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How to Choose the Best Health Insurance for Senior Citizens?
When people get closer to retirement, their well-being and financial stability become their top priorities. Choosing between regular health insurance and senior citizen health plans can be particularly difficult for many when choosing the best health insurance plan. Each of the solutions has specific advantages and disadvantages that are suited to distinct requirements. We'll go over the specifics of regular and senior citizen health insurance policies in this extensive article to help you decide which coverage is best for you as you age.
What Is Senior Citizen Health Insurance?Senior citizen health insurance plans are made especially for people over 60. These policies cover numerous medical costs, such as hospital stays, surgeries, and treatments for serious and pre-existing conditions. In contrast to regular health insurance, senior citizen health insurance policies frequently feature short or no waiting periods for pre-existing diseases, guaranteeing that elderly patients obtain prompt and sufficient care without having to pay large out-of-pocket costs.
Benefits of Senior Citizen Health Policies- Medical Coverage for Seniors
One of the most significant advantages of senior citizen health insurance plans is their comprehensive medical coverage to individuals over 60. While regular health policies may cover individuals only up to age 65, health insurance for senior citizens ensures that those in their later years can still access necessary medical treatments and services. - Minimal Medical Screening
Another benefit of senior citizen health insurance is the minimal medical screening required. Most senior citizen health plans do not mandate extensive medical checks, making it easier for seniors to obtain coverage without the hassle of undergoing numerous tests and evaluations. - Cashless Treatments
With senior citizen health insurance plans, policyholders can avail themselves of cashless treatments at network hospitals. This means seniors can receive the necessary medical care without worrying about paying hefty bills upfront. The insurance provider settles the claim directly with the hospital, alleviating the financial burden on the policyholder. - No Claim Bonus
If a senior citizen goes through a policy year without making any claims, they can benefit from a no-claim bonus. This bonus increases coverage for every subsequent claim-free year, providing additional financial protection as the policyholder ages.
Regular health insurance policies offer coverage for various medical expenses, similar to senior citizen health insurance. However, they do not provide specific allowances for senior citizens. One key difference between regular health insurance and senior citizen health insurance policies is the waiting period for pre-existing illnesses. Regular policies may have a waiting period of up to 48 months, whereas senior citizen health insurance plans typically have shorter waiting periods of just one or two months.
Benefits of Regular Health Insurance- No Mandatory Co-Payment
Regular health insurance has the advantage of not having a required co-payment provision. Policyholders are not obliged to pay a portion of every claim, which simplifies the process of handling medical costs. On the other hand, senior citizen health plans frequently have a required co-pay provision that requires policyholders to contribute to some of their medical expenses. - Short Waiting Periods
While regular health insurance policies have waiting periods for chronic illnesses and pre-existing conditions, they are generally not as long as they once were. Many policies now offer just 30 days or less waiting periods, depending on the insurer and the specific policy. This makes regular health insurance a viable option for many seniors who need prompt coverage. - High Sum Insured Amounts
Regular health insurance policies allow policyholders to opt for higher sum insured amounts, sometimes up to INR 1 crore. In contrast, senior citizen health insurance policies typically cap their coverage at INR 20 lakhs. This higher sum insured amount can provide significant financial protection in major medical emergencies.
Both senior citizen health insurance and regular health insurance have their own advantages and limitations. Let’s compare the two to help you understand which might be the better option for you:
- Sum Insured
Senior citizen health insurance plans often cap the sum insured at INR 10 lakhs, whereas regular health insurance policies can offer coverage up to INR 1 crore. A regular health insurance policy might be more suitable if you anticipate high medical expenses. - Co-Pay Clause
Senior citizen health plans usually have a mandatory co-pay clause, requiring policyholders to pay a percentage of each claim. On the other hand, regular health insurance policies do not have a compulsory co-pay clause, although some policyholders may choose this option to reduce their premiums. - Waiting Periods
One of the most significant benefits of senior citizen health insurance is the minimal waiting periods for pre-existing and chronic illnesses. Regular health insurance policies do have waiting periods, but these have been reduced significantly in recent years, with some offering periods as short as 30 days.
Several criteria, such as age, health, financial status, and needs, influence the choice between regular health insurance and senior citizen health insurance. To assist you in making the right decision, take into account the following:
- Age and Health
Senior citizen health insurance policies with short waiting periods may be better if you are over 60 and have pre-existing conditions. These plans offer prompt and all-inclusive coverage tailored to senior citizens' health needs. - Sum Insured Requirements
A regular health insurance policy might be more suitable if you require a higher sum insured amount to cover potential medical expenses. Regular policies offer higher coverage amounts, which can be crucial in major medical emergencies. - Co-Pay Preferences
A regular health insurance policy might be a better fit if you prefer not to deal with a mandatory co-pay clause. While senior citizen health insurance policies often require co-payments, regular policies typically do not have this requirement. - Financial Considerations
Consider your financial situation and ability to pay premiums. Senior citizen health plans might have higher premiums due to the policyholder's age and health risks, but they also provide specific benefits tailored to seniors. Regular health insurance policies might offer more flexibility regarding premium payments and coverage options.
Securing your health and financial needs as you age depends on selecting the appropriate health insurance plan. Regular health insurance policies and senior citizen health insurance plans provide worthwhile advantages, but they serve different purposes and requirements. You can choose the most excellent coverage for your senior years by being aware of the variations and considering your particular circumstances.
When choosing a health insurance provider, consider trustworthy options like SBI General Insurance, which is renowned for its extensive plans and customer-focused services. You may feel secure knowing that SBI Insurance will care for all your health insurance needs with the utmost professionalism and attention, guaranteeing a safe and healthy future.
Disclaimer: The above information is indicative in nature. For more details on the risk factor, terms and conditions, please refer to the Sales Brochure and Policy Wordings carefully before concluding a sale.
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Health Insurance
How to File a Health Insurance Claim?
With the rising medical expenses and changing lifestyles, it has become imperative to purchase a comprehensive health insurance plan in today‘s time. Additionally, the recent COVID-19 pandemic has further established the importance of health insurance even firmly. A health insurance policy is the finest way to receive the best medical treatment without burning a hole in your pocket.
Be it an unforeseen medical emergency or a planned treatment, a health insurance policy can always come to your rescue. However, to avoid any last-minute hassle, you must be well aware of the process to file a health insurance claim beforehand. Below is a quick guide on how to file a health insurance claim.
But firstly, let‘s understand what a health insurance claim is.
Health Insurance Claim
A health insurance claim is a request that a policyholder must submit to the insurer for getting the services that are covered in their health insurance policy. Depending upon their convenience, policyholders can either opt for a cashless claim settlement option or reimbursement for the availed medical services.
Cashless Claims
For cashless claims, the insurance provider settles the hospitalization bills directly with the hospital. However, to get the benefits of a cashless claim, the policyholder should be hospitalized only at a network hospital of the insurer.
Reimbursement Claim
In case of reimbursement claims, the policyholder pays for the hospitalization expenses and later requests for reimbursement by the insurance company. The reimbursement facility can be availed at both network and non-network hospitals.
Now that you are well aware of the types of health insurance claims, let‘s understand how to file a health insurance claim
How to File a Health Insurance Claim?
1. Get in touch with the insurance help desk at the hospital
2. Show the ID card of the insured provided by the insurance company
3. The hospital will verify the insured‘s identity and will submit the pre-authorization form to the insurance company
4. The insurance company will then review all the documents submitted and process the claim as per the terms and conditions of the health insurance policy.
5. For reimbursement claims, you will also have to submit original bills to the insurance provider. The insurer will then evaluate the claim and make a payment to the insured. In case the treatment is not covered under the health insurance policy, the claim will be rejected.
Make sure that you have the following documents readily available with you before filing a health insurance claim.
Documents Required to Make a Claim
Valid photo ID cards such as Aadhaar, PAN, and Driving License
Copies of prescription for diagnostic tests, treatment advice, and medical references
Original set of investigation reports
Original hospital and pharmacy bill
Original discharge card or discharge certificate
It‘s always advisable to opt for an insurance company with a high claim settlement ratio and a large number of network hospitals. This makes the claim settlement process completely hassle-free.
Frequently Asked Questions (FAQs)
1. When can my health insurance claim be rejected?
Your claim can be rejected if you file a claim for an ailment that isn‘t covered by your health insurance policy. Moreover, your claim can also be rejected if you fail to submit the necessary documents or file a claim during the waiting period
2. What is the minimum time limit for hospitalization to make a health insurance claim?
You can file a claim if your hospitalization is for more than 24 hours. However, for certain treatments, such as dialysis, chemotherapy, etc., the stay could be less than 24 hours
3. What is claim settlement ratio?
The claim settlement ratio is the ratio of number of claims paid to the number of claims received
Health Insurance
All About Adding Spouse To Health Insurance After Marriage
Marriage brings a lot of changes in your life. Not only does it affect your lifestyle, but it also requires you to switch your investments in a way that are better suited for a family. You will now want to include your spouse to your financial world by adding them as a nominee in your banking accounts and other investment assets. Amidst all these personal and financial changes, do not forget to add your spouse to your health insurance plan. Adding spouse to health insurance after marriage is quite easy and can be done in three ways.
Buying a new family floater plan
If you do not have an existing health insurance plan, now would be a great time to invest your money in a family floater health insurance plan. Health insurance plans for family members cover your spouse, parents, and dependent children. The family floater plan allows you to pay a single premium to cover all named family members for medical expenses.
When buying a family floater plan, do ensure that it offers adequate coverage for you and your family. It is also important to keep in mind that the coverage amount is directly proportional to the health insurance premium you need to pay. This means that a family health insurance plan that offers a sum insured of Rs 10 lakh will require you to pay lower premium as compared to a family health insurance plan that offers coverage of Rs 20 lakh. However, it is advisable to opt for a higher sum insured if you have senior members in the plan.
Adding spouse to insurance after marriage
If you already have an existing health insurance policy, you can extend the cover to your spouse by adding their name to the policy after marriage. Upon adding you spouse, the individual health insurance plan will be transformed into a family floater plan. Since the coverage amount will increase, the premium of the policy will be recalculated. You can also add your spouse to your existing health insurance policy at the time of its renewal. You will need an application form and a few KYC documents like identity proof, residence proof, marriage certificate and photographs, to get this process started. You can easily get the application form from the insurer’s website.
Adding your spouse to the health insurance plan offered by your employer
There are many companies that offer health plans to their employees. These plans usually extend the coverage to the immediate family of the employee. However, this condition varies from one insurer to the other. Hence, it is better to check with your insurance company if they allow you to add your spouse to the existing health insurance plan that is issued by your employer. Here, it is important to remember that the health insurance policies offered by employers are group insurance plans and may, therefore, have certain limitations to coverage. Still, these plans offer a great option for coverage in case you don’t have health insurance of your own.
It is quite important to avail the health insurance cover for your spouse after marriage. This can help the both of you to securely plan your financial future.
Disclaimer: The above information is indicative in nature. For more details on the risk factor, terms and conditions, please refer to the Sales Brochure and Policy Wordings carefully before concluding a sale.
Health Insurance
Steps of adding spouse to health insurance after marriage
Marriage is a huge step in everybody’s life. And personal finance has a big role to play for a successful married life. Therefore, it is important to update the financial records, including the health insurance plan, post-marriage.
In case you did not have an individual health insurance policy before the wedding, you can invest in a family floater plan for yourself and your spouse. In case you already have an individual health insurance policy at the time of wedlock, then you do not need to buy another one for your partner. Instead, you can add your spouse to the plan and convert it into a single policy. It is a feasible and simple way of ensuring that you and your partner are adequately covered.
Porting health insurance after marriage is also important. When one of the partners already owns a plan, you simply need to add another partner to the current policy as the spouse. There is no specific rule which specifies who can add the partner. The process of adding the spouse to health insurance after marriage is simple. The one who owns the policy can start this process with the submission of KYC documents such as identity proof, proof of age, photographs and marriage certificate.
The change will come into effect in the next policy renewal by just submitting the additional form and paperwork. Once you do this, the premium will be calculated and pro-rated. It will become a family floater insurance policy that covers all the members of the family for a single premium. You will not have to worry about paying separate premiums for each member of the family. It will cover the entire family at the lowest premium based on the age of the members in the family. Let us take a look at the benefits of a family floater plan.
A major perk of the floater plan is that you can cover yourself and your entire family in one policy. The policy is easier to handle and you do not have to worry about handling separate individual plans
You enjoy additional benefits like a newborn cover, maternity benefits, etc. It will be highly effective for young married couples who are on the road to starting a family. You must ensure that you choose a plan that covers yourself and the spouse and invest in one right after marriage
You must also get maternity cover at the earliest. It has a waiting period between 0 to 4 years and if you buy the cover on time, you will be able to enjoy the maximum benefits
With a family floater plan, you enjoy the same tax benefits under Section 80D as you do on individual health insurance
Many plans come with a reinstatement feature where you enjoy the reinstatement of the entire coverage after it is exhausted in the policy period. This is only applicable to unrelated claims but it is very useful.
If you do not have a policy and are looking to buy one, consider a joint life policy. It will work on the same lines and will provide coverage to your children in future if anything unfortunate happens to the parents. The main reasons couples should think of joint life insurance are premium reduction and waiver benefits. In this case, if one partner dies due to an unfortunate event, the spouse will not only be entitled to enjoy the full sum assured on the cover but will also be absolved of the responsibility of the payment of premium. Alternatively, the spouse may have to pay premiums only applicable for their own cover for the remaining period of the policy.
After your marriage, it is your responsibility to ensure the safety and adequate coverage of your spouse. You must include your spouse in the decision and speak to them about the coverage you wish to buy. Only then proceed with the decision. The right health insurance plan will offer acomplete protection and peace for the future.
Disclaimer: The above information is indicative in nature. For more details on the risk factor, terms and conditions, please refer to the Sales Brochure and Policy Wordings carefully before concluding a sale.
Health Insurance
Advantages of Group Health Insurance
As the name suggests, group health insurance is aimed to offer health insurance cover to a group of people, usually employees, and if offered by an employer. It can also be offered to members of a professional association or a society. As compared to individual insurance, group insurance has many benefits for the employee as well as the employer who offers the insurance.
Comprehensive cover: Group health insurance plans offer wide coverage and can be customised by the employer. It comes with many benefits like cashless healthcare services at network hospitals. There is no waiting period which means the employee is covered from day one. Besides personal accident cover, some group health insurance plans offer cover to family members of the employee.
Guaranteed cover: All employees and in some cases their dependants are covered, even if they have existing medical conditions. A group insurance policy doesn't require a separate medical check-up. As long as an employee is working for the organisation offering group health insurance, he or she shall remain covered under the plan.
Low premium: As group health insurance plans are bought for a larger group of people, they offer comprehensive cover at affordable rates. The costs are much lower than individual health insurance plans. Group health insurance plans can be customised as per the employer’s budget and requirements.
Tax incentive for the employer: Besides safeguarding employees from health issues, group health insurance plans also provide tax benefits to the employer. Under Section 80D of the Income Tax Act, tax relief is offered to businesses that give their employees the benefit of group health insurance.
Happy employees: When companies offer health insurance plans to their employees, they help retain and attract good talent. A Group Health Insurance plan is a significant part of the employees’ total compensation. A group health insurance plan provides employees with financial security against accident and illness.
Rider options: With a nominal extra payment, employees can take advantage of other additional benefits. The employee can also opt for a corporate plan along with the base plan offered by the employer. The riders may differ from one organisation to another.
Provide your employees SBI General Group Health Insurance
Group health insurance is a very important benefit that makes employees feel like a valued part of an organisation. It helps companies retain as well as attract talent. SBI General Group Health Insurance plans offer multiple coverages: Individual, family floater. It offers wide coverage from Rs 1 lakh to Rs 7.5 lakh. The group health insurance plans offer pre- and post-hospitalisation expenses. With SBI General group health insurance plans keep your employees happy.
Disclaimer: SBI General Insurance Company Limited I Corporate & Registered Office: 'Natraj', 301, Junction of Western Express Highway & Andheri - Kurla Road, Andheri (East), Mumbai - 400 069. | The information in the advertisement is indicative in nature. For more details on the risk factor, terms and conditions, please refer to the Sales Brochure and Policy Wordings carefully before concluding a sale. * ‘Tax benefits are subject to changes in tax laws’ I 'For SBI General Insurance Company Limited IRDAI Reg. No. 144 dated 15/12/2009 | CIN: U66000MH2009PLC190546 | SBI Logo displayed belongs to State Bank of India and used by SBI General Insurance Co. Ltd. under license. | Website : www.sbigeneral.in,Tollfree 18001021111 | UIN: SBIHLGP21330V022021 | ADDIG/20-21/AUG/652
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