Senior Citizens Health Insurance Options

by Manshu on August 6, 2012

in Insurance

For this week’s senior citizen’s post I chose health insurance for senior citizens, and I got the idea for the post from this comment on the Suggest a Topic page.

R.Ganesan August 4, 2012 at 3:45 pm [edit]

Dear Manshu,
I am reaching Sixty and my wife’s age is little less than this. We are finding it very difficult to get health insurance coverage. I approached two companies one in private and the other in public sector. Both have declined my requests. What exactly is the reason for this indifference to the elderly population. Can you suggest me a way out.

I just happened to chance upon a post from Manikaran Singal shortly after I read the comment and he has done a good job of listing down the options for health insurance for parents.

I then browsed through reviews of the options listed in his post, and got a general impression (perhaps wrong?) that nationalized companies are easier to deal with when the time actually comes to get the claim.

United India Insurance is a nationalized insurance company that has a health plan for senior citizens so I decided to browse through the documentation available for this plan.

Here are some key things I found about this senior citizen insurance plan, and I don’t know if these are common terms for other senior citizen plans or not since this is the first one I’ve ever looked at so please leave comments to share your experience.

  • You have to be a minimum of 61 years of age, and a maximum of 80 years of age to get this policy.
  • The sum insured can be between Rs. 1 lakh and Rs. 3 lakhs.
  • For a sum insured of Rs. 3 lakhs, the premium is Rs. 9,900 for 61 – 65 years, 12,250 for 66 – 70 years, Rs. 14,050 for 71 – 75 years and Rs. 17,300 for 76 – 80 years.
  • The room, boarding and nursing expense is limited to less than 1% of sum insured per day.
  • ICU expenses are limited to less than 2% of sum insured per day.
  • Pre and post hospitalization expenses are subject to a limit of 10% of the sum insured.
  • Pre – existing conditions will not be covered till 48 months of when you get the policy.

There are two documents that detail out the list of exclusions and also how much will be paid in a lot of scenarios and I think they serve as a very good guideline of not only what you get in this plan, but the questions you should ask if you are looking at another plan.

Here are the three documents related to this plan:

Other than this, I found one more article that has a list of some senior health plans in addition to what Mani has listed, and MediManage has an article on health insurance of seniors above 70 years of age that they did earlier this year which I found useful too.

{ 6 comments… read them below or add one }

Jitendra P.S.Solanki August 6, 2012 at 10:59 am

Hi Manshu,

Good post.Few points which i though would be helpful to readers:

1. Companies who have products in Senior Citizen Health plans have high sub-limits and co-payment clauses.This itself makes claim process easier as high risk has been taken care of by passing on some liability to policyholders.

2. Although companies like Star health do not take medical test but do not cover some major illnesses like cancer and kidney.

3. It’s very difficult to really differentiate between the products as some features of your like will be missing in all of them.

4. Although, Apollo Munich new plan covers individual at any age above 61 it will still have certain limitations or the premium may be out of ones range.

5. Its always advisable to create a health insurance funds for parents because you cannot rely solely on policies with limitations they have.

Regards
Jitendra

Reply

rajesh sundararajan August 6, 2012 at 2:03 pm

Pls be informed that,
star health has got insurance for senior citizens who are age upto 73 years and 364 days.
complete details available below. . its called senior citizen red carpet scheme. i recently covered 2 of my family members, aged 72 years, who do not have any existing disese.
http://www.starhealth.in/health.php?healthid=17

Reply

Paresh August 6, 2012 at 9:05 pm

Just I do not understand the table showing:
Limit of Company’s Liability-

Please share if you have already inquired.

Reply

Jitendra P.S.Solanki August 8, 2012 at 9:35 am

Paresh,

In senior citizens policies insurance companies have a limit to which they will pay the claim.For e.g. if company says that in cataract they will pay the claim up to Rs 50000 then even if you have SA of Rs 2 lakh the company liability will be only upto Rs 50000 and the rest of the amount you will have to bear.

I hope you understood this feature.

Reply

Mahavir Chopra August 9, 2012 at 2:38 pm

Hello All,

Buying Insurance for Senior Citizens is definitely a tricky proposition. With most them having issues with regards to health, the exclusions and limits are very high. But then, we must realize such are the plans you will get, if you waited till retirement to buy your Health Insurance 🙂

I had done a more detailed comparison on Senior Citizen products recently in my review of Apollo’s new Senior Citizen Product. Here’s the link to the same, http://www.medimanage.com/health-insurance-experts-blog/post/2012/07/21/Apollo-Munichs-Senior-Citizen-Product-Optima-Senior-Review.aspx This compares 6 major plans which are open to cover members 60 and above.

Do have a look.

Mahavir Chopra
http://www.medimanage.com

Reply

samantha prabhu January 9, 2013 at 1:57 pm

According to my opinion rather then providing one or two benefits, they need to provide all the benefits including skilled nursing facility to the seniors as they are the one who needs the Medicare at most as the chances for hospitalization will be more for them compare to others !

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