Everything About Operation Mediclaim for Senior Citizens

Did you know that 11% of total global illnesses require surgical intervention for treatment? With the rising medical expenses—especially for people ages 60 and above—more people have been opting for hospital surgical insurance to help cover the hefty medical expenses arising due to critical diseases. Also, you can secure your elders with operation insurance as an additional protection over and above a standard senior citizen mediclaim policy. This article lays down everything you need to know about what is hospital surgical insurance and how it supports senior citizens in dealing with critical medical procedures.

Coverage under Hospital Surgical Insurance

Generally, the expenses covered by hospital surgical insurance include major in-patient charges along with pre and post-hospitalisation expenses. While the coverage may differ from insurer to insurer, One of the leading insurance providers- Care Health Insurance, offers its policyholders the following coverage under its hospital surgical insurance: 

1. Surgical expenses for pre-defined procedures like coronary bypass, organ replacement, joint replacement, etc.
2. Free annual health check-ups, including standard tests like Lipid profile, LFT, etc. for all insured members
3. Expenses for ambulance services during an emergency
4. Expenses incurred towards the Dialysis procedure
5. In-patient hospitalisation expenses and pre and post-hospitalization expenses
6. Expenses for day-care treatments related to cardiology, ENT, neurology, etc.
7. Coverage for organ donation or transplant
8. The expenses incurred to avail of a second opinion regarding the suggested treatment
9. No claim bonus that increases the sum insured by up to a maximum of 100% for all the claim-free years

Exclusions under Hospital Surgical Insurance

Exclusions are those expenses that your operations and surgical insurance will not cover. Here are some of the most common exclusions to check before opting a surgical insurance plan for your elders:.

1. Treatment costs for injuries that are self-inflicted, suicide attempts, or suicides
2. Costs for treating complications during pregnancy. It would be best to avail of specific pregnancy-related insurance for this or add the same as a rider to your health insurance.
3. Treatment of sexually transmitted diseases, including HIV/AIDS
4. Costs incurred in treating injuries resulting from weapon attacks or chemical, biological, or nuclear attacks
5. Cosmetic treatment costs, including plastic surgery
6. Treatment of injuries inflicted due to wilful participation in activities known to be criminal

Things to Consider Before Opting for Operations Mediclaim for Senior Citizens

Below are the essential things to consider before buying an operations mediclaim for elders:

Ensure Maximum Coverage for Affordable Premium

The key to enjoying the optimum benefits of hospital surgical insurance is to opt for the maximum coverage for an affordable premium. Evaluate all the benefits offered by different insurers while comparing their premium amounts. As senior citizens need extra medical attention, look for optional benefits to enhance the coverage while meeting the specific healthcare needs of elders. 

Methods of Claim Settlement

Claims made under hospital surgical insurance are usually settled in two ways – reimbursement and a cashless facility. Under the reimbursement method, you need to pay all the hospital bills initially and then submit the original bills and receipts with other relevant documents, following to claim for reimbursement. Under the cashless method, the insurance company directly settles the payments with the hospital itself. It is always more convenient to opt for the cashless facility as it allows the insured to focus on treatment and recovery without worrying about the paperwork. 

Choose Companies with a Vast Hospital Network

The purpose of hospital surgical insurance plans is to provide financial security if surgical intervention is ever required. A vast hospital network helps senior citizens access quality medical care at prime healthcare centres without spending from their pockets.

Care Health Insurance is one such insurer empanelled with a wide network of over 19,000 healthcare providers across India. It helps senior citizens in accessing healthcare services without any hassle while receiving quality treatment for critical surgeries.

Check for Policy Terms and Conditions

As a rule, policyholders should read all the terms of hospital surgical insurance. Especially the terms related to renewability and waiting period. Renewability refers to whether the policy is eligible to be renewed for one’s lifetime. It helps senior citizens receive continued security without needing to switch policies. Also, it is important to check the waiting period for pre-existing diseases, given that senior citizens deal with several health conditions as they grow old.

Selecting the Right Senior Citizen Mediclaim Policy

Safeguarding elders against frequent medical issues is the top priority for every family. If you are looking for a customised policy to meet the diverse needs of your parents or elders, do check Care Health Insurance Plans. The insurers provide multiple mediclaim policies for people above 60 years while offering unique benefits like no-claim bonuses, minimum waiting period, annual health check-ups, etc. With a high claim settlement ratio and vast hospital network, you can rely on Care Insurance to secure your senior citizens for years to come.