Health insurance is gaining in prominence in one’s portfolio of insurance products. This applies to the 30-year-olds or the 60-year-olds, with the latter now accessing a vibrant insurance marketplace. For the first-time buyer in either age group, the product fit and features should be different, just as aspirations and needs vary. We list some factors in buying decisions that are relevant to both categories in finding the right health insurance.

Focus at 30 - Benefits, family, and wellbeing

A 30-year-old is now health-conscious, has an increased family responsibility and has a higher likelihood of overseas visits. Going by such characterisation, the ideal health policy should also be just as agile and rewarding.

The frequency of hospitalisation if any, should be lower in early thirties — which should allow for maximising the coverage amount through NCBs (No claim bonus). Policies offer not only doubling of coverage amount but also accomplish the same in the shortest time. A ₹5-10 lakh policy of a 30-year-old can increase to ₹10-20 lakh in 3-5 years. While 60-year-olds should also go for the same, a higher frequency of hospitalisation can dilute the benefits of such a feature. Niva Bupa Reassure Direct 2.0 and Manipal Cigna Prime Advantage offer high NCB accumulation to the tune of 2x-5x times base policy in 3-5 years.

The health and fitness conscious 30-year-old can also gain from discounts on premiums for an active lifestyle. Wellness-centred products let the policyholder gain points which are then redeemed for benefits including, discounts on next premium payment. One can annually save up to 10-25 per cent with these rewards. ICICI BeFit app, Aditya Birla’s Activ suite of products can capture lifestyle data through wearable tech, which is then used to deliver benefits.

From 30 years onwards, the individual is likely to take on the responsibility of parents or in-laws on one hand, and spouse and children on the other. A policy that can be expandable to a family floater, has options for maternity covers, large enough restoration cover, should be priority for a 30-year-old. HDFC Optima Secure plans can accommodate the full family (parents, spouse, and child) and can cost between ₹60,000 and ₹1 lakh per annum compared to taking individual plans.

The jet-hopping global citizen of today should also prioritise a health policy that offers a worldwide coverage — including not only emergency hospitalisation but also in-patient care when on an overseas trip. Tata AIG Medicare plans offers the widest scope for worldwide covers.

Wider coverage and lower hassle for the elderly

A first-time health insurance buyer at the age of 60 can face a lower availability of products but compared to five years back the current market is an improvement. However, pricing is thrice compared to a 30-year-old’s premium at average of ₹25,000 per year.

The buyer should focus on coverage and hassle-free settlement at this age. Waiting period for pre-existing diseases starts at 4 years across policies but Star Senior Citizen Red Carpet reduces PED waiting to one year, Niva Bupa or Care Health Insurance and a few others offer two years waiting and so on. Another useful tool to have is to restore the base cover amount used up in the year, and that too for related illness.

A ₹1-crore health policy or alternatively a top-up to a base policy may not be outlandish anymore, considering medical inflation. But despite a strong base cover, a critical illness rider may be useful to cover large outlier risks. For cancer, cardiac or transplant diagnosis, a critical illness rider can provide a large payout (then the policy terminates) to address the treatment suitably.

The senior policy buyer must also confirm the coverage for therapies which are placed under sub-limits. Cataract, knee replacement, dental, are a few of the procedures that are capped on coverage or have an extended waiting period, which is better avoided.

OPD or teleconsultation is becoming a widely used feature and policies that focus on such coverage can be a useful addition to the elderly. The cost of consultation and the frequency of consultation will increase with each passing year and the convenience and coverage can become a coveted feature of policies.

A wide array of features in today’s health policies should allow one to build a product fit to his/her needs. While a 30-year-old can focus on NCB, wellness, global and family floater, seniors can choose policies prioritising coverage, PED waiting and lower hassle achieved through years spent with the insurer.

Different strokes
Young vs old buying decisions should be different, given wide array of features
NCB, wellness, family and global coverage at a younger age
Lower PED waiting, OPD cover, and critical illness covers for seniors
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