Govt. Health Insurance For Senior Citizens
  • Senior Citizen Schemes
  • Key Features
  • Need for Health Insurance
Government Health Insurance For Senior Citizens
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Government Health Insurance For Senior Citizens

In the country, the count of elderly people, who are 60 years old and older, is significantly high. As individuals get older, people become increasingly susceptible to health conditions. It is crucial for patients to access the opportunity for suitable medical care. Realizing the importance of complete medical insurance for the ageing population, the government of India has introduced various govt health insurance schemes for senior citizens, specifically customized for them. These govt medical insurance for senior citizen programs strive to offer economic security and guarantee that elderly individuals are able to pay for excellent health services without huge medical expenditures.

Government Health Scheme For Senior Citizens

There are various govt health insurance for senior citizens. The following are some of them:

Rashtriya Swasthya Bima Yojana (RSBY)

The Rashtriya Swasthya Bima Yojana, which is backed by government funding, is a health insurance scheme designed to offer cashless coverage to families below the poverty line and specific occupational categories. RSBY primarily aims to cover the BPL (Below Poverty Line) population but it also extends its benefits to senior citizens. Its key features include:

  • Eligibility
    The scheme covers senior citizens belonging to below-poverty-line families and certain defined occupational categories.
  • Coverage
    RSBY provides cashless health insurance coverage for various medical treatments, including hospitalization and surgeries.
  • Sum Insured
    The scheme provides coverage of Rs.30,000 annually on a family floater basis.
  • Smart Card
    Empanelled hospitals accept smart cards issued to beneficiaries, allowing them to access cashless treatment.
  • Premium Payment
    RSBY premiums are shared by both the central and state governments, with no premium contribution needed from beneficiaries.

Pradhan Mantri Jan Arogya Yojana

The National Health Protection Scheme, popularly known as Ayushman Bharat - Pradhan Mantri Jan Arogya Yojana, is among the biggest health insurance schemes funded by the government. The target is to grant health coverage to more than 500 million vulnerable individuals and families across India. The scheme includes coverage for both hospitalization expenses and pre-hospitalization expenses. Its key features include:

  • Eligibility
    Under the Socio-Economic Caste Census (SECC) database, AB-PMJAY extends its coverage to vulnerable individuals and families.
  • Coverage
    Coverage for over 1,500 medical procedures is offered by the scheme, including vital treatments like cardiac surgeries, cancer treatment, and organ transplants.
  • Sum Insured
    Every year, families are granted up to 5 Lakhs coverage.
  • Cashless Treatment
    Empanelled hospitals across the country offer cashless treatment for beneficiaries.
  • Portability
    Treatment can be obtained by beneficiaries at any empanelled hospital in India, irrespective of their place of residence.

Senior Citizen Health Insurance Scheme (SCHIS)

The Senior Citizen Health Insurance Scheme is specifically tailored for senior citizens over the age of 60 who lack coverage from another health insurance scheme. Coverage for a diverse set of diseases and therapies is offered by SCHIS. Its key features include:

  • Eligibility
    The scheme is open to senior citizens without any existing health insurance coverage.
  • Coverage
    Coverage under SCHIS includes a broad array of diseases and treatments, with immediate coverage for pre-existing conditions.
  • Sum Insured
    Coverage up to Rs.5 lakh per individual can be extended to senior citizens.
  • Cashless Treatment
    The scheme offers cashless treatment facilities in government and private hospitals.
  • Premium Payment
    The central and state governments provide subsidies for the premium of SCHIS.

New India Assurance Senior Citizen Mediclaim Policy

Designed to provide coverage specifically for older adults in India, The New India Assurance's Senior Citizen Mediclaim Policy is a specialized health insurance option. It is a standalone health insurance policy for senior citizens. Its key features include:

  • Eligibility
    Enrollment in this policy is open to individuals aged 60 and above.
  • Coverage
    The policy offers coverage for expenses incurred during hospitalization, as well as those before and after it.
  • Sum Insured
    The coverage amount ranges from Rs. 1 lakh to Rs. 1.5 lakh, depending on the chosen plan.
  • Ambulance Expenses
    Up to a certain limit, the policy covers ambulance charges.
  • Pre-existing Diseases
    The policy covers pre-existing diseases after a waiting period.

United India Senior Citizen Health Insurance Policy

The United India Senior Citizen Health Insurance policy is specifically designed to provide healthcare coverage for elderly individuals in India. Its key features include:

  • Eligibility
    This policy is open for enrollment to individuals aged between 61 and 80 years.
  • Coverage
    Coverage under the policy extends to in-patient hospitalization expenses along with pre-hospitalization, post-hospitalisation costs, and domiciliary hospitalisation.
  • Sum Insured
    The coverage amount ranges from Rs.1 lakh to Rs.10 lakhs. The price may vary depending on the selected plan.
  • Ambulance Expenses
    The policy offers protection for ambulance expenses up to a specified cap.
  • Pre-existing Diseases
    The policy covers pre-existing diseases after a waiting period.

Pradhan Mantri Vaya Vandana Yojana (PMVVY)

The Life Insurance Corporation of India (LIC) manages the Pradhan Mantri Vaya Vandana Yojana, which is a pension scheme specifically for senior citizens. The scheme for pensions is not linked, not participating, and not unit-linked. Its key features include:

  • Eligibility
    The eligibility criteria for enrollment in the scheme include being aged 60 years and above.
  • Pension Benefits
    The scheme guarantees a steady income through a pension for 10 years. The frequency of pension payments can be selected as monthly, quarterly, half-yearly, or annual.
  • Interest Rate
    The annual return on PMVVY is fixed at 7.4%.
  • Pension Amount
    The highest possible pension under this scheme is restricted to Rs. 1,25,000 per annum.
  • Death Benefit
    Should the policyholder die, the nominee or legal heirs will be reimbursed for the purchase price.

Varishtha Pension Bima Yojana(VPBY)

The Government of India introduced the Varishtha Pension Bima Yojana (VPBY) as a retirement plan aimed at offering financial stability and consistent income to elderly individuals. The Life Insurance Corporation of India (LIC) provides the Varishtha Pension Bima Yojana as a pension plan exclusively for senior citizens. Its key features include:

  • Eligibility
    The scheme is open to individuals aged 60 years and over. No matter your age, you can enrol without any restrictions on the maximum age.
  • Premium Payment
    To secure retirement benefits, the individual must invest a lump sum amount upfront.
  • Lock-in Period
    The lock-in period for the Varishtha Pension Bima Yojana lasted for 15 years. The policyholder is prohibited from withdrawing the invested amount during this period.
  • Pension Benefits
    During a time frame of 10 years, the scheme provides an insured pension income.
  • Interest Rate
    Varishtha Pension Bima Yojana offers a guaranteed return on investment.
  • Loan Facility
    Upon completion of three years of the policy, policyholders have the option to avail of a loan facility, which offers them financial liquidity during times of necessity.

Varistha Mediclaim Policy

The Varistha Mediclaim Policy is an exclusive health insurance policy created for elderly individuals in India. The purpose is to provide inclusive coverage and financial assurance for the healthcare expenditures of elderly individuals. Its key features include:

  • Eligibility
    Individuals aged 60 years and above can enrol in this policy.
  • Coverage
    The policy offers protection for hospitalisation expenses, as well as costs before and after being hospitalised.
  • Sum Insured
    The coverage amount varies from Rs. 1 lakh to Rs. 2 lakhs, depending on the chosen plan.
  • Ambulance Expenses
    The policy has a maximum coverage amount for ambulance charges.
  • Pre-existing Diseases
    The policy covers pre-existing diseases from day one.

Importance of Health Insurance For Senior Citizens

There are various reasons why one should opt for Health Insurance coverage in old age. The following are a few of the reasons:

  • Financial Protection
    As one ages, the probability of experiencing health complications grows. Senior citizens frequently require medical attention, regular check-ups, and treatment for chronic illnesses. Being covered by health insurance guarantees access to essential healthcare services without the need to shoulder the financial costs. Health insurance provides a safety net against unforeseen medical expenses and protects senior citizens' savings from being depleted.
  • Access To High-Quality Healthcare
    Reputed hospitals and healthcare providers offer quality healthcare services to senior citizens through health insurance. It guarantees that they obtain essential medical care and treatment promptly, with no delays caused by financial limitations. Cashless hospitalisation and reimbursement are additional features offered by health insurance, bringing convenience and peace of mind.
  • Comprehensive Coverage
    The need for specialised treatments and medication arises in senior citizens due to age-related ailments. Health insurance plans tailored for senior citizens include coverage for a broad spectrum of diseases and medical conditions. By offering comprehensive coverage that encompasses hospitalisation expenses and pre and post-hospitalization costs, these plans aim to alleviate any financial stress for senior citizens seeking essential healthcare services.
  • Timely Medical Assistance
    Health insurance coverage enables senior citizens to access timely medical intervention. Managing and treating ailments effectively relies heavily on regular check-ups, preventive screenings, and early diagnosis of health problems. Senior citizens are often encouraged to prioritize their health and avail of necessary medical services on time through provisions for preventive care in health insurance plans.
  • Peace of Mind
    The presence of health insurance gives peace of mind to elderly individuals and their loved ones. Being assured of financial security and having reliable healthcare services contributes to a sense of safety. Elderly individuals can prioritize their health and fully embrace their retirement years without the burden of financial concerns related to medical expenses.

In a Nutshell

The well-being and quality healthcare provision for senior citizens in India have been effectively addressed through government health insurance schemes. The government medical scheme for senior citizens financial protection, comprehensive coverage, and timely medical intervention to enhance their overall quality of life. The exploration and enrollment in suitable health insurance schemes is crucial for senior citizens and their families to secure their health and finances during their golden years. A secure and healthy future awaits senior citizens who prioritize health insurance.

Explore Most Popular Health Insurance Plans on PolicyX

Find some of the most trending comprehensive health plans of 2024 below

A special plan designed for women, wherein women can avail multifold benefits along with the coverage to the whole family.

Unique Features

  • Coverage for Modern Treatments
  • Coverage during Pregnancy
  • Preventive Health Check Up

Star Women Care Plan(Pros)

  • Designed for Women's Care
  • Cancer cover optional
  • Bariatric Surgery Cover
  • Mid-term inclusions
  • High SI

Star Women Care Plan (Cons)

  • Obesity Treatment Unavailable
  • Hazardous Activity not covered
  • HIV/AIDS not covered
  • Cosmetic Surgery unavailable
  • Congenital Disease Cover

Star Women Care Plan (Other Benefits)

  • 10% long-term discount
  • 10% Air Ambulance Cover
  • Pain Management Cover
  • Assisted Reproduction
  • Automatic Restoration

Star Women Care Plan (Eligibility Criteria)

  • Entry Age - 91 Days
  • Max Entry Age - 75 Years
  • SI - 5 L to 1 Cr
  • Waiting Period - 30 Days

The plan is ideal for the families who want to get covered under single sum insured.

Unique Features

  • Automatic Restroration of SI
  • Instant Recharge UPTO 30% of SI
  • New born baby cover from 16th day

Family Health Optima Policy (Pros)

  • No Pre-Policy Check-up
  • Lifelong Renewability
  • High SI available
  • COVID-19 cover
  • OPD covered

Family Health Optima Policy (Cons)

  • PED cover not available
  • Obesity Treatment Unavailable
  • Hazardous Activities
  • HIV/AIDS not covered
  • Cosmetic Surgery unavailable

Family Health Optima Policy (Other Benefits)

  • Long term discounts
  • Premium Payment flexibility
  • Health Check-up Cover
  • Domiciliary Hospitalization
  • Modern Treatment Cover

Family Health Optima Policy (Eligibility Criteria)

  • Entry Age - 18 Years
  • Max Entry Age - 65 Years
  • SI - 1 L to 25 L
  • Waiting Period - 30 Days

A new-age plan with loaded benefits covering hospitalization expenses arising due to illness or accident.

Unique Features

  • Premium Payment Flexibility
  • Wellness Program
  • Short Waiting Period

Assure Insurance Policy (Pros)

  • Second Medical Opinion
  • Health Check-up Covered
  • 100% Cumulative Bonus
  • Compassionate Travel
  • AYUSH Treatment

Assure Insurance Policy (Cons)

  • 10% Co-pay applicable
  • Deductibles
  • HIV/AIDS not covered
  • Cosmetic Surgery unavailable
  • Injuries due to breach of law

Assure Insurance Policy (Other Benefits)

  • In Utero Fetal Surgery
  • Pain Management
  • Rehabilitation Cover
  • Organ Donor Cover
  • Modern Treatment Cover

Assure Insurance Policy (Eligibility Criteria)

  • Entry Age - 18 Years
  • Max Entry Age - 75 Years
  • SI - 5 L - 2 Cr
  • Waiting Period - 30 Days

Niva Bupa Reassure 2.0 provides insurance holders with a high sum insured through their platinum, titanium, and bronze variants along with a multitude of other features.

Unique Features

  • Booster+ Benefit
  • Lock premiums at entry age
  • Health check-ups from day 1

Health ReAssure 2.0 Plan (Pros)

  • Personal accidents covered
  • Acute Care
  • Emergency Ambulance
  • Three Plan variants
  • Home Care Treatments

Health ReAssure 2.0 Plan (Cons)

  • No OPD Cover
  • No Maternity Cover
  • No Sleep Disorder Covered
  • Pre-Existing Diseases after 3 yrs.
  • Alcoholism not covered

Health ReAssure 2.0 Plan (Other Benefits)

  • Air Ambulance
  • Modern Treatments
  • Second Opinion
  • Booster Benefit
  • Shared Accommodation Benefit

Health ReAssure 2.0 Plan (Eligibility Criteria)

  • Entry Age - 18 Years
  • Max Entry Age - No Age Limit
  • SI - 5 L to 1 Cr
  • Waiting Period - 30 Days

This plan is designed for youngsters and allows the policyholder to go overseas for treatments.

Unique Features

  • Exclusive maternity benefits
  • Adoption is included
  • Borderless facilities

Niva Bupa Aspire Plan (Pros)

  • Overseas treatment coverage
  • Booster benefit
  • Covers organ donor transplant
  • Second medical opinion
  • Teleconsultation

Niva Bupa Aspire Plan (Cons)

  • No suicide cover
  • No war injury cover
  • Baby food & utility charges excluded
  • Laundry charges excluded
  • No certificate charges

Niva Bupa Aspire Plan (Other Benefits)

  • 4 unique variants of the plan
  • Cash-bag benefit
  • WellConsult OPD Wallet
  • Cashless claim settlement
  • AYUSH Treatment

Niva Bupa Aspire Plan (Eligibility Criteria)

  • Entry age - 18 years
  • Max entry age - No AgeLimit
  • SI - INR 3L to 1 Cr
  • Waiting Period - 30 days

A unique healthcare plan offering extensive coverage to individuals and families under a single plan with affordable premiums.

Unique Features

  • Unlimited E-consultations
  • Unlimited Automatic Restoration
  • Avail Up to 30% Discounts

Care Supreme Plan (Pros)

  • Day Care Treatments
  • No Sub-Limits
  • Emergency Ambulance
  • No-Claim Bonus
  • Organ Donor Cover

Care Supreme Plan (Cons)

  • Change of Gender Treatments
  • Obesity Treatment Unavailable
  • Hazardous Activity Not Covered
  • HIV/AIDS not covered
  • Cosmetic Surgery unavailable

Care Supreme Plan (Other Benefits)

  • Unlimited Recharge
  • 30% Renewal Discount
  • Unlimited E - Consultation
  • Wellness Benefits
  • Nutrition and Fitness Coaching

Care Supreme Plan (Eligibility Criteria)

  • Entry Age - 90 Days
  • Max Entry Age - No age limit
  • SI - 5 L to 15 L
  • Waiting Period - 30 Days

Plan with comprehensive coverage up to INR 3 crores with benefits like OPD cover, global cover, women's care, and continuity benefits.

Unique Features

  • Avail Global OPD
  • Cancer treatment
  • High SI

Manipalcigna Lifetime (Pros)

  • No room rent limit
  • Avail Loyalty discount
  • Global OPD
  • International Second Opinion
  • 27 CI Covered

Manipalcigna Lifetime (Cons)

  • Hazardous Activities not covered
  • Injuries due to unlawful activities
  • Obesity
  • Cosmetic Surgery
  • Injuries due to illegal activities

Manipalcigna Lifetime (Other Benefits)

  • Travel Expenses Benefit
  • Global Second Opinion
  • Critical Illness Cover
  • Women+ Cover
  • Air Ambulance Cover

Manipalcigna Lifetime (Eligibility Criteria)

  • Entry Age - 91 Days
  • Max Entry Age - 65 Years
  • SI - 1 L to 3 Cr
  • Waiting Period - 30 Days

A health insurance plan designed for parents and senior citizens to protect them in their golden years of life. The plan offers a high SI of up to 50 Lakh INR.

Unique Features

  • Individual and Family Floater
  • 2 Plan Variants
  • Up to 50 Lakh INR

Manipal Cigna Prime Senior (Pros)

  • Low Waiting Periods
  • Flexible Room Category
  • Avail Cumulative Bonus
  • Flexible Health Check-up
  • Tele-Consultations

Manipal Cigna Prime Senior (Cons)

  • Injuries Due to Breach of Law
  • Adventure Sports
  • Obesity
  • Cosmetic Surgery
  • Injuries Due to Illegal Activities

Manipal Cigna Prime Senior (Other Benefits)

  • Modern Treatment Cover
  • 10 % Cumulative Bonus
  • Cashless Health Check-Up
  • Mental Illness Cover
  • Domiciliary Hospitalization Cover

Manipal Cigna Prime Senior (Eligibility Criteria)

  • Entry Age - 56 Years
  • Max Entry Age - 75 Years
  • SI - 3 L to 50 L
  • Waiting Period - 30 Days

Activ Health Platinum Enhanced

A unique Plan with features such as a chronic management program, modern treatments, covid-19, and more.

Unique Benefits

  • High SI
  • Affordable Premiums
  • Wellness Benefits

Activ Health Platinum Enhanced (Pros)

  • Earn 100% Health Return
  • Cover for Dental Consultations
  • Modern Treatment Cover
  • Wellness Coach
  • Mental Illness Cover

Activ Health Platinum Enhanced (Cons)

  • Illness due to intoxicants
  • Change Of Gender Treatment
  • Hazardous Activity not covered
  • HIV/AIDS not covered
  • Cosmetic Surgery unavailable

Activ Health Platinum Enhanced (Other Benefits)

  • Chronic Management Program
  • Premium Waiver Benefit
  • Reload of SI
  • Road Ambulance Cover
  • Second e-opinion

Activ Health Platinum Enhanced (Eligibility Criteria)

  • Entry Age - Years
  • Max Entry Age - Years
  • SI - 1 L to 1 Cr
  • Waiting Period - 30 Days

A plan that covers you and your family offering a sum insured of 5 lakhs to 5 crores. The plan offers 15 different types of discounts.

Unique Features

  • No Sub-limits on benefits
  • Robotic surgery for quick recover
  • 90 days free cancellation

Health Infinity Insurance (Pros)

  • 10% Online discount
  • 5% Early Bird Discount
  • 10% Stay Healthy Discount
  • Credit score discount
  • Concurrent Disclosure Discount

Health Infinity Insurance (Cons)

  • No Obesity Treatment Cover
  • Infertility Treatment Unavailable
  • No Alternative treatments
  • Out-patient not covered
  • Cosmetic Surgery unavailable

Health Infinity Insurance (Other Benefits)

  • 5% Girl Child Discount
  • Restore Benefit
  • 2.5% Vaccination Discount
  • 5% BMI Discount
  • 2.5 % Renewal Discount

Health Infinity Insurance (Eligibility Criteria)

  • Entry Age - 3 Months
  • Max Entry Age - 65 Years
  • SI - 5 L to 5 Crore
  • Waiting Period - 30 Days

Government Health Insurance For Senior Citizens : FAQs

1. What does govt medical insurance for senior citizens encompass?

Public health insurance for the elderly means healthcare programs and schemes introduced by the Indian government aiming to offer extensive coverage and economic safety to individuals aged 60 or older. The initiatives strive to guarantee elderly individuals gain entry to high-quality medical care without financial strain. These initiatives intend to offer senior citizens with top-notch, affordable healthcare procedures.

2. What are the benefits of Government-run health insurance?

Government-run health insurance for older adults provides various advantages. It includes safeguarding their financial resources from medical expenses, enabling them to avail high-quality medical care, offering comprehensive protection for a broad spectrum of ailments and therapies, promising quick medical response, and granting serenity to the elderly and their family members.

3. What medical coverage initiatives are provided by the Indian government for senior citizens?

There are several public health insurance schemes for senior citizens in the nation, including Pradhan Mantri Jan Arogya Scheme (AB-PMJAY), Senior Citizen Health Scheme (SCHIS), and Pradhan Mantri Vaya Vandana Yojan (PMVVY Scheme). These initiatives are customised for senior citizens and provide various ranges of insurance and benefits.

4. Who's the designated recipient of this government health insurance?

Elderly individuals aged 60 and above and beyond often meet the requirements for public health coverage. Nevertheless, based on the designated program or guideline, the eligibility criteria can differ. Prior to enrolling, it is crucial to assess the entry conditions for every curriculum.

5. How do senior citizens register for government-funded health insurance plans?

Senior citizens can sign up with the government medical insurance by going to official sites of specific schemes. For other options, people can contact relevant government organisations. The citizens are required to confirm their age and identity for the enrolment. It is suggested to consult someone with the knowledge of insurance to assure a hassle-free signing up method.

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Daina Mathew

Written By: Daina Mathew

Daina is a content writеr with a profound grasp of Insurancе, Stocks, and Businеss domains. Hеr extensive 3-year еxpеriеncе in thе insurancе industry еquips hеr with a nuancеd undеrstanding of its intricaciеs. Hеr skills еxtеnd to crafting blogs, articlеs, social mеdia copiеs, vidеo scripts, and wеbsitе content. Her ability to simplify complex insurancе concepts into reader-friendly content makes her an еxpеrt in the domain.