I’m currently exploring insurance options for my parents, aged 66 and 61, who also have diabetes. I would appreciate your guidance on whether there are suitable health insurance policies available for them at their current stage of life. Additionally, I’m keen to understand which specific diseases might be excluded under such policies.

Varun

I understand and appreciate your concern for your parents’ well-being, and it’s great that you are exploring health insurance options for them, considering their age and diabetic condition.

The good news is that there are many health insurance plans available catering to senior citizens with pre-existing conditions, and with the recent regulatory changes, insurance companies are actively developing more policies tailored to senior citizens.

In the case of your parents and other senior citizens, health insurance has evolved significantly, which ensures that they have access to quality health care without the burden of financial worries. This not only provides them with the necessary medical support but also instils a sense of hope and optimism for their future health and financial security.

Changes regarding waiting period, moratorium period

Recent regulatory changes have significantly eased the process of obtaining health insurance for senior citizens, making it more customer-friendly and straightforward. With the introduction of new policies and the implementation of the Customer Information Sheet (CIS) mandated by IRDAI, the regulator, policyholders can now get a clear overview of their coverage, including any exclusions.

This means you will understand exactly what’s covered and subsequently are able to make an informed decision about the most suitable plan, without any hidden surprises. A common concern among senior citizens is the waiting period for pre-existing conditions. Following IRDAI’s recent decision, the waiting period for health insurance has been capped at a maximum of 36 months for all conditions. This includes both pre-existing conditions and specific diseases, providing a clearer and more manageable framework for coverage.

Along with this, IRDAI has introduced a new rule to enhance long-term security for policyholders. You will be interested to know that there are also relaxations on the moratorium period, from eight years to five years, which means that after continuously holding a policy for five years (previously eight years), insurers are prohibited from rejecting claims or denying renewal based on unintentional non-disclosure of pre-existing conditions, ensuring long-term financial security.

Another significant benefit mandated by the IRDAI is the lifetime renewal option under normal circumstances. This ensures that policyholders can continue their coverage without interruption, providing a sense of security and peace of mind.

Sum insured and coverage factors

Let me break down some key points to assist you in selecting the most suitable policy for your parents.

You have the option to choose between individual health insurance plans or a floater family plan that covers your family members. With individual plans, you can opt for separate coverage for each parent. In contrast, a floater plan allows you to cover your parents and your family under a single plan.

Given the recent changes in IRDAI regulations, you must know that now is an ideal time to secure health coverage for your parents. As a first step, it’s crucial to consider the sum insured carefully. Due to potential inflation, the cost of medical treatments is on the rise, so having a substantial sum insured will provide significant financial protection for you and your parents. There are various options in the market offering different sum insured levels.

After deciding on the sum insured, ensure that you look for comprehensive coverage. This will ensure your parents are fully protected with a wide range of features that cater to their age, medical, and family history. You can find policies offering benefits such as in-patient hospitalisation treatment, pre and post-hospitalisation, day care procedures, road ambulance services, modern treatment methods and technological advances and domiciliary expenses.

You can also get preventive health check-ups, which is an important part, especially for senior citizens, for early detection of diseases. These may include physician consultations, fasting blood glucose tests, complete blood count, serum cholesterol tests, urine routine analysis, chest X-rays, ECGs, etc.

Be aware of the exclusions

I recommend paying close attention to the exclusions in your policy. Being fully informed about your coverage can give you a lot of clarity. You will be happy to know that there are some policies that offer a waiting period as short as 12 months for pre-existing conditions. Treatment for specific conditions and surgeries may be excluded until the policy has been in effect for 12, 24, or 36 months, depending on the terms. Also, expenses related to any illness within 30 days of the first policy commencement date are excluded, except for accidents, which are covered if included in the policy. It’s important for you to understand these exclusions when choosing a health insurance policy.

Riders for seniors

After considering all the above-mentioned pointers, if you still feel that you need specific coverage, then consider adding riders to the base health insurance plan. Recognising the need for comprehensive support, many insurance companies now offer riders designed specifically for seniors. These riders provide a wide range of benefits, from essential services such as ambulance coverage to advanced features such as fall-detection technology integrated with wearable devices, and much more.

So, Varun, with the recent regulatory changes and the introduction of customer-friendly measures by the IRDAI, now is an excellent time to secure health insurance coverage for elderly family members. The various options available, coupled with comprehensive coverage features and flexible payment plans, make it easier than ever to ensure financial protection against rising medical costs. By understanding and utilising the available policies and riders, you can make an informed decision that best suits your needs.

The writer is MD & CEO, Bajaj Allianz General Insurance

Send your queries to insurancequeries@thehindu.co.in 

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