We have analysed 7 policies by both public sector as well as private health insurance companies, based on various parameters. When you choose a policy, you must look at various factors like the scope of cover, premium charged, exclusions, co-payment clause, pre-existing diseases waiting period and salient features offered. Let’s look at these factors in the policies we analysed:
Scope of cover: As you grow older, chances are that you will need a higher cover to protect yourself. Most public sector players offer a very low Sum Insured cover for senior citizens, with the maximum being Rs.3 lakhs by United India Insurance. Private players like Star Health, Bajaj Allianz and Apollo Munich offer upto Rs. 5 lakhs cover, but this is still on the lower side compared to other policies these companies offer to the young. Max Bupa, on the other hand, offers very high coverage, with upto Rs.50 lakhs cover on its Platinum plan option.
Premium charged: Despite offering options of high Sum Insured coverage, Max Bupa’s plan for senior citizens is extremely expensive, compared to other plans. Senior citizen plans by other private players are also on the costlier side. Attractive premiums are charged by state run players like National Insurance and New India Assurance.
Co-payment Clause: All senior citizen plans come with a co-payment clause, wherein the policy holder will have to contribute a part of the claim made. The lower this proportion, the better it is for you. Plans by National Insurance and New India Assurance require 10% co-payment, United India Insurance, Bajaj Allianz and Max Bupa require 20% co-payment while Apollo Munich requires 30% co-payment. Co-pay is highest for Star Health’s policy at 50% for pre-existing diseases and 30% for all other diseases.
Pre-existing diseases waiting period: This is on the lower side for policies by National Insurance, New India Assurance, Star Health and Bajaj Allianz, while it is higher for policies by United India Insurance, Max Bupa and Apollo Munich.
Other salient features: Some policies like those of United India Insurance, New India Assurance, Bajaj Allianz and Apollo Munich offer a small discount in premium charged if any family member is included in the policy. There is also a cumulative bonus clause which some policies offer, wherein, you are eligible for an increase in Sum Insured amount if you complete a claim-free year. Some policies like Apollo Munich and Max Bupa offer value-added services like a free second-opinion from a medical panel or a discounted value of health services and products. Evaluate the benefits you receive vis-à-vis the premium you pay for these benefits.
Which is the best policy for Senior Citizens?
All health plans for senior citizens come with several conditions and restrictions, and are expensive too. If you are okay with having a low cover, you can opt for policies by National Insurance or New India Assurance as premiums are low and the co-payment clause is also low. However, these policies may individually not be sufficient due to the ever-increasing medical expenses in today’s world. Policies by Star Health and Bajaj Allianz have higher premiums compared to the public sector counterparts; but can be considered on the back of the benefits offered. If you do not mind paying a higher premium, you can look at these options as well.
It is better to avoid the policy by Apollo Munich due to the high co-pay clause as well as the high pre-existing diseases waiting period. Similarly, Max Bupa’s policy can be avoided due to the prohibitive premium rates. You can also avoid United India Insurance’s policy unless you do not have a pre-existing disease history, as the waiting period is very high at 48 months.
If there are no pre-existing diseases, you can also consider health insurance policies offered by nationalized banks. These come at a low premium and most policies have a high renewal age. Policies by Indian Bank, Oriental Bank and Punjab National Bank have a high entry age as well. Please click here for a detailed comparison of policies by nationalised banks. On the ground, we observe that most of the companies deny the policy if you have pre-existing diseases instead of issuing the policy with an appropriate waiting period. Insurance companies claim that they are within their rights, but we doubt the same. You should always ask the insurance companies to give their rejection in writing. Complaining to IRDA and using RTI may help in such cases.
Another option for senior citizens to get a policy is when their children have a decent cover from their employer. Most corporate health schemes cover parents with pre-existing diseases included, and you can get a good amount of cover for your parents. It is expected that in sometime, porting from company group health policies to private policies will be easier, although this is not clear at the moment. However, it is always better to establish a secondary cover instead of solely relying on the company cover for parents.
A detailed comparison is available below. If you prefer to download the excel file, please click here.
For more details, refer to the prospectus or websites of individual companies. Kindly note that this analysis covers offerings from major insurers only & this is not an all-product comprehensive comparison. The analysis is valid on the date being published.