June 14, 2024

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Myths about senior citizen health insurance policies debunked; know facts related to pre-existing medical conditions, coverage and benefits, and age factor

3 min read

Health inflation in India rises faster than economic inflation. Health inflation is estimated to rise by 14 per cent year. So, having the best treatment gets costly every year. If one doesn’t have a health insurance policy and suffers from a severe disease, there are chances that their lifetime savings can go towards treatment. So, it is necessary to have a health policy for all your family members.

When you are young and in the best of your health, buying a health insurance policy at a low premium is not difficult.

But as you grow older and your chances of having severe and critical diseases increase, buying health insurance becomes more difficult.

Not only might your application for a health insurance policy be rejected, but you end up paying a high premium even if you manage to buy a policy.

Situations become worse when you are 60 or older. 

However, a recent order by Insurance Regulatory and Development Authority of India (IRDAI) last month removed the ceiling of 65 years for a person to buy a health insurance policy.

It encouraged many of the health insurance companies to launch policies for senior citizens.

Many of them are offering health insurance policies to citizens up to 99 years of age.

Yet, there are several myths about senior citizen health insurance policies that linger around.

In this write-up, Amit Bhandari, Chief Technical Officer, Magma HDI General Insurance, helps you to ward off some of those myths. 

Myth: One cannot get health insurance after 65

While some insurers had been hesitant to provide health insurance to individuals over 65, a few have already developed specialised products for this segment of senior citizens.

Some insurers had extended the entry age limit up to 100 years.

However, thanks to a recent circular from the Insurance Regulatory and Development Authority of India (IRDAI), all insurers are now obligated to consider applicants over 65.

This change ensures that seniors have an opportunity to access health coverage, regardless of their age.

Myth: Health insurance for seniors is unaffordable

Health insurance premiums are higher for seniors because of the greater health risks that come with aging.

However, to lower premiums, one has the option to choose policies with co-payment or opt for top-up policies.

A co-payment is the amount of the claim that you pay yourself, and top-up policies require you to cover costs up to a certain deductible amount.

By selecting policies with higher co-payment or top-up policies, you can get coverage with more affordable premiums.

You can then set aside the money you save on premiums and use it for co-payment or the deductible in case of a medical emergency.

Myth: Senior citizen health insurance does not cover pre-existing medical conditions

Contrary to this myth, most health insurance policies, including those for senior citizens, cover pre-existing conditions.

However, there may be a waiting period before coverage for pre-existing conditions.

Hence, it’s important to read your policy document carefully to understand the waiting period and coverage details related to pre-existing illnesses.

Myth: All policies provide same coverage and benefits regardless of age, whether you are 20 or 60

One size never fits all, and insurers do understand this.

Hence, there are tailor-made products designed specifically for the elderly to offer a suitable solution for that age.

A prime example is Magma HDI’s OneHealth Senior product, which provides extended post-hospitalisation benefits, nursing care at home, and an option for domiciliary (in-home) treatment, which is often essential at this stage of life.

Myth: Savings can cover healthcare costs

Although having savings is crucial, relying solely on them to cover healthcare costs in old age may prove insufficient due to reasons like disease complications and higher medical inflation than interest rates.

Health issues at this age can be unpredictable and often escalate into serious conditions.

We frequently receive claims where hospitalisation for a minor health concern evolves into a major issue, resulting in substantial bills.

For example, if someone is hospitalised for heartburn, it may also lead to a heart attack, leading to a prolonged hospital stay and substantial expenses.


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