Covid scare: Picking health plan for seniors

After a brief period of respite, Covid seems to have made its way into our lives once again in the form of Omicron sub-variant BF.7. With cases being detected in India, concerns regarding fresh waves of infections have gained momentum yet again. The virus, albeit a threat to all age-groups, can be even more dangerous for the elderly, especially those with pre-existing diseases (PEDs). Lower immunity, comorbidities and being more prone to infections puts this group at a higher health risk and therefore, they need a sound health insurance to battle medical as well financial concerns.

Often, people rely on their group health insurance plan for their elderly parents or they make them a part of their family floater policies. With the rise in medical inflation and fresh surge in Covid cases, this can turn out to be insufficient. They need their own comprehensive coverage to be able to withstand the effect of an unannounced medical emergency.

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Moreover, it also ensures that they get uncompromised and high-quality treatment. If you are looking for a plan that can adequately cover senior citizens during this time, here’s what you should know –

Pick comprehensive coverage

When it comes to choosing a health plan for the elderly, it’s a prerequisite to account for not only present health conditions but also the possibility of issues that might strike in the future. Therefore, it is always recommended to opt for broader coverage that comes with a comprehensive individual health plan. This entails that the plan should have high sum insured and cover pre and post hospitalisation, ambulance charges, nursing charges, day-care treatments among others.

Also, in several cases, they might not need hospitalisation but doctor visits and check-ups alone might cost a bomb. So, including OPD visits, preventive health check-ups, telemedicine coverage makes your plan truly comprehensive to battle any medical emergency. Since Covid has yet again become a threat, it also makes sense to add a consumable cover to your policy. This will make sure the expenses for PPE kits, masks, gloves, syringes, etc is sufficiently covered.

PED coverage and waiting period

The risk of being impacted by a disease has increased due to unfavourable lifestyle changes. The risk is even higher among the elderly who have to bear in mind the waiting period for PEDs. Waiting period is the fixed time period before one’s coverage starts. Earlier, this was anywhere from three to four years. The health insurance market now offers plans that come with a low or even zero waiting period depending on the policyholder’s profile. This will save you from paying out of pocket. There are some plans available that cover pre-existing illnesses from the first day and also offer 30 or 40 days, so choose accordingly.

Domiciliary treatment coverage

Domiciliary care refers to patients receiving care at home rather than in a hospital due to mobility restrictions or a lack of hospital rooms. As one grows older, the possibility of the former may increase. Also, with Covid striking again, the chances of home isolation and treatment may also go up. So, domiciliary coverage is a must for senior citizens during this time.

Choose plans without co-pay

In order to cut down on their premium, policyholders often opt for a plan that has a co-payment clause. This means that the policyholder has to pay a certain fixed proportion of the claim amount out of pocket at the time of claim settlement if they have opted for this clause in their policy. This might reduce your premium, but prove to be a costly affair at the time of claim settlement. So, always go for a plan with zero or minimal co-payment.

Check senior citizen specific plans

There are many plans specifically designed for senior citizen plans that ideally work better for people with PEDs. However, there might be some limitations like limit of sum insured or copayment. If you don’t have a PED, it is recommended that you opt for a regular health plan with high coverage and suitable riders to maximise your protection.

Network hospitals

A senior citizen should also look for features like cashless hospitalisation and a large number of network hospitals. It could be difficult to arrange a huge sum on your own at the time of hospitalisation and to follow up for reimbursement later. This will streamline the payment process and relieve the additional pressure of looking for a hospital. Also, avoid the co-payment clause, wherein you must pay a predetermined percentage of the claim amount. All health insurance plans offer tax benefits under Section 80D of the Income Tax Act.

In conclusion, the health insurance market in India is evolving to cater to every demographic effectively. Especially after the pandemic, safeguard yourself with an adequate policy before a health emergency strikes. Instead of a family floater plan, look for individual health policies for senior citizens. Also, compare the features of various available health plans online and read the inclusions, exclusions, and terms and conditions before making the final selection.

(The author is Head - Health and Travel Insurance, Policybazaar.com)