By: Preeti Kulkarni While health insurance cover for parents under employers' group schemes is a source of comfort for salaried individuals, there is a growing realisation that it may not be adequate. Healthcare inflation is estimated to be rising at 12-18% per annum and most group schemes offer a family floater cover of Rs 2-3 lakh. Moreover, many employers are either withdrawing parental coverage or placing restrictions like co-pay in claims and premium sharing to cut costs. WHY BUY INDEPENDENT COVERS Given this scenario, enhancing your coverage for your parents is an absolute must. “In any case, it's best to buy separate covers for your elderly parents as the chances of claims are higher, potentially leaving very little sum insured for the other members,“ says Saroj Sathpathy, CEO, Ideal Insurance Brokers. If your parents are simultaneously covered under both group and standalone health cover, they will not hit the pre-existing illness wall at any point in time. Since group covers typically do not exclude pre-existing diseases, they come in handy when your independent policy's waiting-period clause is in force. “Your pre-existing diseases will get covered and yet your individual policy will have better claim history . As a result, you will be able to retain no-claim bonuses on your independent policy ,“ says Sushil Jain, national head financial planning & client connect, Bajaj Capital. Remember, the earlier you buy a policy for your parents, the better will be the benefits. “Many products have restrictions in cover if the individual enters into coverage at a higher age. Many insurers have a mandatory co-payment clause if the age of entry is higher,“ says Shreeraj Deshpande, head, health insurance, Future Generali. That is, if an individual buys a fresh policy when she is under 60, she may not be burdened with any co-payment clause for lifetime. On the other hand, a 65-year-old individual will have to live with restrictions like co-payment. While it is clear that you must buy a separate policy for your parents, you also need to do your homework to ensure that choose the best products. 1. COVER FROM EMPLOYERS If your employer offers you the option to fund your parents' insurance as part of the group cover or lets you enhance the cover at an additional cost, you must consider it. This is be cause it is easier to secure a policy under the corporate cover route typically, insurers do not deny coverage. The claim settlement process under group covers tends to be smoother. In addition, insurers feel such policies be it base or voluntary group top up covers -tend to become unviable for employers and insurers over time result ing in scrapping of the facility. “Such policies tend to become unviable because of a reverse spiral which is due to anti-selection on the policy. The cover as well as premiums may look very attractive at the beginning but with increasing loss ratios, the premiums tend to increase,“ says Shreeraj Deshpande. You also need to remember covers offered by employers cease to exist the moment you switch jobs. You will then have to port to the same insurer's retail policy. 2. SENIOR CITIZENS' POLICY If your parents happen to be senior citizens, you can look at dedicated products that insurers like Star health, Apollo Munich, Oriental Insurance and Bajaj Allianz offer. The key advantage in most senior citizen policies is the shorter waiting period of one to two years for pre-existing illnesses, compared to standard waiting period of four years under regular policies. For one, Star Health's Red Carpet policy comes with a waiting period of 12 months for pre-existing ailments. On the flipside, they carry a copayment clause. For example, under Bajaj Allianz's senior citizens' cover, the company will foot the bill for only 50% of the claim amount related to pre-existing ailments. “Such covers should be considered in spite of restrictions, as it is difficult for senior citizens over the age of 65 to buy independent policies otherwise,“ says Sathpathy . 3. TOP-UP POLICY While a full-fledged health cover independent of your employers' group scheme is always preferable, such covers may not fit into your budget. In such cases, you can look at top-up covers to enhance your parents' coverage, as they are likely to be cheaper than independent covers, including senior citizen policies. “If your parents are already covered under your employers' group health scheme, it makes sense to buy a top-up cover that can take care of higher claims,“ says Sandeep Patel, CEO, Cigna TTK Health Insurance. The maximum cover available under top-ups is usually higher than that of senior citizen policies. Keep in mind, that top-up covers kick in only after your base sum insured is exhausted.
Dependent parents, who are in their older ages, need a health insurance plan. They, being old, face a lot of health-related issues and need frequent medical attention. If there are no existing health ailments, your parents are exposed to high health risks due to their advanced age. Since medical costs are rising steadily, meeting your parents’ healthcare expenses might put a strain on your finances. That is why it is better to insure your parents under a health insurance plan. Moreover, when your parents are old, they might not be able to afford a health insurance plan for themselves. As such, you need to buy health insurance for parents so that if they suffer any medical contingency, the policy would cover the medical costs incurred.
In a normal health insurance plan, there is, usually, a maximum entry age up to which the policyholder can buy the plan. In most plans, the entry age is restricted to 60 or 65 years of age. What about individuals who are older? Can they get health insurance coverage?
Yes, they can. There are senior citizen health insurance plans available in the market. These plans are specifically designed to provide health insurance for parents. Let’s explore what these plans are all about –
What is senior citizen insurance?
As mentioned earlier, senior citizen health plans are specially designed health insurance plans for parents who are available for older individuals only. The coverage features are designed keeping in mind the needs of individuals in their older ages. These plans are offered to individuals who are aged 60 years and above, i.e. those who are senior citizens. Senior citizen plans are indemnity-oriented health insurance plans that cover the actual medical costs incurred when the insured member is hospitalised.
Features and benefits of senior citizen health insurance plans
Parents’ health plans, providing medical insurance for parents above 60 years of age, have some distinguishing features. These features are as follows:
- Restricted sum insured
Health insurance plans for parents come with a limited amount of sum insured. Since insurance companies know about the high health risks which are associated with older age individuals, the coverage amount is restricted. You can avail coverage for up to a maximum of Rs.10 lakhs under most parents’ health insurance plans while some plans even allow coverage up to Rs.25 lakhs.
- Co-pay ratio
Every health insurance plan, which covers individuals over 60 years of age, comes with a co-pay ratio. Co-pay means sharing of the claim. In case of any claim made under the plan, a part of the claim would be payable by the policyholder. The co-pay ration denotes the portion of claim payable by the policyholder. If the ratio is 10% the policyholder would have to pay 10% of the claim amount from his own pockets.
- Waiting period for pre-existing illnesses
Pre-existing illnesses are covered after a short waiting period in parents’ health insurance plans. Since the plan is meant for parents above 60 years, the waiting period is kept low so that coverage can be made available from the earliest possible date.
- Discounts
You can get multiple discounts on your parents’ plans for:
- Choosing long term coverage
- Including spouse under the cover
- Buying the policy online
- Pre-entrance medical check-ups
The insurance company might require the insured to undergo pre-entrance medical check-ups before the policy is issued. These medical check-ups are done on the cost of the policyholder. When the policy is issued, 50% or 100% of the costs incurred on the check-ups is reimbursed back by the insurance company.
- Sub-limits on coverage benefits
Though health insurance for parents allows coverage for hospitalisation and medical expenses incurred thereon, there are restrictions on the amount of coverage available. These restrictions are called sub-limits and common sub-limits can be found under the following coverage heads –
- Sub-limits on room rent
- Limits on cataract treatments
- Limits on knee replacement surgeries
- Sub-limits on other specified treatments
- Limit on coverage for domiciliary and AYUSH treatments, etc.
- Long term coverage
Health insurance plans for parents allow long term coverage. You are allowed to buy a policy with a term of two or three continuous years.
- Instalment premiums
With recent changes dictated by the IRDAI (Insurance Regulatory and Development Authority of India), you are allowed to pay the premiums of the health insurance policy for parents in instalments. Instalment premiums are accepted in monthly, quarterly or half-yearly modes.
- Tax benefits
The tax benefit is allowed on the premium paid for health insurance for Indian parents. You can avail an additional deduction of up to INR 25, 000 by paying the premium for an additional health insurance policy for parents. If you buy health insurance for parents above 60, the deduction limit increases to INR 50, 000. So, if you buy one policy for yourself and your family and another policy for your senior citizen parents, you can claim a maximum deduction of up to INR 75, 000 (INR 25, 000 for self and INR 50, 000 for parents).
What is covered under health insurance for parents?
A parents’ health insurance plan would have the following common coverage features:
- Inpatient hospitalisation
If the insured is admitted to a hospital for at least 24 hours, the plan pays the costs incurred on room rent, nurse’s fee, doctor’s consultation fees, surgeon’s fee, expenses incurred on blood and medicines, etc.
- Pre-hospitalisation expenses
Expenses incurred before being actually hospitalised are called pre-hospitalisation expenses. Parents’ health plans cover pre-hospitalisation expenses for up to a specified number of days.
- Post-hospitalisation expenses
Post-hospitalisation expenses include those expenses that are incurred after you are discharged from the hospital. These expenses can be incurred on medicines, doctor’s consultations, diagnostic tests, etc. for recovery. Post-hospitalisation expenses are also covered for a specific number of days
- Ambulance charges
The expenses incurred in hiring an ambulance for transporting the insured member to the hospital are called ambulance charges. Such charges are covered up to a specific amount.
- Daycare treatments
Treatments which do not require a 24-hour stay in the hospital due to the advancement of medical technologies are called day care treatments. These treatments are also covered in health insurance plans for parents.
- Domiciliary treatments
Some parents’ health insurance plans offer coverage for treatments taken at home. Such treatments are called domiciliary treatments. However, coverage is available only if such treatments are taken due to non-availability of hospital beds or if the insured was in no condition of being transferred to a hospital for treatments.
- Organ donor treatments
Under some plans, you can also find coverage for expenses incurred in harvesting an organ from a donor for organ transplant treatments.
- No claim bonus
If no claim is made under the health insurance plan in any policy year, there is a no claim bonus which is allowed to the policyholder. Under this bonus, either the sum insured increases at the same rate of premium or the policyholder is allowed a discount in the renewal premium.
- AYUSH treatments
Non-allopathic treatments taken by senior citizens are also covered under many senior citizen plans. These treatments include Ayurvedic, Unani, Siddha and Homeopathic treatments.
- Free health check-ups
Most health insurance plans for parents allow free health check-ups after a specified number of policy years. These health check-ups allow you parents to track their health regularly. Some plans allow free health check-ups annually while some allow after 2, 3 or 4 consecutive claim-free years.
What is not covered under health insurance for parents?
Plans of health insurance for parents above 60 have certain coverage exclusions. In case of these exclusions, the claim is not paid. Common exclusions, which are not covered by health insurance plans for parents, include the following –
- Pre-existing illnesses are not covered within the specified waiting period of 12 months to 48 months
- Certain specified illnesses are not covered within the first 2-4 years of the policy
- Illnesses suffered within the first 30-60 days of buying the policy are excluded
- Treatments which are not medically necessary are not covered
- Scientific, experimental and unproven treatments are excluded
- Cosmetic treatments, weight management treatments, circumcision and dental treatments are not covered
- OPD expenses are usually excluded from coverage
- Claims due to war, mutiny, nuclear perils and other similar perils are not entertained
- Congenital defects and debilitating conditions are not covered
When you buy health insurance for parents, know the exclusions to find the scope of coverage of the policy.
Best health insurance for parents
Since a health insurance policy for parents is essential, there are many insurers that offer such coverage. Among the different plans available in the market, here is a list of the best health insurance plans for parents –
|
Name of the insurance company |
Name of the plan |
Salient features |
|
HDFC ERGO General Insurance Company |
Optima Secure |
|
|
Bajaj Allianz General Insurance Company |
Silver Health Plan |
|
|
HDFC Ergo |
Health Insurance Plan for senior citizens |
|
|
New India Assurance Company Ltd. |
Senior citizen mediclaim |
|
|
Universal Sompo |
Senior citizen health insurance |
|
|
Star Health |
Senior citizens red carpet insurance plan |
|
|
Niva Bupa |
Health Companion |
|
How to buy health insurance for parents?
Health insurance for parents should be bought only after comparing. Comparing lets you select the most suitable plan from a list of available plans. To compare, look at the following parameters:
- The allowed limit of sum insured
Since the sum insured under parents’ plans is limited, look at the maximum sum insured allowed.
- The co-pay ratio
Co-pay is that percentage of claim which is payable by you. When comparing, opt for the lowest co-pay ratio to reduce your claim burden.
- Available discounts
Choose a plan which offers the maximum possible discounts
- Pre-existing waiting period
If your parents have pre-existing illnesses, the same would be covered after a waiting period. Compare the applicable waiting periods of different plans and choose the lowest period.
- Restricting coverage limits
The sub-limits of the coverage features should also be compared. You should try and opt for a plan which has the highest limits.
- Coverage features
Opt for a plan which offers the most inclusive coverage features. Besides comparing the different plans, you can also enhance your health insurance plan with super top-up plans. this would increase the coverage of your existing health insurance plan and you would be able to meet the health insurance needs of your parents.
Compare and buy the best health insurance plan for you and your loved one online
To buy a health insurance policy for parents, you can choose the online mode. The online mode allows you to compare and buy online within minutes through an easy process. You can just provide the coverage details and check the best health insurance for parents online. To buy online, visit //www.turtlemint.com/health-insurance/, select ‘Buy New Policy’ and proceed to provide the details of the members to be insured. Select from the list of displayed plans and buy the best health insurance plan for parents through Turtlemint’s portal.
Why choose Turtlemint for buying health insurance for parents?
Turtlemint is an online platform which allows you easy purchase of a health insurance plan for parents. It is tied up with all the leading health insurance providers in India which provide a health insurance plan for parents above 60 years of age. By simply visiting Turtlemint’s website and entering the relevant details, you can find the different plans available for parents. You can then compare the available plans and shortlist the one which fulfils your requirement.
Turtlemint also helps in settlement of health insurance claims. They have a dedicated claim settlement team which gets your health insurance claims settled quickly.