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In-patient Hospitalization of Senior Citizens

Good grief! It’s an emergency!

Old age is the most fragile and delicate age where care and treatment become a necessity for aged people. They are more prone to diseases and might already suffer from few diseases. It might not be in the knowledge of your parents, so you must be a little more cautious and take them for regular check-ups and find out about pre-existing ailments. Majorly, hospitalization for senior citizens becomes an essential thing. It’s common to miscalculate the exact need and requirement for in-patient hospitalization under the health insurance policy. Prior research is a must! To lessen your stress and save your precious time, we have stated some facts necessary to be acknowledged before looking for in-patient hospitalization coverage.

What is In-patient Hospitalization in Health Insurance?

In-patient hospitalization is the admission to the hospital for medication and treatment. It depends on the doctor to permit or admit you to the hospital. By examining your health status, the doctor may write a note to admit you in case of severe trauma or critical illness.

Your health insurance covers ICU room charges, doctor’s fees, Anesthesia, etc. The insurance company will provide you with a large cover but with sub-limits. In-patient hospitalization comes with its costs and benefits.

Why is in-patient hospitalization most efficient for senior citizens?

Ageing is an extraordinary and natural process. With advancing age, you gradually become more prone to diseases. You will remain confident on how to fight these diseases.

In the later period of life, your body organs don’t function well; body aches become a regular problem. This makes doctor’s regular supervision a necessity for you. In case of any untoward incident, it becomes an uphill task for an aged person to visit the hospital for treatment.

Senior citizens require constant checks during their treatment. A minute of ignorance can result in serious errors. To avoid such additional risks, it is advised to opt for in-patient hospitalization for senior citizens.

Features of In-patient Hospitalization for Senior Citizens 

Is health insurance coverage sufficient for senior citizens?

When it comes to your loved ones, you have to stay vigilant to secure them out and out. Health insurance cover alone is not sufficient for the assurance of well-being of senior citizens during treatment. It would help if you had to be sure about some variables that may affect the in-patient hospitalization.

  • Waiting period- it is the period in which you cannot enjoy your claim benefits; well neither in case of planned hospitalization nor in case of emergency hospitalization. It varies between 30-90 days, but in the case of senior citizens, it could be lower than usual. 

Senior citizens have reduced immunity strength; thus are most prone to diseases. As a result, they require immediate treatment and hospitalization. The waiting period also varies by the type of illness, pre-existing illness or critical illness.

  • Daily allowance- It includes a lump-sum amount that your insurance provider would give you to take care of the day to day expenses of your aged parent’s treatment. This cash benefit includes a fixed amount that varies from insurer to insurer.    

How is it calculated? It is a percentage amount of the total sum assured. It helps in dealing with expenses like X-ray charges, in-patient expenses, doctor’s fees, etc. for maximum 5-10 days.

  • Co-payment- It is the fixed amount that you commit to pay towards medical expenses. It is a percentage amount that you have to pay, and the insurer would spend the rest amount. There is a separate co-payment clause in the insurance document.

What is so fancy about the co-pay clause? 

Opting for the co-pay clause in the health insurance for senior citizens results in a lower premium amount or even ensures discounts at a pre-defined rate. Co-payment is a kind of expenditure but acts as a financial aid during in-patient hospitalization.

  • Sub-limits- In the later years of life, the probability of getting sick increases, which results in a more financial burden for medical treatment. It is advisable to hunt for high coverage health insurance for senior citizens, but it increases the premium amount.

How does it affect the claim?

The claim amount gets capped, i.e., a limit would be set on the total amount that you’ll get. It gives maximum coverage offered for specific expenses rather than additional expense benefits.

  • Medical observation- To officially avail the in-patient hospitalization benefits, you must stay in the hospital for at least 24 hours.

What if you stay for more than 24 hours but under medical observation? 

Sometimes, in case of an emergency, you have to rush to the hospital. The doctor might keep you under medical observation in the emergency room for more than 24 hours. Ageing parents might shock you with some medical emergency like attack, stroke, etc., which requires time to operate.

  • Covers wide array of expenses- Health insurance cover deals with various costs during in-patient hospitalization, which buffers your financial sentiments. List of covered medical expenses includes hospital expenses, other medical expenses, ambulance charges, organ donor expense, day-care treatment expenses etc.

How does it provide security to senior citizen hospitalization?

Financial and medical aid acts as a protection to the old age of your elderly parents. When such expenses get covered, it provides a sense of relief to you and results in streamlined treatment.

  • Premium to benefit- Benefit is the utility derived from the product. Benefits should be generally compared with the cost of the product. In the case of health insurance, the premium is the cost. Health insurance for in-patient hospitalization offers benefits covering a wide array of expenses, provides you with daily allowances, tax benefits for up to Rs.30,000 for senior citizens up to 60 years of age, cashless hospitalization, critical illness treatment etc. 

Due to high coverage for senior citizens, the premium also increases. But facilities dispensed by the health insurance in comparison to premium cost are reasonable.

Coverage for an In-patient hospitalization policy

The primary aim of health insurance is to cover costs. Health insurance for in-patient hospitalization for senior citizens covers a series of expenses-

  • Hospital expenses- In-patient hospitalization incurs various hospital expenses like room charges, ICU charges, doctor’s fees, nursing fees, fees charged for consultation, by surgeons, anesthetist, specialists, diagnostic tests, x-ray, blood tests. It might also include ambulance charges up to a specific limit in case of emergency transportation.
  • Medical expenses- Medical costs vary by the type of treatment. Some expenses are generic, like the cost of medicines, blood, anesthesia, surgical appliances, room charges, etc. Other costs include specific charges like dialysis, orthopedic implants, radiotherapy, chemotherapy—the cost of medical devices and appliances like a pacemaker, vascular stents and cost of surgical instruments.
  • Organ donor expenses- It includes expenses incurred in the surgical treatment of transferring an organ or a tissue from one person to another. Organ donor expenses include the cost of surgery and storage of organ. Such expenses are covered under the health insurance policy for senior citizens but only up to a specified limit.
  • Day-care expenses- Already, you would have incurred a hefty sum on the treatment of senior citizen. The health insurance policy provides daily allowances, i.e. lump-sum amount to deal with various daily costs incurred from in-patient hospitalization. These costs include X-Ray, in-patient expenses, medicine costs, doctor’s fees, etc. for maximum 5-10 days to ease your burden.

In-patient hospitalization is more important than ever before

The above key points are sufficient to demonstrate the importance of in-patient hospitalization of senior citizens. In-patient hospitalization ensures vigilance, care and treatment if senior citizens. You are the only support for the old age of your parents, to ensure their well-being, go for health insurance which would provide maximum in-patient coverage, as it will act as resistance against aging-related diseases.

FAQs: In-patient Hospitalization of Senior Citizens

What is the difference between in-patient and out-patient hospitalization?

There is a thin line separating in-patient and out-patient hospitalization. They mainly differ from each other due to technicalities. In-patient hospitalization means receiving medical treatment by having admitted to the hospital for more than 24- hours. Out-patient hospitalization means receiving medical treatment without being hospitalized. You can get a doctor's consultation, daily allowances and diagnostic tests under out-patient hospitalization. You should know well in advance such benefits offered by your health insurance policy.

Is past medical history considered while buying senior citizen health insurance?

Your past history plays an important role to decide the future. Similarly, pre-existing diseases or ailments and past medical history are essential to be furnished to your health insurer. It depends on the terms of your insurance contract whether to cover your parent's pre-existing ailments or not. Sometimes, insurance companies may refrain from offering cover for pre-existing diseases because treatment for senior citizens might incur high cost. But there are also a lot of companies which provide cover by modifying the terms.

What is Incurred Claim Ratio?

It is the ratio of net claims incurred pertaining to the net premiums received in the same year.

For instance, If the company received 100 lakhs as premium in a year and net claims un the same year accounted 90 lakhs. Then ICR = 90%.

To decide whether the company is working well, ensure that the Incurred Claim Ratio (ICR) must be between 50-100%. If the ICR is less than 50% then the health insurance company is in excess surplus. If it is more than 100%, the company has given more than what it has received.

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