Wednesday 6 August 2014

Health Insurance Plans for Parents or Senior Citizens in India

Health insurance for senior citizens or parents is a must, considering the rate at which the medical expenses are rising every year. On an average, the medical costs are rising around 15% every year. Interesting fact is, Indians pay around 75% of their medical expenses from their own pocket.
In last few years, I have seen many companies (employers) stopped offering health insurance coverage for employee's parents. So, irrespective of whether your employer offers or not it is advisable to buy health insurance for your Senior Citizen parents.
Why health insurance for Parents?
  • The medical costs are increasing more than the average inflation rate.
  • Parents may have limited income or unstable income after their retirement
  • Parents may be financially dependent on their heirs
  • They are easily prone to illnesses or accidents. There might be sudden requirement of financial help.
  • Their employer's health insurance policy might be ceased to exist after retirement.
If you are living with dependent parents who are aged above 60 years then buy individual health insurance plans instead of family floater plan. In family floater plans, the age of the oldest family member is considered in determining the premium rates.
Terms to watch out for in a Senior Citizen's Health Insurance Plans:
  • Co-payment clause: Co-payment means the policyholder will bear a specified percentage of the claim amount. For example, in an 80%-20% clause, the policyholder will bear 20% of the cost and the remaining amount (80%) can be claimed.
  • Sub-limit: Health insurance companies may specify limits for certain illnesses or treatments. For ex: the policyholder can claim only Rs 20,000 for a cataract operation but the policy sum assured might be Rs3 Lakhs.The policies without sub-limits are better but charge high premiums.
  • Pre-existing diseases: You need to check if the existing diseases are covered by the policy. In some policies all the existing diseases may be covered and in some the policy holder has to wait for few years before making a claim.
  • Waiting Period: The policy holder has to wait for certain period of time (in most of the cases it is 30 days) before claiming any expenses.
  • Alternative Treatments: Some policies also cover alternative treatments such as homeopathic, ayurvedic etc.,
Below are the salient features of different health insurance Plans:
Star health's Red Carpet plan:
  • All pre-existing diseases are covered except for diseases for which treatment was recommended by or received during the immediately preceding 12 months.
  • Co-payment clause - 30% for other than claims for pre-existing diseases and 50% for pre-existing diseases.
  • Discount of 10% on the premium is available if lab tests documents are submitted.
  • Enhancement of SA is permitted during renewal time.
Apollo Munich's Optima Senior:
  • Husband and wife can be covered under the policy on individual sum insured basis and get 5% discount on the premium
  • Pre-screening medical tests are mandatory. The company would reimburse 50% of these expenses.
  • 140 day-care procedures, which do not require 24hours hospitalization, are covered.
  • Enhancement of SA is permitted during renewal
  • Cumulative Bonus (CB) of 5% for every claim free policy year
  • Pre-existing diseases are covered after 3 years
  • 2 years waiting period for specific diseases like cataract, hernia, joint replacement surgeries etc.,
  • Co-payment of 30% applicable on specified illness/surgeries like Cataract (each eye), Hysterectomy, Arthroscopy etc.Co-payment of 15% shall be applicable to all Day Care Procedures;
Max Bupa's Heartbeat:
  • Reducing co-payment clause. This is a very good feature. After 4 years of continuous renewals the co-payment percentage will become nil for senior citizens.
  • Free health check up every year
  • Plan will not cover treatment during the first 90 days of the policy, unless the treatment needed is a result of an accident or emergency.
  • All day care treatments are covered.
  • 10% additional sum assured at each renewal.
ICICI Lombard's iHealth plan:
  • No mandatory sub-limits. However the customer can get the hospitalization cover with a reduced premium by limiting the medical expenses pertaining to specified medical and surgical procedures.
  • Co-payment clause is voluntary
  • Free health check up every year
  • Certain list of diseases or ailments are not covered for first 2 years.
  • Cumulative bonus of 10% on Sum assured can be accumulated for every claim free policy year.
National Insurance's Varishtha Mediclaim:
  • Policyholder can either opt for a premium discount of 5% for each claim free year till it reaches 50% or can select the cumulative bonus option.
  • Mandatory co-payment of 10% and additional 10% for pre-existing diseases.
  • Sum Assured amounts are fixed at Rs 1Lakh for mediclaim and Rs 2 Lakhs for Critical Illness.
New India's Senior Citizen Mediclaim:
  • Premiums will increase by 10% for renewals between age of 81-85 years and 20% for renewals between the age group 86-90 years
  • Reimbursement of Medical Check-up costs once in block of 4 claim free years.
United India's Senior Citizen Plan:
  • Free Medical check-up once at the end of every three policy years provided no claims are reported.
  • Family discount of 5% on the total premium if policy is taken for self and any one or more family members viz. spouse or dependent children.
Bajaj Allianz's Silver Health:
  • Reimbursement of pre-medical tests' costs.
  • Cumulative bonus of 10% for every claim free policy year.
  • 20% co-payment is applicable if the policyholder is hospitalized in a non-network hospital.
  • 1 year waiting period for pre-existing diseases. After one year, the company will pay only 50% of the claim amount on these diseases.
  • 130 day-care procedures are covered.

Article Source: http://EzineArticles.com/8614989

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