SENIOR CITIZENS CAN OPT FOR IT TO REDUCE THEIR PREMIUMS

As senior citizen health insurance premiums continue to rise, opting for a co-pay option can be a practical way to manage costs. Co-payment significantly lowers the insurance premium, making it more affordable for those who may have limited income post-retirement.

The insured agrees to pay a part of the medical expenses, while the insurer covers the rest. For instance, if an insured opts for 20% co-payment and the total hospital expense is

Rs 1 lakh, he will have to pay Rs 20,000 and the insurer will pay the rest. This percentage is decided at the time of purchase of the policy.

Choosing a co-pay option can also offer flexibility, allowing seniors to tailor their policy according to their health needs and financial capacity. Sharad Bajaj, chief operating officer, InsuranceDekho, says with reduced premium costs, they can maintain access to essential health coverage without straining their savings. “This option is particularly beneficial for those who do not frequently require hospitalisation or expensive treatments, helping them save money while staying insured against major health risks.”

Rakesh Goyal, director, Probus, an insurance broking company, says opting for a co-pay can reduce the premium for senior citizens’ health insurance policies. “They should check if their preferred hospitals are included in the insurer’s network, as receiving care outside the network could result in higher expenses.”

Limitations on coverage

Co-pay options for senior citizens can come with limitations such as caps on claim amounts, exclusions for certain treatments or higher co-pays for specific pre-existing conditions. There may also be limits on coverage for specific treatments or procedures and the insured may have to cover a larger share of the costs if expenses exceed the policy’s cap.

Room rent limits can apply in co-pay, where the insured may need to pay extra if they choose a room that exceeds the allowed rent limit. Additionally, co-pay typically applies only to covered treatments, so non-medical expenses such as consumables or administrative charges may not be included under the policy. Some co-pay plans may set limits on the total amount payable by the insurer annually or over the policy’s lifetime.

Siddharth Singhal, head, Health Insurance, Policybazaar.com, says coverage might also be limited to certain hospitals or could even come with a longer waiting period, which helps make premiums more affordable for the insurer. “Since co-pay is meant to bring your premium down, make sure you compare premium savings against potential out-of-pocket costs with the co-pay.”

Factors to bear in mind

Before opting for co-pay, a senior citizen must evaluate his current health status and frequency at which he may need to get admitted and treated. “If frequent medical attention or hospitalisation is expected, a lower co-pay percentage or no co-pay might be more cost-effective in the long run,” says Bajaj.

2024-09-15T12:27:32Z dg43tfdfdgfd