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Why buying health insurance for seniors is different

Increasing lifespan enables us to enjoy this beautiful world for a greater span of time. But it brings with it the challenges of facing up to the ailments of old age for a relatively longer period. With people living longer and medical facilities getting costlier, it has become imperative for everyone to take a health insurance policy more so for the elderly.

Senior citizens health policies have some special features, which we will describe here. So when you buy a senior citizens health insurance, it is not the same as buying any other health insurance policy.

Premium Band: according to the age band of the insured. For example, A is 61 years of age and B is 64. If both opt for a Rs 3 lakh policy, their premium would be the same as they fall in the 601-65 age band.

Co-Payment: This is a mandatory feature in all senior citizen health policies. It essentially means the insured has to bear a fixed percentage of the medical cost. This percentage could vary from 10-30% depending on the policy, aliment and the hospital charges. It is essential that you get clarity on this specific clause to avoid confusion later. One can try and negotiate with the insurer for the waiver of co-payment on payment of additional premium, if possible.

Medical history: You must show your medical history to the insurer and undergo medical tests suggested by the insurer, before taking the policy. Any wrong information given to the insurance company could lead to rejection of the application or your claim. For example, if you are diabetic, but applied for a policy as a non-diabetic, just because your blood sugar levels were normal at the time of medical tests, there are chances of claim rejection in future, if it is related to any diabetic diseases.

Tax Benefit: Premium paid for senior citizen health insurance is eligible for tax benefits up to Rs.30,000, under Section 80D of the Income Tax Act 1961. If your children pay the premium, they can avail this tax benefits over and above the tax benefits availed from their own health policies.

Mandatory medical check-up: No health policy for senior citizens can be taken without undergoing a medical check-up. Most of the time, the insurer bears the cost of these tests. But be sure to double check with the insurers about the same. Do not skip medical tests even if the insurer is okay with it as it will cause you problems later on.

Exclusion of pre-existing diseases: All senior citizen policies exclude pre-existing ailments from coverage for a period that may range from 24 to 48 months. You must get clarity about the exclusion period for various illnesses and also the rate of compensation. Some companies pay only 50% of the claim in case of such diseases while others could cover pre-existing conditions like hypertension after a certain period on payment of additional premium.

Waiting period: There is a compulsory waiting period of 30 days in most policies except for accidental cases. There could also be a cap on expenses on certain treatments. Make sure you know all such information before buying a policy.

Additional Features: Take into account the additional features of a policy before buying it. These include ambulance expenses, second opinion, organ donation expenses and family discount on premium. It is good to opt for some add-ons based on your pre-existing diseases, lifestyle and situations.

Take your time. Like any other policy purchase, do a thorough research of the various plans available. Shortlist atleast 3-4 plans that suit you according to your financial and medical condition, before making a decision.

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