Get Best Senior Citizen Health Insurance Plans in India

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Senior Citizen Health Insurance

Senior Citizen Health Insurance Plans are specially designed to fulfil the needs of individuals who lie in the age group of 60 to 75 years. When it comes to health insurance for senior citizens, you would get several benefits such as cashless admission in hospitals, free-of-cost ambulance service, and coverage for critical illnesses, etc.

Senior citizen health insurance plan is more of a necessity, especially in those cases where a person is retired and wants to enjoy the post-retirement life with the pension amount and interest that he/she would receive upon their savings. Multiple general insurance companies deal with senior citizen health insurance plans and it is imperative to select the one that can easily go well with all your needs and can offer an effective health cover for all your ailments.

Senior Citizen Health Insurance: Features

Some of the key features of senior citizen health insurance plans are:

  • It allows senior citizens to choose a higher Sum Assured option that would be sufficient to meet all the medical needs.
  • Many senior citizen health insurance plans offer lifetime renewability.
  • Several medical-related amenities, e.g. Emergency ambulance services & cover for certain illnesses are covered by almost all the health insurance policies for senior citizens.
  • Pre-existing diseases would be liable to get cover after a fixed period of time.
  • Policyholders can go for cashless treatment and even ask for reimbursement of all medical-related expenses post the actual hospitalization.
  • There are a few health insurance plans for senior citizens that offer coverage to individuals along with the option of enrolling their spouse as well under the same plan.
  • Many senior citizen insurance policies provide the option of co-pay. Opting for co-pay can lead you towards paying lower premiums and in a few cases; it will assure your eligibility to receive discounts.

Senior Citizen Health Insurance: Benefits

A senior citizen health care plan is developed in such a way that it can offer multiple advantages to the customers:

No Pre-policy Medical Screening

Most of the insurers do not ask for medical tests before buying health insurance policy for senior citizens.

OPD (Outpatient Department) Cover

Senior citizen health insurance companies offer OPD cover which helps to manage the financial needs when the treatment of some diseases can be done by visiting a doctor's clinic or on the advice of a medical practitioner.

Special Discounts

If you are enrolling for a senior citizen health insurance policy together with your spouse, the insurance company will offer family discounts of 5% on the total premium.

Choice of Second Opinion

Your first opinion is not always effective and you are willing to go for a second opinion for the proper treatment of a disease. Senior citizen health plans allow you to take a second opinion from a medical practitioner, typically an e-opinion (every year).

Domiciliary Treatment Expenses

Many senior citizen plans provide coverage for domiciliary treatment, i.e., when the doctor suggests getting treated from home, which otherwise requires hospitalisation to be covered by other health insurance plans.

Health Check-ups & Renewal

Get the benefit of free annual health check-ups along with lifetime renewal facility.

Tax Benefits

The best thing about investing in a senior citizen health insurance plan is that all premiums paid by the policyholder will be liable to get tax benefits ranging from Rs. 25,000 up to Rs. 75,000 under Section 80D of the Income Tax Act, 1961.

Popular Health Insurance Plans For Senior Citizen in India

Senior Citizen Health InsurerSenior Citizen Health Insurance Plan NameSum AssuredAge at Entry (in years)Waiting Period for Pre-existing DiseasesPre & Post Hospitalisation Cover (in days respectively)Medical Screening Tests
National InsuranceVaristha Mediclaim Policy for Senior CitizensHealth Coverage: Rs. 1 lakh;
Critical Illness: Rs. 2 lakhs
60-80After 1 year30 & 60Not required (if the policyholder is already covered by a health plan for at least 3 years)
New India Senior Citizen Mediclaim PolicyRs. 1-1.5 lakhs60-80After 1.5 years30 & 60After 50 years
Star HealthSenior Citizen Red Carpet Health PlanRs. 1-10 lakhs60-75After 1 yearOnly post hospitalisation after 60 days expenses is included upto Rs. 5000Not Required
Bajaj Allianz Silver Health Senior Citizen Health PlanRs. 50,000-5 lakhs46-70After 1 year30 & 60After 46 years
ReligareCare SeniorRs. 3-10 lakhs61 and aboveAfter 4 years30 & 60Not Required
United IndiaSenior Citizen Mediclaim PolicyRs. 1-3 lakhs61-80After 4 years30 & 60After 60 years
HDFC Ergo HealthHealth Optima Senior(previously known as Apollo Munich Health Optima Senior)Rs. 2-5 lakhs61 and aboveAfter 3 years30 & 60After 60 years

Points To Remember While Buying Senior Citizen Health Insurance Plan

Investing in a health insurance plan for parents above 60 years of age is a process that should be done smartly. Do not forget to analyze the plan based on the below points before purchasing one.

Check for Sub-limits

There is a cap or sub-limit on different hospital expenses like the cost of medicines, room rent, doctor's fees, etc. and mostly the insurer pays a percentage of the Basic Sum Assured during the claim. You need to check for sub-limits to prepare for out-of-pocket expenses.

Number of Network Hospitals

Nothing can beat the benefits of a cashless facility. Do not forget to note down all the network hospitals around your residence area before finalizing any senior citizen health insurance plan.

Waiting Period

There are several waiting period intervals (pre-existing disease, particular ailments like ENT disorders, osteoporosis, etc., maternity) in the policy that one should take care of while choosing a plan for senior citizens. Only accidental hospitalisation is covered from day one and no other disease is covered within 30 days from the commencement of the policy. Usually, pre-existing diseases get coverage only after a waiting period of 4 years.

Pre-existing Requirements

It is an important element in senior citizen health care plans. The coverage should be clear before buying one. Some of the companies offer 2 to 3 years waiting period but are liable to pay only 50% of the claim. While in a few cases such as diabetes along with its complications, hypertension, a waiting period of 18 months is applicable but only after paying extra premiums.

Medical Tests Expenditure

Insist for a medical check-up before purchasing a senior citizen health plan, even though the insurer is denying the same. Insurance companies are responsible to pay or reimburse the fees or impose any charges to undergo tests, particularly when done in their enlisted hospitals.

Individuals Covered Under the Plan

If you wish to add your spouse in the same plan along with you, there is a need to make decisions as per your and your spouse's health conditions. Remember to plan accordingly, keeping all the requirements in mind before you proceed to buy one.

Claim Settlement Process

To avoid undue hassles and smooth claim settlement, make sure to check the claim settlement ratio and time for settling claims. A higher claim settlement ratio defines the reliability of the insurance company.

Documents Required

While applying for senior citizen health insurance plan, you need to carry certain documents as follows:

  • Pre-policy medical checkup documents
  • Duly-filled proposal form
  • Supporting documents for any pre-existing condition
  • Age proof

Exclusions

There are some basic exclusions of senior citizen health insurance plans which are not covered by the policy:

  • Pre-existing diseases or injuries that are detected within 4 years before the inception of the first policy.
  • Any diseases diagnosed during the first 30 days of the policy commencement date, except those due to accidents.
  • Expenses as a result of self-inflicted injury (resulting from suicide and attempted suicide).
  • Expenses incurred as a result of alcohol or drug abuse or any related diseases.
  • Cost of dental treatment, spectacles or contact lenses and any cosmetic surgery.
  • Medical expenses occur in the treatment of AIDS.
  • Treatment costs arising from injuries or diseases due to war, nuclear attacks, riots, strikes, etc.

Senior Citizen Health Insurance: FAQs

Indeed, the premium that you would pay towards a senior citizen health insurance plan will be slightly more, as compared to a basic health insurance plan and this is because older people are more prone to diseases than the young ones. Increased age may lead to more medical complications, for which insurers charge more.

No, there is no limit related to the number of claims that you can make during your policy. However, you have to make sure that your claims do not exceed your sum insured. If they cross the sum insured amount, your claim will be rejected, and you have to pay from your pocket.

We all know that there is a tough competition among all the private, public and standalone health insurance companies in India. Almost all insurance companies provide cashless hospitalization at their listed network hospitals. You just need to check the list of the network hospitals to avail cashless benefits.

Yes, most of the insurance companies offer a free health check-up for every block of claim-free years.

The waiting period for pre-existing disease cover and no-claim bonus are known as the 'continuity advantages' which are available in senior citizen health insurance plans.

Yes, as per IRDAI regulations, if the policyholder is not satisfied with the existing insurer, he/she is allowed to switch the same which makes it more feasible for senior citizens to choose the most suitable plan.

Last updated on 20-02-2020