The Health Insurance Handbook

for Senior Citizens

 1. Why should you buy Health Insurance?

Rising cost of Medical treatments and increasing incidence of Covid-19

makes it mandatory for Senior citizens to buy Health Insurance

RISING COST OF MEDICAL TREATMENTS

IMRT Average cost of

(Cancer Stage 2) Chemotherapy cancer treatment
Cancer Rs. 4 – 5 Lacs Rs. 0.6 – 1.9 Lacs Rs. 10 - 15 Lacs

Angioplasty Valve Replacement Heart Transplant

Heart Rs. 3 – 5 Lacs Rs. 8 – 10 Lacs Rs. 15 – 25 Lacs

Knee Replacement Cataract Brain Stroke

Age Related Rs. 3 – 5 Lacs Rs. 1 – 2 Lacs Rs. 7 – 10 Lacs

RISK OF COVID - 19

Covid-19 is spreading at a rapid pace across the globe.

Since senior citizens have higher chances of contracting
the disease, buying health insurance is important
Average Treatment Cost – Rs. 7 Lacs

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2. Factors to consider while buying a policy for Senior
Citizens

While it’s great to have choices, it can get difficult to shortlist the right
Health Insurance policy. There are 4 key decisions to make:

Decision 1 Decision 2
Sum Pre-Existing
Insured Disease
Waiting
Period

Decision 3 Decision 4
Co- Payment Ease of
Buying

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 Sum
Insured

How much Sum Insured is enough?

Sum Insured is the maximum coverage you will get in a particular year

 You can choose sum insured from Rs. 3 Lacs to 1 Crore

 Higher the Sum Insured, better it is as any claim amount above

the sum insured will have to be paid by you

 Recommended Sum Insured is at least Rs. 10 lacs per person

What sum insured do most people choose?

65%

30%

5%

< Rs. 5 Lacs Rs. 5 - 10 Lacs > Rs. 10 lacs

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 Pre-Existing Disease
Waiting Period

How long are you willing to wait before

coverage for your Pre-Existing Disease starts?

 Waiting period is applicable if you have an existing illness like

Diabetes, Hypertension, etc. at the time of buying the policy

 It can vary from zero i.e. Day 1 cover to maximum 4 years

[=
 It is for existing illnesses only; means any other illness that happens

after buying the policy will be immediately covered

 Lower the waiting period, the better it is

Pro-tip – Do check if your insurance company provides an

option to reduce waiting period by paying extra premium

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 Co-Payment

Do you want full cover or are you willing to share

the treatment expenses with the insurer ?

Co-pay refers to the part of the claim amount that will be borne by the

Insurer at the time of the claim

 This means, you will pay a part of the medical expenses out of your

own pocket.

 For example: If your policy has Co-Pay of 20% and your

hospitalization expenses are Rs. 1 Lac, you will have to pay Rs. 20k

out of your own pocket and the insurer will cover the remaining Rs.

80k.

Pro-tip – If you have budget constraints, you can choose to buy a

plan with co-payment as they are cheaper

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 Ease of Buying

Are you willing to undergo medical check-up or

you want an instant policy ?

 Before issuing the policy, an insurance company may ask you to go for

either a) physical check-up or b) tele-medical or c) no medical

(instant issuance)

 Tele-medical examination has become more popular in the current

Covid-19 times

 Instead of running for a physical checkup, you only need to answer

few questions over telephone and policy is issued instantly

Pro-tip – Compare the type of medical check-up and number of

days required for issuance before buying a policy

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 3. Process of buying Health Insurance

There was a time when buying insurance meant meeting several people,
understanding the terms and conditions of each plan, getting long and
tedious medical check-ups done before getting a policy.

However, the process has become a lot simpler now

Step 1
Compare & Shortlist

Step 2
Fill Proposal Form

Step 3
Payment

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 Compare & Shortlist

The insurance market has numerous health insurance plans for senior

citizens:

 You can either opt for a specialised Senior Citizen plan or a standard

Comprehensive Health plan

 Senior Citizen plan is available for higher ages and at competitive

prices; however there might be certain restrictions like co-payments,

room rent limits etc.

 Comprehensive plans might be a bit expensive, but they have no

limitations and provide exhaustive coverage

Pro-tip – If there is no budget constraint, buying a Comprehensive

plan can give long term peace of mind and no out of pocket
expenses in the future

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 Fill Proposal Form

Once you have selected your insurance plan and made the payment, you

will need to fill the proposal form.

 A proposal form seeks information about insured like name, age,

address, education, employment details etc.

 It also gathers information on the medical history of the insured

members

 This is a completely online process and takes less than 5 mins

Pro-tip – It is advisable to share details of any medical history to

ensure there are no issues at the time of claim

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 Payments

After the proposal form is filled, there can be 3 possible scenarios –

 Monthly Mode: Instead of paying the complete premium at one go,

you can choose to make payments on a monthly basis

 EMI on Credit or Debit Card: You may also choose to set up an EMI

while making payments through your credit or debit card

 Multi-year: You can also opt to buy a multi-year policy to avail special

discounts on the yearly premium that you pay on your single year

policy

Pro-tip – Ask your insurance agent about the issuance process and
time taken so you can get a policy without any hassles

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