint)