One possibly cannot plan for their golden years without taking into account the endless pit of medical expenditure. While health issues commonly tend to soar with age, senior citizens too have unique healthcare needs that need to be addressed with personalised healthcare solutions. Moreover, to be able to avail of the best of healthcare, it is pertinent to be first covered by a robust health insurance policy.

In India, people often overlook the need for adequate health insurance unless a medical emergency strikes. Especially, if we talk about the senior citizen segment, the awareness regarding health insurance is acutely low.

The silver lining, nonetheless, is the constantly evolving insurance industry that now offers more customised solutions for this segment.

Traditionally, the plans came with certain restrictions for senior citizens for the simple reason that they fall in the high risk category profile.

Limitations like lower sum insured or longer waiting periods for pre-existing diseases were common in these plans. However, as the health insurance sector becomes more inclusive and expansive, senior citizen plans move towards a higher and more comprehensive coverage.

Here’s outlining some new-age features that will make senior citizens plans more modular and more flexible for consumers.

Cover from Day 1

India is often referred to as the Diabetes Capital of the World, and rightly so. The country has over 77 million diabetic patients and around 35 million are at risk of developing diabetes. The elderly are more risk-prone when it comes to conditions such as diabetes and hypertension.

These alarming figures make diabetes coverage a mandatory inclusion in health insurance. Keeping this in view, new plans are being devised that offer coverage for these pre-existing diseases right from day 1. A medical condition is classified as pre-existing if the individual has had it for 48 months or more. Day 1 coverage implies absolutely no waiting period for such conditions and the coverage starts right after buying the plan.

High sum insured

Conventionally, the plans would come with a capping on sum insured for senior citizens. However, this segment needs a high sum insured to adequately cater to all their health needs.

The elderly are more prone to health risks, infections or even accidents, so they should be equipped with sufficient coverage at all times to battle these expenses.

Now, plans available for senior citizens offer up to Rs 1 crore sum insured at a monthly premium of around Rs 3,000 in a metro city.

Not just this, plans are now available for policyholders up to 98 years of age, which effectively caters to healthcare needs of super senior citizens as well.

Higher modularity in plans

The plans are now highly modular and the premium can be adjusted as per policyholder’s choice. Earlier, the plans came with a compulsory copayment clause or sub-limit for senior citizens. This placed a restriction on the coverage offered for certain expenses incurred by the policyholder.

Now, the plans have become more flexible to suit the budget and requirements of the policyholder. For instance, you can now reduce or increase your limit of copayment. Similarly, you can choose a single room or shared room depending on your budget and preference.

You can also adjust your voluntary deductibles to lower your premium. The plans also come with minimum to no copayment clause making them an affordable as well as more robust safety shield for senior citizens.

No reduction of bonus

Plans come with a feature called cumulative bonus which allows a certain percentage of sum insured to be added to the coverage every year. Earlier, this bonus would get revoked in case the policyholder filed even a single claim.

The plans now facilitate no reduction of bonus on account of claim, which means your bonus remains unaffected even if you happen to make a claim. So, this feature not only makes your coverage stronger and better every year but also doesn’t let it get affected even if a medical emergency strikes.

The bonus can be up to 10 per cent of the sum insured which significantly adds up to your coverage. The feature is meant to encourage the policyholder to renew their health insurance policy and avail of this benefit.

Flexibility with OPD cover

OPD coverage in health insurance has gained a lot of momentum in recent times. The rise in infectious diseases and other health issues have made OPD or out-patient department expenses a common occurrence for everyone.

Senior citizens, who are more risk prone in such cases, have become even more vulnerable now. Therefore, inclusion of OPD coverage in health insurance is a prudent addition to senior citizen plans in today’s times.

OPD can be part of your plan or can be opted for as an add-on or rider. This will provide coverage for doctor consultation, pharmacy bills, health check-ups or lab tests. So, even if you don’t get hospitalised, you still have the flexibility to get coverage for your healthcare needs.

With the growing need for more modularity and flexibility in senior citizen plans, more benefits like no medical check-ups for policy issuance and more relaxed norms are gradually coming into play to ensure quality healthcare for elders.

The writer is business head —health insurance, Policybazaar.com

Loss of PRAN

My PRAN card has got damaged. How can I request a new card? Is it possible to get one online?

R. Kumar, Calcutta

PRAN (Permanent Retirement Account Number) is a unique number allotted to every subscriber of National Pension System (NPS). In case of loss or damage of PRAN card, the subscriber needs to fill up form S2 - request for change/correction in subscriber master details and/or reissue of PRAN card. You may check the form at the NSDL website. The filled up form needs to be submitted to the respective point of presence service provider. After the request is processed by CRA (Central Record keeping Agency), a fresh PRAN card will be printed and set to the subscriber’s registered address. If you have registered for the online services of NPS, you may view the ePRAN card or reprint PRAN card using mobile based authentication through OTP.

Gap in LIC pension

My monthly pension under LIC’s Jeevan Akshay VI was stopped from November 2021 to March 2023 without informing me. On complaining, the authority started paying from April 2023. Am I entitled to receive interest for non-payment period?

Dilip Syam, email

LIC’s Jeevan Akshay is an immediate annuity plan with at least 10 options depending upon the choice of the policyholder. But the very nature of the policy being immediate annuity, you should immediately start receiving regular income after investment. So, you may first think about getting back the annuity amount that was not paid between November 2021 and March 2023. If you think that you have a valid case and there was no reason for the insurance company to stop the annuity, you may consider approaching the insurance ombudsman. There are instances where the insurance companies have settled claims on an ex-gratia basis on successful complaints.