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Once You Retire, How Does Health Insurance Work

Growing older frequently results in more healthcare needs. People must consider pricing, coverage, and eligibility requirements when navigating a variety of insurance after retirement.

  • 12 Jan 2024
  • 2 min read
  • 375 views

Retirement is a big life change; it can be physically, mentally and emotionally challenging. This emphasises the need to have a comprehensive health insurance and an understanding of how this health insurance work, to ensure enough funds for unexpected medical expenses. The following piece explores how health coverage works after retirement

 

How Does Health Insurance Work After Retirement?

When people switch from employer-sponsored to independent health insurance after retirement, their health insurance needs significant change. 

Eligibility Criteria for Senior Citizen Health Insurance

  • Generally, senior citizen health insurance is available to individuals aged 60 years or older who do not have access to other health insurance coverage. 
  • Some plans, however, may have other limitations for eligibility, such as residency or income requirements.

Transition from Employer Coverage:

  • Upon retirement, individuals typically lose employer-sponsored health insurance.
  • They can explore options like private insurance or government-run schemes available for senior citizens in India.

Government Health Schemes in India:

India offers several health insurance plans for the elderly, including:

  • Pradhan Mantri Jan Arogya Yojana (PMJAY): Mantri Pradhan Seniors below the poverty line who have no other choices for insurance are eligible for free treatments, surgeries, and medicine under this scheme.
  • The Senior Citizen Health Insurance Scheme: provides coverage for medical costs, including hospital stays and procedures for individuals aged 60 or older without additional health insurance.
  • Rashtriya Swasthya Bima Yojana (RSBY): For seniors who fall below the poverty line and have no alternative access to healthcare, RSBY covers hospital stays and procedures.
  • The Central Government Health Scheme and the Employees' State Insurance Scheme (ESIS): both provide benefits to government workers, retirees, and workers in the organised sector, as well as to their families.

Conclusion

Growing older frequently results in more healthcare needs. The network of healthcare providers, potential out-of-pocket costs, and the appropriateness of the coverage should all be considered while evaluating insurance alternatives. Senior citizens must maintain health coverage after retirement to guarantee access to critical medical treatments. People must consider pricing, coverage, and eligibility requirements when navigating a variety of insurance after retirement.

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