One of my relative is 78 years old with no pre-existing diseases. Can he apply and get a health insurance plan?

Ans: Yes, they can get insurance at this age. They will need to undergo a pre-policy medical test as these are mandatory for most insurance companies and help the insurance company to make decisions on appropriate cover for the insured or denial of the same. These tests play a pivotal role during the claims process.

A claim can get rejected if the insurance company discovers that the illness was caused due to a pre-existing medical condition that was not disclosed by the policyholder. So, it is advisable to disclose all pre-existing illnesses and to go for such pre-medical test as it makes it easier for both the insurance company and policyholder at the time of the claim.

Ans: Yes, you can claim exemption under Section 80D for medical expenses incurred on family members aged 60 years or more, who do not have health insurance coverage.

Family members include self, spouse, dependent parents. One can claim a maximum deduction of Rs 50,000 in a financial year.

To claim the deduction, all the medical expenses need to be paid in any valid payment mode like net banking, digital channels, etc, except cash.

Ans: Health insurance is hence important for senior citizens. Medical costs increase with rising age. Insurance helps in controlling the increasing expenses.

Some Features to Look for in a Policy
While selecting a health insurance policy for seniors, look out for the following features in it:

No Co-Payment: Ensure that the policy does not have any co-payment clauses. This ensures that the insurer will bear the entire amount of the claim.

No Deductibles: A policy with no deductibles is preferable. The insurer will pay right from the first rupee.
No Sub-Limits: Avoid policies having sub-limits for treatments or room rent. This will ensure that the policy provides complete coverage.
Available Options
Many insurers have products designed specifically for seniors. Here are some of the features these products could have:

High Sum Insured: Go for a policy that offers a sufficiently high sum insured. Medical treatments are expensive propositions.
Cashless Hospitalization: Pick policies which provide cashless treatment at a maximum number of hospitals. This relieves the financial strain during emergencies.
Pre-Existing Disease Coverage: Check that the policy covers pre-existing diseases after some waiting period.
Annual Health Check-Ups: Some policies offer annual health check-ups. This helps in early detection of health problems.
Domiciliary Hospitalization: Check whether the policy covers home treatment in case hospitalization is not possible.
Recommended Policies
Though no specific recommendations are given, take policies from reputed insurers. Here are some aspects to check:

Claim Settlement Ratio: High settlement ratios indicate reliable insurers.
Customer Service: It is essential and facilitates the smooth processing of claims.
Renewability Age: Some policies provide for lifetime renewability. This is vital for senior citizens.
No-Claim Bonus: Policies that come with a no-claim bonus increase the sum insured. This proves advantageous to healthy policyholders.
Keeping away from Common Pitfalls
While choosing a policy, watch out for common pitfalls:

Hidden Clauses: Go through the policy document with great care. Check hidden clauses that may severely limit coverage.
Network Hospitals: Ensure that there is a good number of network hospitals for the insurer around you.
Exclusions: Check what is excluded under the policy. Ensure that it does not exclude common treatments needed by seniors.
How to Buy
You can buy these policies online or through an insurance agent. Here are some tips for buying:

Compare Policies: There are comparison websites where you could compare different policies. Check coverage, premium, and features.
Consult a Certified Financial Planner: A Certified Financial Planner can provide advice with expertise. They will help you choose the best policy suiting your needs.
Final Insights
Health insurance for seniors is indispensable. Choose policies with no co-pay, no deductibles, and no sub-limits. Evaluate insurers on the basis of claim settlement ratios, customer service, and network hospitals. Consult a Certified Financial Planner for advice pertaining to the need.
Best Regards,

K. Ramalingam, MBA, CFP,
Chief Financial Planner,
www.holisticinvestment.in

Ans: Health Insurance for Senior Citizens with Pre-existing Conditions

1. Availability of Health Insurance for Senior Citizens:

Coverage Challenges:

Health insurance for senior citizens, especially those with pre-existing conditions, can be challenging. Most insurers have strict underwriting guidelines for elderly applicants.
Pre-existing Conditions:

Existing conditions like CAD, elevated creatinine, and urea levels often lead to higher premiums or exclusions.
Policy Options:

Some insurers offer policies for senior citizens but with specific terms related to pre-existing conditions.
2. Insurer Considerations:

Age Limits:

Choose insurers that cater to elderly individuals. Many insurers have age limits that might exclude those above 70-75 years.
Pre-existing Conditions Coverage:

Look for insurers who provide coverage for pre-existing conditions after a certain waiting period.
Hospital Network:

Ensure the insurer has a broad network of hospitals, especially those known for treating cardiac conditions and renal issues.
Cashless Facility:

Verify if the insurer offers cashless treatment in a wide range of hospitals.
Premiums and Terms:

Compare premiums, policy terms, and sub-limits. Policies with higher premiums often offer better coverage for pre-existing conditions.
3. Recommended Insurers:

Leading Insurers:

Reputable insurance companies in India like Star Health, Max Bupa, and HDFC ERGO often provide policies for senior citizens.
Specialised Plans:

Some insurers offer specific plans designed for senior citizens, covering various medical conditions with benefits like no claim bonus and coverage for pre-existing conditions.
4. Steps to Take:

Consult Insurers:

Contact multiple insurers to discuss policy options based on your brother's health conditions.
Medical Examination:

Some insurers may require a medical examination. Ensure all relevant health information is disclosed.
Professional Help:

Consult a Certified Financial Planner or insurance consultant to get the best policy recommendation and to navigate the options available.
Policy Review:

Carefully review policy documents and terms before purchasing. Ensure that all pre-existing conditions and future medical needs are covered.
Final Insights

Securing health insurance for an 82-year-old with pre-existing conditions requires careful consideration. Look for insurers with policies catering to senior citizens and those that cover pre-existing conditions after a waiting period. Leading insurers like Star Health, Max Bupa, and HDFC ERGO might offer suitable options. Consulting a Certified Financial Planner can provide personalized assistance and ensure that you choose the best policy for your brother's needs.

Best Regards,

K. Ramalingam, MBA, CFP,

Chief Financial Planner,

www.holisticinvestment.in