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What Happens When You Buy A Medical Policy After You Are Old?

Neha Gadoo Neha Gadoo 30 January 2017

In your adult life, you start earning, spending and saving. As you grow older, post retirement, you start spending more and earning less, or not earning at all. So how do you tackle this?

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Well, that is where a retirement fund can be extremely useful. It defines the quality of your post-retirement life. For some wise people, this fund includes investing to buy a health insurance policy while they are young. But most don’t and realize this much later. Here is what happens when you buy a health insurance at later stage of life.

Age Limit- Limits Your Options

The higher your age, the more likely that you would make a claim on your health insurance. Thus, most of the policies have an entry age limit.It means that if you buy a policy at an older age you are left with a limited choice of plans.

Co-payment or Co-pay

Even if you get a policy that covers most of the benefits you want, it might have co-payment or Co-pay clause. Co-pay is the percentage of claimable hospital expenses you have to pay out of your own pocket.It increases your expenses in each case of hospitalization.

It might sound a bit sad to you, but most of the plans which do not have an upper entry age limit, or those plans that are exclusively designed for senior citizens have co-pay beyond certain age. To know about the best medical insurance policy for senior citizens.

Pre-existing diseases or conditions

Pre-existing diseases or conditions are disease, disorders or any other health condition that you might have at the time of buying a policy.

As we grow old most of us have some or the other ailment. If you buy an insurance policy you have an ailment then, one or more of the following are the possibilities:

  1. You will be charged a higher premium based on your ailment at the time of buying a policy this is known as premium loading. You will be charged a higher premium than any other person of the same age but who has bought the policy at younger age (before ailment).This is because as per Insurance Regulatory and Development Authority (IRDA) your premium cannot be loaded in case you have any major disease or condition after buying a policy and if you are renewing it without any break. However, it is completely legal if your insurance company charges you more premium based on a pre-existing condition at the time of buying a policy.
  2. You would have a waiting period of 2 to 4 years only after which your pre-existing is covered, depending on the plan you buy.
  3. Your pre-existing disease would never be covered. Sometimes in case your pre-existing is a little severe then the insurance company would not only load your premium, they might even deny to cover your pre-existing disease and related complications. This might leave you with heavy expenses in spite of having insurance.
  4. Insurance company can deny selling a policy to you. In case, if your pre-existing is chronic and severe like a medical history of heart attack, high diabetes, etc. then the insurance company has a right to deny you a policy. Thus, even if you plan to buy a policy you may not get it when you need it the most.

Even if you have no pre-existing disease and have had a healthy life so far there is a possibility that you might get ailment because of long time lifestyle habit (like smoking or drinking) or because of old age itself. You will be charged a higher premium because of your vulnerability to any illness.Thus, in a true sense if you want to buy a policy right time would be when you are healthy have no disease or conditions.

Medical check-up

Many companies have medical check-up mandatory before issuing a policy beyond certain age.The medical check-up itself is a conditional clause which indicates that only if a person clears the medical check-up will he or she get the policy. Moreover, if your policy is denied the amount spent on medical check-up by the insurance company would be paid from your own pocket.

About 80% of the Indian healthcare industry is privatized. The cost of health care is thus expected to increase to a very large extent in the coming years. With the change in lifestyle, there is an increasing threat of lifestyle diseases which eats up maximum expenses. Thus, to be secure, buy what will cover your expenses as per future needs. You can buy a top-up plan along with a regular health insurance policy. This would save your health expenses with lower premium.

Be healthy, be safe. And don’t let old age come in the way of living a full life!

Neha Gadoo
Written by Neha Gadoo
Daring and Bold, Neha loves philosophy, trekking and walking bare feet in the rain. Loves talking and can stare out of a car window for hours continuously.