Logo of Bima bachat
  1. Home
  2. Insurance Insight April-2022
  3. Senior Citizens

Senior Citizens

5 Deficiencies you should be worried about in your Policy

Health Insurance

Odoo image and text block

Senior Citizens (SCs) in India have no social security when they retire or are not active professionally. Only if someone has retired from the government enjoys a pension and health cover. The retirees or SCs should be careful with the health Policy they hold, if at all they do, as any incomplete policy can be detrimental to the entire family both financially and mentally. Many of you would have a Policy running for years and you wouldn’t have made use of the same in many years to realize that the Policy you own has deficiencies. Thus, we are listing below some of the shortcomings which are essential to understand and in the later part; we are covering the solution one should look for;

  1. Room Rent Capping is a very common feature in all the old generation policies, especially if you are holding PSU Policy and it can hit your pocket hard if you have to put your Policy to use. 

  2. Cumulative Bonus- Floater health policies bought specially from PSUs do not have a cumulative bonus added for a claim-free year, which denies the option of enhancement in your SA. 

  3. Capping in Policy- Many policies have a capping on the amount of claim one would be entitled to for some diseases/surgeries listed in the Policy. This can also hit your pocket hard, which can bring a situation where the treatment expenses are more than the entitlement and the same is required to be paid by the Insured. 

  4. Pre and Post Hospitalization expenses- The expenses in the old policies are limited to 30 and 60 days, which takes away many costs incurred before and after the hospitalization. 

  5. Co-payment- Most of the Policies bought by the SCs after the age of 65 have an element of co-payment in all the claims. This means that the insured is supposed to contribute 10-20% of the claim amount for every claim. It can pinch heavily in a critical ailment as the contribution out of the pocket could be heavy as many other expenses are being incurred that are not in the scope of the Policy.

The Policies of today which are available for the SCs are very appropriately designed for them to have complete coverage. This covers all the features that have restrictions in the policies bought in yesteryears and gives you many other features which help you have a comprehensive policy. Below are some of the salient features:

  1. No Room Rent Capping 

  2. A cumulative bonus is added to your SA for every claim-free year 

  3. No co-payment in any claim 

  4. The Policy continues for life long. 

  5. The premium gets fixed after the age of 70 years 

  6. Annual Medical Check-up for all Insured 

  7. Automatic Recharge of Sum Assured 

The SCs can buy or port their existing policies only when one is healthy and doesn’t have any pre-existing diseases. Healthy persons with medical tests and/or declarations of good health can explore better coverage policies. It can be tricky to find the right product giving you the best-suited solution thus it would be prudent to reach out to your Broker for the same.