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Is there a Health Insurance Age Limit for Buying a Policy?

  • Author :
  • TATA AIG Team
  • Published on :
  • 25/07/2022

The onslaught of the recent pandemic taught us two pertinent things: firstly, the importance of hygiene, and secondly, the unpredictability of life. While there is no time for illnesses and diseases to knock on our door, the probability of contracting them increases with age. However, the Insurance Regulatory Development Authority of India (IRDAI) maintains that the maximum age for health insurance in India is up to the age of 65. This means that any individual up to 65 years of age can invest in a health insurance policy. Regardless, it is always advised to invest in medical insurance in the early stages of life to reap the many benefits it offers.

The Disadvantages of Investing in a Health Insurance Plan After the Age of 50

Now that we know the age limit of health insurance let us understand why financial experts recommend an early investment in medical insurance. Buying insurance when an individual reaches the health insurance age limit in India comes with greater scrutiny from insurance providers with terms such as compulsory pre-insurance health check-ups, no coverage for pre-existing ailments, etc. This is because regardless of how well you maintain your health, when you reach a certain age, your susceptibility to illness increases.

Following are some of the disadvantages of investing in a health insurance plan when one reaches the maximum age for health insurance in India: -

  • Limited Benefits

What a medical insurance age limit does not reveal is that the benefits of a health insurance policy are limited for senior citizens as compared to younger adults. Whether it is to strengthen a cover with riders, or even something as simple as getting a cheaper premium payable, once you invest in a health insurance plan after the age of 50, your coverage will be comparatively less inclusive.

  • Higher Premium Payable

The health insurance age limit may be pegged at 65, but by then, insurers view potential policyholders as high-risk candidates which subsequently translates to higher premiums payable. The logic is simple — the younger you are, the healthier your body is. And therefore, as you climb up the age ladder, your premiums are bound to increase. Individuals over the age of 50 might even have to make adjustments with limited coverage and removal of certain insurance riders.

  • Longer Waiting Period

All medical insurance covers come with a waiting period. Meaning, that once the policy is purchased, the claim can only be made after a certain period passes wherein the policyholder makes regular premium payments. And while this waiting period varies, when you are older, you do not know when you will need the money, which is why investing in medical insurance long before one reaches the health insurance policy age limit is recommended. Doing so increases the probability of the waiting period ending so you can make a claim when you most need it.

  • Limited Sum Insured

Most insurance providers will have a cap on the coverage amount that policyholders can claim. This is determined by the health of the insured member through a medical check-up. If your medical check-up reveals pre-existing health conditions, then chances are you will get a limited sum insured as the possibility for illnesses increases as one inches closer to the health insurance age limit.

  • Pre-Existing Ailments

Pre-existing illnesses are the ones that a medical insurance seeker is aware of or seeking treatment for the same at the time of policy purchase. When one is closer to the health insurance policy age limit, the chances of contracting these diseases increases. That is why most insurance providers refrain from covering pre-existing illnesses unless under a special plan or when the policy seeker purchases a rider. Several insurance companies also secure themselves by increasing the waiting period for individuals with pre-existing illnesses.

Considering the above-mentioned points, it is easy to understand why financial experts recommend buying a health insurance policy before an individual reaches closer to the health insurance age limit in India. However, there is no need to fret if you have reached the age limit of health insurance as there are several insurance providers who offer medical insurance plans for senior citizens and cover all the medical treatment charges, such as pre-, and post-hospitalisation, surgeon’s fees, ICU charges, etc.

Myths About Senior Citizens’ Health Insurance Plan That Need to be Busted

Misinformation leads to several problems and must be avoided, especially where financial decisions are concerned. Here are the most commonly believed myths surrounding senior citizen’s health insurance policies that need to be cleared for informed investment decisions: -

  • Group cover is all-inclusive:

Most aged Indian parents believe that being covered through their children’s company is enough to pay for all their medical expenses. This may not be entirely true. A company’s health insurance policy has limitations and is rarely ever as good as a separate medical cover.

  • No cover for pre-existing illnesses:

Several aged persons wrongly assume that simply because they have a pre-existing ailment, they cannot avail of a health insurance plan. However, most insurance providers will still provide health coverage despite the applicant’s pre-existing health condition. They might only have a longer waiting period.

  • Health Insurance is not important for healthy persons:

Just because you are healthy today does not mean you can predict your health for the future. While it is always recommended to maintain a healthy lifestyle, life is unpredictable, and a health insurance policy covers your worst-case scenario.

Factors to Consider Before Investing in Health Insurance

  • Analyse personal needs: Every individual is unique, and so their insurance needs will also be diverse. It is important to know your lifestyle and take a look at your family’s medical history before you invest in a cover for comprehensive protection.

  • Compare plans: Regardless of the kind of insurance you seek, it is always recommended to compare different policies to find one that meets your requirements. The factors for comparison include coverage, premium, and inclusions.

  • Read the document thoroughly: Just as with inclusions, it is equally important to be aware of the policy exclusions. Ask your insurance provider to reveal the exclusions before you make a purchase to avoid any unpleasant surprises in the future. Additionally, make sure that all the insurance documents are carefully read and understood before signing.

  • Make a note of the waiting period: There is no use for a health insurance plan if you cannot get the money when you most need it. And so, it is crucial to check the waiting period for making a claim at the time of policy purchase.

  • Check the hospital network: Finally, for a seamless medical service, check the network of the insurance provider’s hospital to avoid paying from your pockets when the time comes.

To Conclude

Although the medical insurance age limit is pegged at age 65, it is wiser to purchase insurance early. As lifestyle diseases increase with a subsequent rise in medical expenses, investing in a comprehensive health insurance plan becomes all the more relevant. Moreover, in addition to covering the soaring medical and hospitalisation expenses, you can also avail of health insurance tax benefits which accumulate over time. As per Section 80D of the Indian Income Tax Act, individuals can get health insurance tax benefits on the premiums paid. Therefore, when one invests in medical insurance early, the financial burdens on behalf of the policyholder are taken care of by the insurance provider in the later stage of life.

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