Teleconsultations for Senior Citizens Coverage Importance

Posted on: Aug 21, 2024 | 3 mins | Written by: HDFC ERGO Team

Teleconsultations for Senior Citizens Coverage Importance

Immunity weakens with age, and some vital organs also start losing their functions. These factors make senior citizens prone to infections and age-related health conditions, some of which may require frequent consultation and long-term treatment. However, due to age and ill health, seniors may find it difficult to visit a healthcare practitioner every time they feel sick. This is when teleconsultation can help! If you are worried about the bills, your comprehensive health insurance policy will cover them. Read on to learn about the coverage for teleconsultation in health insurance and the benefits of this healthcare service.

What is teleconsultation?

Teleconsultation is a remote healthcare service that helps patients consult healthcare practitioners without physically visiting a hospital or clinic. This service uses telecommunication and electronic information systems to provide long-distance health-related assistance. If a patient is unable to visit the doctor due to ill health or any other reason, he or she can opt for teleconsultation through phone calls, video calls, or messaging platforms.

Teleconsultation may include remote medical evaluation, medical diagnosis, sharing medical reports and images, health monitoring, etc. Thanks to this remote healthcare service, one can consult a specialist in any part of the country without having to visit his/her hospital or clinic for regular check-ups and healthcare assistance.

The following are some reasons why teleconsultation is a good option for senior citizens and other patients —

1. Convenience:

If you opt for teleconsultation, you can consult doctors from the comfort of your home. This saves you from commuting to the hospital or clinic, waiting for your turn in crowded waiting rooms, etc., especially when you are not well.

2. Better access to quality healthcare:

Thanks to teleconsultation, you can consult a specialist in any part of the country without stepping out of your home. All you must do is book an appointment online and consult the doctor at the appointed time.

3. Easy on the pocket:

Teleconsultation can help you save on costs associated with in-person visits. This may include transportation costs, parking fees, and more.

4. Helps manage chronic diseases:

If you are suffering from a chronic disease, teleconsultation can help the doctor track your vital signs continuously. Thus, he/she can make the required changes to treatment plans and medications on time and prevent the condition from worsening.

5. Prevents exposure to illness:

Teleconsultation can reduce your exposure to infections while commuting on public transport and in crowded waiting rooms, especially during the flu season.

How does teleconsultation work in health insurance?

From October 2020, IRDAI, or the Insurance and Regulatory Development Authority of India, asked insurance companies to cover the teleconsultation bills of the insured. The IRDAI took this decision in the wake of the COVID-19 pandemic to encourage more people to consult doctors online rather than going out of their homes. Patients with mild symptoms were advised to opt for teleconsultation and quarantine themselves to prevent the spread of the condition.

While teleconsultation is an important healthcare service for everyone, it is a boon for senior citizens. Those aged over 60 experiencing health conditions and mild symptoms can get in touch with their doctor through voice or video call whenever they want to. This saves them from visiting hospitals and clinics for consultations and routine check-ups.

Here’s how teleconsultation works in health insurance:

• If your health insurance policy covers OPD or outpatient department expenses, the insurance provider will cover your teleconsultation bills for e-opinions, if added in your plan.

• If your health plan does not have OPD coverage, you can check with your insurance provider and take it as an add-on by paying an additional premium.

• If you opt for teleconsultation before hospitalisation or after, the bills can be covered under pre- and post-hospitalisation expenses.

• Insurers must cover teleconsultation if consultation with a healthcare practitioner is included in the policy terms and conditions.

• Teleconsultation claims are settled, keeping the sub-limits, monthly or annual limits, and other policy terms and conditions in mind.

Conclusion

To sum up, although health insurance policies may not explicitly mention teleconsultation or online consultation in the policy wording, the service is covered by insurance providers. Hence, if you have a comprehensive senior citizen’s insurance policy with OPD cover, you can opt for teleconsultation services for timely treatment and care. This service comes in handy when you want to take a second opinion before talking a call for a scheduled surgery or undergoing any major treatment. It can also help you manage your health and finances, especially if you have limited retirement funds. The service bridges geographical gaps and helps you consult specialists in any part of the country or across the globe.

Disclaimer: The above information is for illustrative purposes only. For more details, please refer to the policy wordings and prospectus before concluding the sales.

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