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Health cover: Good news for pensioners
Freny Patel in Mumbai |
July 29, 2005
Turning 50 and still not covered or perhaps you have all along relied on your office to take care of your medical costs while still engaged in active employment.
Now that you have retired, seeking medical cover till the ripe old age of 70 is not easy.
Most insurers do not offer cover after an individual touches 55. Other insurers continue with the practice of not covering pre-existing diseases. This essentially means that a senior citizen would hardly be covered considering that most do have some physical complaints or other.
|Age||Rs 50,000 SA||Rs 2-lakh SA|
|46-50||Rs 1,995||Rs 4,676|
|56-60||Rs 3,824||Rs 8,963|
|61-65||Rs 4,780||Rs 11,203|
|66-70||Rs 7,170||Rs 16,805|
|71-75||Rs 8,963||Rs 21,006|
- Most insurers do not offer cover after an individual touches 55
- Other insurers continue with practice of not covering pre-existing diseases
- Bajaj Allianz General covers all ailments post retirement, right from heart problems to diabetes
- The only catch is that the all inclusive cover starts from the second year of coverage, but all insurance cover stops at the age of 75
- Royal Sundaram General on the other hand, covers senior citizens up to the age of 80
- Pre-existing diseases are included but only after an individual has continued his policy with the insurance company for at least 5 consecutive years
- Senior citizens suffering from diabetes, however, can get covered by Royal Sundaram General at no additional cost
Today, Bajaj Allianz General Insurance Company and Royal Sundaram General Insurance Company are among the few companies offering an all-inclusive health insurance plan for senior citizens. Bajaj Allianz General covers all ailments post retirement, right from heart problems to diabetes.
The only catch is that the all inclusive cover starts from the second year of coverage, but all insurance cover stops at the age of 75. Royal Sundaram General on the other hand, covers senior citizens up to the age of 80.
Pre-existing diseases are included but only after an individual has continued his policy with the insurance company for at least 5 consecutive years.
Senior citizens suffering from diabetes, however, can get covered by Royal Sundaram General at no additional cost.
Of course, the obvious questions one would then ask is a medical check up compulsory for those above 55 before a policy is issued?
Yes, Royal Sundaram asks for a medical check-up after an individual reaches 60 years of age. Bajaj Allianz does not since it offers the all inclusive cover in the first year of renewal.
Second important question that arises is would there be any cap on the maximum cover a senior citizen can avail of?
As medical costs tend to increase with age, insurers do impose a cap on the maximum coverage. Individual wishing to avail of a Rs 3 lakh medical risk cover under Bajaj Allianz's Silver Health can do so only upto the age of 55. Premiums of course are on the higher side the older one gets.
Silver Health is a unique medical reimbursement insurance plan that offers wide ranging benefits for middle-aged and aged, keeping in mind the risks associated with their age.
Individuals between the ages of 46 and 70 are fully covered even in terms of pre-existing diseases one year after continuous renewal.
This means even an individual who has suffered from a heart attack in the past or has undergone a by-pass or even if he's on insulin is covered during the life of the policy (i.e. 75 years in the case of Bajaj Allianz General) for all hospitalisation expenses after the first year of cover. Only AIDs and other sexually transmitted diseases are excluded from coverage under all mediclaim policies.
So how expensive can the cost be to ensure coverage for senior citizens?
Well, the cost of cashless medical risk cover obviously does not come cheap. Premium varies depending upon the age bracket and value of the medical cover taken.
Individuals in the age bracket of 46 to 50 years seeking a Rs 50,000-medical cover would pay a premium of Rs 1,995 according to Bajaj Allianz.
For an enhanced coverage of Rs 200,000, the premium cost increases to Rs 4,676 for a one year policy. For individuals in the age bracket of 56 to 60 years, the premium cost stands at Rs 3,824 and Rs 8,963 for a sum assured of Rs 50,000 and Rs 200,000 respectively.
Those in the age group of 71 to 75 would have to shell out an annual premium of Rs 8,963 and Rs 21,006 respectively for the same amount of coverage, that is, Rs 50,000 and Rs 200,000, respectively.
Premium costs exclude the 10.2 per cent service tax that has to be borne by the individual policyholder.