Senior Citizen Mediclaim Premium & Misc. Mediclaim Related Issues for Claim

Usually, Insurance Companies increases Mediclaim premium as the age of the person increases. Like after 60 years, after 70 years the premium amount increases.

Actually, the premium amount should be lesser as the age increases. The persons cover mediclaim usually at the age around 35 years to 45 years and then they continue by renewal and paying the premium for many years. When the person becomes old, the senior citizen at that time he/she has paid the sizable amount by way of premium to Insurance Company. So persons crossing 60 age, the premium for old people should reduce gradually and not increase.

There are many cases that person covered Mediclaim Insurance but never claimed when he/she is 60 years and up. There are some who never have claimed even after 70 years. In such case, they have paid a huge amount of premium in last 30 / 40 years of insurance coverage. For such cases, seriously & sincerely Insurance Company & it’s regulatory board IRDA should decrease premium after 60 age.

The CASHLESS word in Medicalim Policy is misguiding. There is no CASHLESS system. In cities, all hospitals have rate contract with Insurance Companies for the particular surgery. So due to this individual rate contract, you do not get full refund of the amount which you spent for surgery. You will get the only amount as per the rate contract agreement between that hospital & Insurance Company. So when you approach hospital for admission, they will say Yes, it is CASHLESS. But afterwards at the time of discharge, they will ask huge amount from you saying that they have agreement/contract with Insurance Company and so Insurance Company has passed small amount, rest of the balance amount you have to pay. This is some sort of cheating done by hand in gloves by Hospitals & Insurance Companies.

In such cases, some people, who can afford, they pay full payment to the hospital and claim directly to Insurance Company for Mediclaim, in that case, they get almost 80%/90% depends on the cost of surgery and hospital bill. So CASHLESS is just eye wash by Hospitals & Insurance Companies.