People get more prone to diseases as they get older. So, having comprehensive health insurance becomes absolutely necessary in old age to cover the increase in expenditure on medical treatment and to cope with the high rate of inflation in the healthcare sector.

To get a full range of coverage without restrictions, it’s better to buy health insurance at a younger age before diseases set in and continue in old age. As the premium increases with the age and is revised periodically to match the increase in healthcare costs, there should not be much difference in the cost of such a health insurance plan and that of a plan designed for elderly people. Yet, senior citizen health policies come with lots of limitations and restrictions on both the insurance benefits and the sum insured as well. This is because in old age people generally have some pre-existing diseases and due to the increased probability of illness, insurance companies don’t want to provide higher coverage.
However, insurance companies underwrite the applications for senior citizen policies leniently – considering the general health conditions at an old age – and issue policies with some limitations, taking into account the associated risk factors. So, before applying for a senior citizen health insurance policy, apart from comparing the premium, you should check how many limitations there are.

Most health insurance companies put the following limitations on the policies for senior citizens:

Cover Amount
Due to higher risks, health insurance companies generally don’t provide higher sum insured to senior citizens and limit it mostly within Rs 5 lakh. On the other hand – depending upon his/her premium paying capacity and eligibility at a lower age – a person may take cover up to even Rs 1 crore, and continue it for life. Try to get a higher cover amount at a competitive price.

Co-payment

To limit their liabilities, most health insurance companies put a co-payment clause in the senior citizen policies, which makes the policyholder bear a percentage of the cost of medical treatment. The higher the percentage of co-payment, the lower will be the liability of the insurer. Some insurers provide the option to select the percentage of co-payment, based on which, the premium would vary inversely. A policy with a lower co-payment will be more beneficial.

Capping

Senior citizen policies mostly come with a capping on the amount to be paid on room rent or for operations related to old-age conditions like knee replacement, organ transplant etc. Try to get a policy with very low or no capping.
Depending on the health conditions of an applicant, insurance companies may also put more limitations – like the exclusion of some diseases, which would limit the benefits of having a health insurance policy for a senior citizen. Try to avoid a policy with too many limitations, which would defeat the purpose of taking insurance in old age.