After retirement, you may not want to get into a situation where your health insurance claims are rejected. So, you must get the appropriate health insurance policy that suits your retirement needs. How to do it? Well, here are the factors that you should consider when choosing a senior citizen health insurance policy.

Clause Related To The Sub-Limit

“Senior citizens must check the clause related to the sub-limit, which restricts the ceiling amount the insured can claim for a certain medical procedure or expense. Since the sub-limit for different medical complications varies, it is important to review the fine print carefully to understand the clauses related to each procedure”, says Shilpa Arora – Co-founder & COO (Chief Operating Officer) at Insurance Samadhan.

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Depending on the policy’s terms and conditions, senior citizens’ health insurance policies may consist of sub-limits on claims related to certain ailments, so you must check it before getting your policy.

Waiting Period For Pre-Existing Disease (PED)

Older adults are more prone to illnesses and their likelihood of getting hospitalized is also significantly high mostly due to their pre-existing medical conditions. To offset this risk, insurance companies use the waiting period to prevent senior citizens from claiming benefits for pre-existing illnesses a few months into the policy. However, due to their high susceptibility, senior citizens are advised to look for products that are lenient when it comes to the waiting period for PEDs.

Coverage Of Domiciliary Treatment

Aroraadds, “Individuals must check whether the health insurance has provisions for domiciliary care and the clauses that find them. Sometimes, geriatricians recommend certain treatments to be administered to patients at their homes. The domiciliary care provision helps cover expenses related to home-based treatments, helping individuals address the potential treatment costs”.

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Other Factors That Senior Citizens Must Consider

Seniors planning to buy a health policy may prefer products that offer additional benefits such as critical illness add-ons, wellness benefits, free annual health checkups, etc.

Experts point out that most senior citizen policies come with a co-payment clause and the percentage of the amount depends on their waiting period. Typically, the percentage of co-payment increases if the policy comes with a short waiting period. So, individuals should check the co-payment clause which requires the insured to pay a certain portion of their claim amount from their pocket

The author is an independent financial journalist.