Health Plan for The Elderly: Understand the Particularities of This Type of Health Insurance

For many, old age is known as the best part of life. It is during this period that individuals have more time to devote to their hobbies, in addition to all the knowledge and wisdom they have acquired over time. However, to ensure that such moments are, in fact, well spent, it is important to take some precautions — and investing in a health plan for the elderly is one of them. 

As we are well aware, unfortunately, the public health sector in Brazil has been facing a long crisis and has become inefficient in many situations. Therefore, ensuring that the elderly person has quality medical care is an excellent request and that it can even provide more peace of mind and security for the whole family. 

Even so, there are people who are unaware of the particularities of a health plan for the elderly, nor do they understand how this type of contract works and what it can offer. With that in mind, we decided to clear all the information in today's post. Just follow the reading and make the right choice!

After All, How Does a Health Plan for Seniors Work?

According to the World Health Organization (WHO), the third age begins at 60 years of age in countries considered to be developing, and at 65 years of age in developed regions. Although for many, this is one of the most pleasant phases of life, it is essential to keep in mind that this period also requires some constant attention and care. 

Over time, visits to the doctor begin to become more frequent and, consequently, the individual starts to need a good support network — composed of well-equipped specialists, laboratories, and hospitals. At this moment, the health plan for the elderly is extremely necessary. 

As with other publics, with the elderly, health insurance works as follows: the contracting party pays a monthly amount and, after the grace period, is already authorized to use all the services in the package. 

Speaking of the grace period, it is worth paying attention to the requirements imposed by this type of service. Most of the time, operators follow a standard period, which can be described as follows: 

·        24-hour grace period for emergency and urgent cases; 

·        30-day grace period for consultations; 

·        180 days for admissions;

·        2-year grace period for pre-existing conditions.

The scope of care must also be considered — especially when choosing services. To avoid a headache, check if the health insurance has a good network in the region where the elderly person lives, from clinics to hospitals with emergency rooms. 

There's even more: on some occasions, products aimed at the elderly have coverage limitations. This may be the case when carrying out transplants or treating psychiatric complications. Therefore, all attention is little!

Is Health Insurance for Seniors More Expensive?

Compared to conventional products, the health plan for the elderly may indeed have a higher value. There is only one reason for this: when calculating the price of an agreement, operators need to consider certain basic factors. From all of them, we can highlight the range of services, the accredited network, the accommodation characteristics, and even whether or not there is a preference for co-participation. 

Another point worth mentioning is how often the plan will be used. As mentioned, the elderly require more health care and, in general, an individual aged 59 or over tends to have more medical appointments, in addition to other highly complex procedures — which, in turn, have a very high value. Together, these details account for the remarkable price difference. 

How Do You Choose This Type of Product?

Currently, there are several companies that work with health plans for seniors. Due to such variety, many people are in doubt when closing a deal and making the right choice.

So as not to have a problem, the first point to be analyzed is what you are, in fact, looking for: a health insurance plan that performs treatments at home? One with hospital care? Or, one with national coverage and not just in your city? All these points will make a huge difference when using the services. 

After considering these elements, it is worth paying attention to other equally relevant points. Below, we'll explain more about each of them. 

Quality 

It is useless to choose the most expensive health plan for the elderly on the market if, in the end, the services provided are not of high quality. Thus, an efficient way to ensure the right choice is to check the ranking of the famous National Supplementary Health Agency (ANS). 

Annually, the agency is responsible for disclosing extremely valuable reports that, among other issues, including information on the performance of the main agreements in the country, involving details ranging from the quality of services provided to economic factors.

Even every three months, on the same portal, ANS informs consumers which health insurance has been suspended — whether for non-compliance with the required deadlines or any other reason. 

Accredited Network

Once you have analyzed the quality of services provided by the agreement, consider checking your accredited network. In other words, the clinics, laboratories, and hospitals are included in the contracted package. Thus, it will already be possible to have an idea if the product is able, or not, to offer the patient high standard and efficient care. 

If the accredited network is wide, there will also be different emergency room options in the list and the possibility of carrying out emergency admissions. See if the hospitals have a good evaluation and how the contracted hospital coverage works: 

·        how many nights are covered?

·        Which additional exams are covered?

·        What procedures are included?

·        Is the accommodation collective or private?

What Are the Advantages of The Health Plan for The Elderly?

Surely, you've probably heard “prevention is better than cure”, right? And when we talk about the health plan for the elderly, this maxim makes even more sense. By hiring this service, the elderly — and the rest of the family — will be able to enjoy numerous benefits. Next, we talk about them.

Prevention

A good part of the health plans for the elderly has preventive medicine modalities. This means that, during consultations, the patient will be able to talk to doctors who are prepared to provide a better quality of life for individuals, preventing the emergence of numerous diseases. 

On the other hand, and without specialized monitoring, each and every person is more likely to discover some health complication at an advanced stage — requiring complex treatments, of high value, and, often, with less possibility of cure. 

Capable Professionals

Due to the great demand existing in the Unified Health System (SUS), it is inevitable that there will be more delays in care or even a lack of trained professionals to solve patients' problems. 

In the private network, however, the scenario is different. By contracting an agreement, the elderly will be able to count on doctors and nurses specialized in geriatrics, in addition to other specific diseases. This is all without counting the comfort, practicality, and tranquillity - since, often, the point of care is located close to the patient's home.

Age Adjustment Exemption

The issue of readjustment is widely discussed in the universe of health plans. In summary, this revision in value, previously defined by the ANS, usually occurs in two situations: 

• ON the anniversary of the Contract; 
• In the change of age Group.

The good news is that, after the age of 59, the readjustment is no longer applied due to a change of age - only the annual review continues to occur normally. This fact, without a doubt, is a great attraction for those who want to hire health insurance without facing the constant changes in the monthly budget. 

So, did you like to understand more about the particularities of the health plan for the elderly? We hope so!