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How Much Health Insurance Cover is Adequate for a Senior Citizen?

18 May 2022, 1:34 PM

In India, healthcare costs are rising by 20% every year. The need for adequate health cover therefore becomes important not only during the working life of an individual but also after retirement. Health insurance for senior citizens is a health insurance policy that provides coverage to individuals over 60 years of age. Senior citizen health insurance cover provides a range of unique benefits such as regular health check-ups, pre and post-hospitalisation expenses, cover for pre-existing diseases and daily ongoing treatment cost. 

In any health insurance policy, the total insured amount plays a very important role. This is usually the amount the insurer reimburses for the medical expenses incurred. It is always recommended that you purchase a higher sum insured health insurance plan for senior citizens to cover the medical costs effectively.  An optimal sum insured is one that will provide adequate coverage regardless of the diseases. Usually, a sum insured of INR 10 lakhs or above is a must for senior citizens. You can get this coverage in the following ways –

  • Through Senior Citizen Health Plans

As mentioned earlier, senior citizen health plans are specifically designed for older individuals. So, if you are a senior citizen or you want coverage for your senior citizen parents, you can avail these plans for specialized coverage benefits. The sum insured under senior citizen plans is, usually, limited given the high risk of claims. These plans offer a sum insured up to INR 25 lakhs. So, you can choose such high sum insured levels under senior citizen policies which would be adequate for the coverage needs of senior citizens.

  • Through Top-up or Super Top-up Plans

Though a high coverage is desirable, the premiums might not be affordable, especially in older ages when premiums increase considerably. So, if senior citizens already have a health insurance plan of a low sum insured, they can enhance their coverage through top-up or super top-up health plans and save on the premium cost. Both these plans have a deductible limit and claims exceeding the deductible limit are covered. So, if you have an existing health plan, its sum insured could be the deductible of a top-up or super top-up plan. In such cases, claims up to the deductible would be paid by the existing health policy and excess claims would be covered by the top-up or super top-up plans.

For example, say you have a cover of INR 5 lakhs. You want to enhance this coverage to INR 10 lakhs. For this enhancement, you can invest in a top-up or super top-up plan of INR 5 lakhs with a deductible of INR 5 lakhs. Claims up to INR 5 lakhs would be paid by the health insurance plan that you have. If, however, the health insurance claim exceeds INR 5 lakh, the excess would be covered by the top-up or super top-up plan.

Thus, top-up and super top-up plans extend the coverage at affordable premiums and can be selected for enhancing the sum insured.

In older ages, the probability of claims increases and given the rising medical costs, a high sum insured is essential. However, you must check on certain factors that will help you choose the right insurance policy before you purchase any senior citizen insurance product. These factors are:

  • Coverage: Select a plan which provides extensive coverage against old-age vulnerabilities.
  • Cost: You must look for a plan whose premiums are affordable.
  • Convenience: You must seek health plans that include maximum features to make treatment easy for senior citizens.

Even though you opt for a high sum insured, make sure the premiums are affordable so that they can be paid easily for availing uninterrupted coverage. 

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