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What Is Not Included in Health Insurance for Senior Citizens

Not Included in Health Insurance for Senior Citizens

Health Insurance : Mr. Krishna Chopra had no idea that after working as a yoga instructor for 40 years and living a healthy lifestyle he would need to get an operation for kidney failure. Not only he had to bear physical pain, but also undergo mental agony as he had no insurance policy to act as a security blanket in this hour of calamity.

Health InsuranceHealth insurance is a must, especially when you are planning to retire, or live on pension/savings you have collected all this while. Also, with rise in medical expenditure and health hazards, health insurance cannot be surpassed. There are many good policy providers out there, you can try HDFC ERGO health insurance for senior citizens.

Large number of insurance providers deal with policies designed for senior citizens aged between 65 years to 80 years. However, the challenge lies in picking the right one. As suggested by financial advisors, the key to own a successful health plan is to carefully read all the documents including both inclusions as well as exclusions.

Majority of the people focus on the inclusions part, but forget to read through the exclusions part while zeroing on the chosen policy. As suggested by financial advisors, the key to own a successful health plan is to carefully read all the documents including both inclusions as well as exclusions.

Through this article let’s understand the exclusion clauses pertaining to a senior citizen health policy.

Co-payment clause

In old age a critical surgery can force you to spend all your savings and can create a big financial burden in the future. One should always opt for a very low co-payment, but this comes at a higher premium. For instance, if one has a co-payment clause in his policy then he pays a part of the medical expenditure and rest the insurer. If one opts for a co-payment of 15% then the insurer pays the same amount depending on the terms and conditions of the policy.

Sub-limits

This is the amount of limit on your coverage. Beyond that specified sub-limit, insurer will not be willing to make a payment. However, do choose the sub-limit keeping in mind your health condition and future requirements. In case of a medical surgery, beyond your sub-limit you will have to bear all the cost alone. Also, sub-limits can be levied on doctor’s fees, diagnostic test other related matters.

 

Other common exclusions

  • Any illness contracted within 30 days of the inception date of the Policy, except those that are incurred as a result of an accident. This clause is not applicable on the subsequent renewals
  • Expenses attributable to self-inflicted injury (resulting from suicide, attempted suicide)
  • All pre-existing covered after 1 year (differs from company to company)
  • Treatment arising from or traceable to pregnancy and childbirth, miscarriage, abortion and its consequences
  • Congenital disease
  • Medical expenses incurred for treatment of AIDS and related disorders
  • Tests and treatment relating to infertility and in vitro fertilization
  • Use of Intoxicating drugs and alcohol
  • Some treatments such as non-infective arthritis, joint replacement etc., which are covered only after completion of 2 consecutive policy years (differs from company to company)
  • Cosmetic surgery
  • Dental treatment except treatment arising out of accident
  • War, Act of foreign enemy, ionizing radiation and nuclear weapon
  • Non-allopathic treatment
  • Any treatment which is conducted outside your native country
  • Sex change and treatment related to it
  • Yoga, acupressure, acupuncture, naturopathy, massage and treatments that differ from the conventional therapies
  • A routine check-up, cost of spectacles etc.

Some other factors to keep in mind before finalizing the deal

Look for specialist mediclaim advisor

If one is a senior citizen and incurs very high medical bills, then it’s important to look for aprofessional advisor who can customize a health insurance plan as per the needs. Also, don’t forget to check his employment history.

Time factor

It is wiser to get an insurance policy as early as in the age bracket of 50 to 69, there are some very good health insurance company’s which can help you provide a lifelong medical coverage. After the age of 69, getting a policy becomes more difficult.

Waiting period

Mediclaim policies have waiting period for pre-existing ailments as well as mandatory waiting periods for specified illnesses. Because of this clause in your policy, you may not get claim for your existing diseases or may have to pay a higher premium amount. Opt for a plan which claims to have lower waiting period.

A good policy with good coverage and benefits is a blessing in disguise, particularly for senior citizens.

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