How to Ensure Continuous Health Insurance Coverage for Retirees?

For those working in the organised sector and corporates, health insurance was one of the benefits that usually accompanied the job. A number of companies in India today offer health insurance coverage to their employees through a group health insurance plan. Many of these health insurance benefits are extended to the immediate family and dependents. But as one nears retirement, the question of coverage becomes all the more important as old age is often accompanied by increased ailments.

It is thus practical to keep yourself protected with a health insurance plan to help you tide over any health crises. However, if you buy a new plan, there is almost always a set of permanent and temporary exclusions. With the exception of hospitalization in the case of an accident, most health insurance plans have a waiting period of 6 months before you can seek any coverage from the policy. If you are hospitalised due to any condition related to a pre-existing disease that you may have, then the waiting time is usually two years to four years. Many critical illnesses are also permanently excluded from most basic health insurance plans.

Thus, it is important to start your research and enquiries on health insurance much before you retire. Here are some questions to which you may find it useful to have answered.

1. Can you continue to be covered under the group health insurance policy offered by your employer? 

Many companies do offer this benefit to their employees. However, one may have to pay the premium separately. Doing this will should allow you continuous coverage of all conditions as covered by the group insurance policy without any waiting period that one must go through while taking a new policy

2. Do I need an add-on critical illness policy? 

If the answer to the above question (No. 1) is “yes”, you need to study the diseases/conditions excluded from coverage from that policy offered by your employer. Almost all basic health insurance policies exclude coverage of hospitalisation for conditions related to critical illnesses. If you  are more at risk of some illnesses than others due to hereditary and other factors, you may consider buying a separate critical illness policy?

3. Can I port from the existing group insurance policy to an individual or family floater policy? 

The answer in most cases is “yes”. However, you need to begin the dialogue early. Finding the best policy takes time. Once you have shortlisted the top three or four, you need to contact the health insurance service provider and apply for porting of the policy - this is usually between 45 to 60 days before your coverage on the original  policy expires. By porting the policy, again you will not have to go through the waiting period if you have already covered it under the existing group insurance policy.

If you are allowed to continue with the same health insurance policy by paying the premium, you may still want to check if the premium asked from you is worth it or whether you can get a similar coverage at a lower premium if you port, migrate or buy a new policy. While selecting the new policy, be sure to select one that offers the lifetime renewability feature.

Here are Some Plans That are Specially Tailored for Retirees

1. Senior Citizens Red Carpet Health Insurance from Star Health Insurance

This has a 13,000 plus network of hospitals with the sum insured (SI) ranging from INR100,000/- to INR 25,00,000/-. It is available as individual and family floater policies. The age of entry is from 60 years to 75 years with a lifetime renewability option assured at constant premiums. Pre-existing diseases are covered from the 2nd year onwards. Coverage is also provided for out-patient medical consultation in network hospitals, as well as for listed day-care procedures. Premiums can be paid on a quarterly or half yearly basis as well. Policies can be taken out for a term of one to three years.

2. Silver Health Plan from Bajaj Alliannz

With a network of 6500+ hospitals, this plan offers an SI ranging from INR 50,000/- to INR 500,000/-. The age of entry is 46 years to 70 years. This also has the lifetime renewability feature. It also offers a No Claim Bonus (NCB) of 10% for every claim free year, up to 50% of the SI. It also offers a free health check up after completion of four claim free years at their designated centres. Pre-existing diseases have a four year waiting period and cover up to 50% of the SI. Any other conditions except accidents have a 30 day wait period.

3. Varistha Mediclaim for Senior Citizens from National Insurance

The SI offered ranges from INR 100,000/- to INR 200,000/-. Network hospitals are more than 6000 in number. It offers coverage of domiciliary hospitalisation, in addition to inpatient hospitalisation. It also has a life-time renewability option. The plan prescribes sub-limits of 1% and 2% of SI for room charges and ICU charges respectively. There is a mandatory co-payment of 10% for the majority of claims. The NCB offered is 5% for every claim free year up to a maximum of 50%. The insured can also opt to take a 5% reduction in premium amount instead of topping up of SI against a NCB

Having a health insurance plan in hand post retirement is critical, considering the rising cost of health care. It is also equally critical to begin planning for this early so that you enjoy continuous coverage without bumping into a waiting period.