I am a retired banking professional, aged 65, and have type-2 diabetes. I currently have a senior citizen health insurance policy with a sum insured of ₹10 lakh. I have had a claim-free history for the last five years. However, while renewing my health insurance premium this year, my insurer asked me to pay a hefty premium. I am seeking expert advice on whether there is any way to manage my premium and make this policy more affordable without losing benefits such as PED coverage, pre-and post-hospitalisation cost coverage, free annual health check-ups, etc. Also, can I port my policy?
Sarathy
Affordability in health insurance premium is an understandable concern for senior citizens. Irrespective of the reasons, it is a good idea to review your health insurance plan from time to time to assess if it still meets your needs, and whether it is still the best option available in the market for you. Since you have stated that the reason you are thinking about this is a substantial rise in cost, let me first discuss some ways to manage the premium.
The two most common ways to do so are deductibles and co-pay.
Deductibles and co-pay
In co-pay, you would have to pay a certain pre-decided percentage of hospitalisation expenses out of pocket. For instance, if your co-pay is 10 per cent and the bill is₹12 lakh, you’ll end up paying ₹1.2 lakh.
If you opt for a deductible, you will be required to pay a certain portion of the bill out of pocket. Deductible can be as high or as low as the policyholder wishes it to be.
For instance, if you opt for a deductible of ₹1 lakh and your hospital bill is ₹12 lakh, the insurer will pay ₹11 lakh and you will need to pay ₹1 lakh. This differs from co-pay, where the out-of-pocket expense increases with the hospital bill. When you opt for a deductible, you are setting your liability to a set amount, which is a better way to manage the premium outgo. Also, you can select the aggregate deductible as opposed to per-claim basis, which will ensure that you don’t need to pay for every claim separately.
Porting one’s policy
Now, coming to the question of porting your policy, fortunately, you need not stick to the same policy, or even the same insurer. You can explore and compare premiums and coverage offered by different insurers. The insurance regulator has formulated certain rules for health insurance portability which ensure that policyholders don’t lose the accumulated renewal benefits if and when they switch to another health insurance company. So you don’t have to lose out on your accumulated no-claim bonus (NCB) while porting. However, you can port your policy only at the time of renewal.
As a senior citizen with type-2 diabetes, you can opt for plans that offer coverage against pre-existing diseases from day one. A health plan that offers day-1 protection is highly recommended for senior citizens. It usually comes in the form of an ‘Instant Cover’ rider and covers you against listed pre-existing ailments, such as diabetes, hypertension, etc.
At your age, you can also consider increasing your sum insured by opting for a top-up plan. A top-up plan provides additional coverage once your base policy limit is exhausted. However, it costs much less than increasing the sum insured in your base plan itself.
The writer is Joint Group CEO, PB Fintech
Send your queries to insurancequeries@thehindu.co.in