Is It Good To Buy A Separate Health Insurance Plan For Senior Citizen Parents?

by SMCIB on Tuesday, 09 January 2024

Is It Good To Buy A Separate Health Insurance Plan For Senior Citizen Parents?

Your parents brought you into this world, provided you with a safe, nurturing environment to grow up in, and taught you the values and skills needed to be successful in life. All the experiences and lessons you learned from your parents are what helped you become the person you are today. So, it is time to pay your parents back by showing them the same care and love they have always shown you. And, you want to prioritise their health and well-being, no matter the challenge.

There is no price that can be put on the comfort and peace of mind that come with knowing your parents are taken care of and safe. What could do that better than health insurance? It is a small token of appreciation for all the love and care they have given you throughout your life. It is a way to ensure their physical, emotional, and financial well-being.

As you search for the ideal health insurance for your parents, you may encounter two major options on the market: family floater health insurance and individual health insurance.

While a family floater policy may seem like an attractive choice, is it the right fit for your parents’ needs? Which is the ideal health insurance plan for senior citizens?

Let's find out!

First, What Is Family Floater Health Insurance?

A family floater is a type of health insurance plan that can cover your whole family under a single cover - and all covered members have access to the entire sum insured.

Family floaters are a convenient option because you don’t have to manage multiple policies and pay multiple premiums for different family members. And, the likelihood of multiple family members needing hospitalisation at the same time is very low, so this plan is a viable option for families.

However, including your parents in family floater health insurance may not be a good idea. Let’s see why

Why Family Floater Insurance Is Not Recommended For Senior Citizens?

  1. You May Have To Pay A High Premium
    Health insurance premiums are generally determined by various factors, primarily the age of the covered person. In a family floater, the premium is determined by the oldest family member’s age. Hence, if you include your old parents in your family floater policy, the premium will be calculated based on their age and may be pretty high. As people age, they are highly susceptible to diseases and may also have pre-existing illnesses, which increases the risk to the insurance company.n order to compensate for the risk, insurers may charge higher premiums. If you don't want to end up spending a fortune on premiums, avoid adding your senior citizen parents to your family floater policy.

  2. Other Family Members Will Be Left With Insufficient Coverage
    If you cover your parents under the same family floater policy, then you might have less coverage at the time of need. This is because your parents may need frequent hospitalisations due to medical conditions and old age complications. So, they may end up using a significant portion of the cover amount. Should another member of the family require hospitalisation the same year, they will be left with little or no coverage. So, despite having health insurance, you may have to pay these costs out of your own pocket.

So, What is The Right Solution?

When you add your parents to your family floater policy, the premium can be significantly high due to their age and any pre-existing diseases. Thus, you should either add both of your parents to a separate floater policy or buy individual health insurance policies for them - based on their medical history. Generally, the best way to go about buying health insurance for senior citizen parents is to look for -

  1. Comprehensive Health Insurance
    These are mainstream health insurance plans that come with a wide range of benefits and features along with lesser limitations and exclusions. They typically don't have any age limit as well. Though these plans are expensive, they make a suitable choice in case your parents are relatively healthy.

  2. Senior Citizen Health Insurance Plans
    If your parents aren’t in the best of their health, it may be difficult for them to get coverage under comprehensive plans. So, in such cases, you can opt for a senior citizen health insurance plan. These plans may not mandate pre-policy medical tests but can come with certain financial restrictions like copay, room rent limits, and sub-limits on treatments/illnesses. These limits will be discussed later in the article.

Factors To Consider While Buying Health Insurance Plans For Senior Citizen Parents

These are some of the things to keep in mind when buying senior citizen health insurance -

  • Sum Insured
    The first and foremost thing you should do is choose an adequate sum insured after factoring in inflation. This is because they are more likely to contract diseases, requiring frequent hospitalisations. So, in order to cover their hospitalisation expenses, it is essential to have a sufficient sum insured.

  • Comprehensive Hospitalisation Cover
    It is important to verify that the plan you choose covers a wide range of hospitalisation expenses including inpatient costs, pre- and post-hospitalisation costs, daycare treatments, domiciliary treatments, etc.

  • Check The Waiting Periods
    A waiting period is a duration during which the insurer will not provide coverage for certain illnesses/treatments.
    Types of Waiting Periods
    Make sure you pick a plan that has a shorter waiting period, so your parents can start using the policy as early as possible.
    • Initial Waiting Period: Only accidents are covered from day one of purchasing the policy. All other treatments are subject to a 30-day waiting period.
    • Pre-existing Diseases Waiting Period: A pre-existing disease refers to any condition, ailment, injury, or disease diagnosed or treated by a doctor 48 months prior to the date of issue of your health insurance policy. According to the policy conditions, pre-existing conditions will be subject to a waiting period of 2 to 4 years.
    • Specified Disease/ Procedure Waiting Period: The insurer also applies a 2 to 4-year waiting period for specific medical conditions and treatments, such as hernias, haemorrhoids, chronic kidney disease, and spinal disorders. You can view the list of illnesses mentioned in the product brochure or policy wording.
  • Day Care Treatments
    Surgeries or treatments that can be completed in a few hours (less than 24 hours) of hospitalisation are called daycare procedures, like kidney dialysis, cataract surgery etc. If your parents suffer from a health condition requiring such daycare procedures, make sure that they are covered under the plan.
  • Domiciliary Treatments
    Your parents can get treated at home in case there is a non-availability of hospital beds or their health condition prevents them from moving to the hospital. This is called domiciliary hospitalisation. Older people are likely to require this form of treatment, so you need to look for health insurance policies that cover such expenses.

  • AYUSH Treatments
    AYUSH = Ayurveda, Yoga, Unani, Siddha, and Homeopathy.

    These are treatments that don't belong to the wing of western medicine. If parents prefer AYUSH treatments for their health conditions, you can look for a plan that covers such expenses.

  • Bariatric Surgery Coverage
    There is a higher rate of obesity among the elderly (especially elder women) due to a lack of physical activity. Obesity entails other health complications as well such as cardiovascular diseases, etc. In such cases, bariatric surgery is carried out to lose excess weight and reduce the chances of developing potentially life-threatening health complications associated with being overweight. You should look for a health insurance plan that covers the costs of bariatric surgery as well.

  • Network Hospitals For Cashless Claims
    A cashless claim is a mode of health insurance claim settlement where you need not pay cash for treatment. The insurer will directly settle the hospital bill with the hospital on your behalf.

    Now, to raise a cashless claim, your parents must be treated in a hospital that is on the insurance company's network hospital list, i.e., a hospital the insurer has a tie-up with. So while buying the health insurance policy for your parents, check the insurer’s network hospital list to see whether the ones in your area are on the insurer’s network list and will provide a cashless facility.

Conditions To Look Out For In Health Insurance For Senior Citizen Parents

Here are some conditions you need to keep an eye on when buying health insurance for them -

  • Co-Payment
    Copay is a specific percentage of the approved claim amount that you’ll have to pay from your end before the insurer steps in to pay the remaining amount. In senior citizen plans, co-payments usually range between 10% and 30%. It is advisable to find a plan with a lower or no copay limit.
  • Room Rent Limit
    The ‘room rent limit’ is the maximum amount that your insurer will pay for a hospital room per day when you are admitted for treatment. If you choose a room that costs higher than the limit, the insurer will deduct the difference in room charges and proportionately deduct all related medical expenses.
  • Exclusions
    It is common for insurance companies to exclude certain medical conditions or healthcare expenses from coverage. When choosing a plan for your parents, ensure you select one that has fewer exclusions - so they have all-around protection.
  • Restoration Limit
    Your parents are likely to require frequent hospitalisation due to their age and there is a possibility that the sum insured may get exhausted very soon. To tackle such situations, you can opt for the Restoration Benefit.
    If you opt for this benefit, the sum insured will get restored if your parents use up a part or the entire sum insured for a hospitalisation. They will have a ‘refilled’ sum insured which they can use for subsequent treatments during the same policy year.
    ​​​​​​​While choosing a plan with this benefit, make sure -
    • It provides unlimited restoration, wherein the sum insured gets restored any number of times in a year.
    • The sum insured gets restored even after partial utilisation, so your parents have access to the entire cover for every hospitalisation.
  • Sub-Limits
    Insurers may impose sub-limits on particular surgeries such as cataract surgery, knee replacement surgery, etc. to keep claims under control. So, these treatments will be covered only up to the specified limit, even if the costs fall within the policy’s sum insured.
    Sub-limits are often imposed on senior citizen health insurance policies. To know the sub-limits applicable to the plan, it is crucial to review its terms and conditions so you can avoid and be prepared for any out-of-pocket expenses.

  • Zone-Based Copayment
    ​​​​​​​Copay is a specific percentage of the approved claim amount that you’ll have to pay. The insurer will pay the rest. If you buy health insurance from a Zone II city or beyond, some insurers may charge a zone-based copayment, the associated limits and discounts of which will vary depending on -
    For example: If you buy a health insurance plan and pay the premiums in Zone II, but want to get treatment from a hospital based in Zone I, then the insurance company may impose a copay of say 15%. So, you will be responsible for 15% of the approved claim amount and the insurer will bear the remaining 85% of the claim amount.
    ​​​​​​​​​​​​​​So, in case you live in a lower zone and wish to get treated in a hospital based in a higher zone, you need to verify whether a zone-based copayment is specified in the plan and how much it amounts to.
    • The city you reside in
    • The city you pay the premiums in
    • The city of hospitalisation for the treatment

Wrapping up!

Your parents have taken care of you all your life; it is now your turn to protect their health and well-being. In the course of ageing, their bodies become more fragile and more susceptible to illnesses and diseases. So, it is important to ensure that your parents receive the care and attention they need to stay healthy. Therefore, investing in a separate health insurance policy for your parents is an important step in securing their health and overall well-being.

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