Senior Citizen Health Insurance

Health insurance for senior citizens are some of the top-selling plans in India. Our elders require special care which is duly fulfilled by comprehensive health insurance for senior citizens. These plans offer benefits like home care, domiciliary hospitalization, ambulance charges, daycare procedures, OPD, daily hospital cash, and much more.

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Health insurance for senior citizens

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Health Insurance For Senior Citizens In India

We are indeed reminded of things when we need them and the same is true in the case of health insurance. Though health insurance might not be a priority for us youngsters, with growing age it becomes a necessity. So, we need to make health insurance our priority before it becomes a necessity.

Several companies in India offer health insurance for senior citizens. Health insurance plans provide medical coverage to elderly people, mostly for those who are 60 years and above. Senior individuals are more prone to falling sick or catching common ailments therefore it is necessary to buy a plan which are exclusively dedicated to our senior citizens.

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Best Senior Citizen Health Insurance Plans

Best Senior Citizen Health Insurance Plans

Key Points of Senior Citizens Health Insurance Plans in India.

  • These plans are very different from the regular health insurance plans.
  • It is very important to go for a pre-policy check-up before purchasing health insurance for senior citizens.
  • Also, medical insurance for senior citizens comes with a co-payment clause.
  • The minimum entry age for senior citizens is 60 years.
  • Premiums might be higher due to age but gives complete coverage.

This article talks about the importance of health insurance plans for senior citizens, and what you need to know before you decide to purchase.

What is the Need For Medical Insurance For Senior Citizens?

There are many benefits to getting a health insurance policy if you or your parents are 60 years or above. Here are some of the reasons why you should consider buying the insurance-

  • Facing Critical Conditions
    Sometimes, treatments can get out of hand and might drain your savings. Critical illnesses need extra medical attention and expensive treatments. With a senior citizens' health insurance plan, you will be secured for the treatment of any such illness.
  • Rising Medical Costs
    A rise in medical costs has been seen recently in India. However, the advancement in the medical industry has provided a cure for almost every disease. For senior citizens, it becomes a necessity to have medical policy for senior citizens to beat inflation.
  • Comprehensive Medical Insurance Plans
    There are a lot of insurance plans available for senior citizens in the market. Sometimes, the employees get parent's inclusion too in their group policy. Moreover, this coverage is not enough, so you can go with the family floater plan or dedicated individual plans for your old parents.
  • Domiciliary Treatment
    Under the senior citizens' health insurance policy, you will get domiciliary coverage as well. For elder people, it is not very comfortable to stay in the hospital for longer. Thus, domiciliary coverage allows them to get treatment in the comfort of their home.
  • Transportation Charges
    Transportation coverage for senior citizens is as important as other hospitalization coverage. Thus, many health insurance covers ambulance charges along with health insurance policies for senior citizens.
  • Annual Health Check-Up
    With senior citizens' health insurance, you or your parents will be covered for health check-ups every year. This will help in the early diagnosis of any critical illnesses that might arise in the near future..

Key Features of Senior Citizen Health Insurance At a Glance

Sum Insured - The sum insured for senior citizen health insurance plans ranges between 1 lakh to 25 Lakhs, depending on the plan that you purchase.

  • Renewability
    Health plans for senior citizens offer lifetime renewability.
  • Pre-policy Check-up
    Certain senior citizen medical policies may ask for a pre-policy check-up since it is for seniors.
  • Critical Illness
    Senior citizen plans offer cover for certain critical illnesses under the same policy, up to a certain stage.
  • Restoration
    Certain insurance companies offer senior citizen mediclaim policies with restoration benefits. It means that the sum insured will be restored once the original amount is exhausted.
  • Co-payment
    Several health insurance plans for senior citizens have co-payments where the policyholder has to pay a pre-decided percentage against the medical bills and the insurance company pays the rest.
  • No-claim bonus
    Senior citizen health plans also offer no-claim bonuses.
  • Loading
    Loading is the additional charge that has been put in by the insurance company in the case of risky situations. In case of detection of diabetes mid-policy term, loading is imposed on senior citizen health insurance premiums.

Why Should I Buy A Senior Citizen Health Insurance?

Purchasing health insurance for senior citizens has a lot of benefits. It gives mental peace and other benefits which are given below-

  • All-Inclusive Coverage
    Senior citizen health insurance policies offer inclusive coverage which consists of AYUSH treatments, homecare, domiciliary hospitalization, ambulance charges, daycare procedures, OPD, and hospital daily cash.
  • Less waiting period for pre-existing diseases
    The waiting period for pre-existing diseases is lesser in senior citizen health plans as compared to other health policies.
  • Free Health Check-ups
    Most health insurance policies for senior citizens offer free health check-ups at regular intervals.
  • Spouse Cover
    You can also add your spouse to your senior citizen health plan and share the sum insured with them.
  • Option of Co-pay Waiver
    The policyholders can add a rider to waive off the co-payment in their senior citizen health plans. Adding the rider will increase the premiums minimally but the co-payment clause will be removed.
  • Tax Benefits
    Medical insurance for senior citizens also offers tax benefits under the Income Tax Act, of 1961. The tax benefits of Rs. 50,000 to Rs. 1,00,000 can be availed under Section 80D.
  • Critical illness coverage
    As mentioned in the policy, senior citizen health insurance plans cover critical illnesses. Once diagnosed, the policy pays out a lump sum amount meant for the treatment and the policy terminates.

Eligibility

Minimum Entry Age 60 years (Last birthday)
Tenure 1, 2, and 3 Years
Sum Insured 1 lakh to 25 lakhs
Renewability Lifelong

Best Health Insurance For Senior Citizens

Given below are some of the best health insurance senior citizen plans along with a few details.

Senior Citizen Plans
Sum Insured (Rs.)
Entry Age
Policy Type
Pre- Medical Check-up
OPD and Daycare Coverage
Co-Payment
Star Senior Citizen Red Carpet 1L, 2L, 3L, 4L, 5L, 7.5L, 10L, 15L, 20L, 25L 60 - 75 Years Individual and Family Floater No All Day care treatments 30% per claim
Care Senior Plan 3L. 5L, 7L, 10L 61 Years - Lifelong Individual and Family Floater No 540 Day care treatments 20% per claim
ManipalCigna Prime Senior 3L - 50L 56 - 75 Years Individual, Multi-individual and Family Floater No mandatory check-up Covered up to the sum insured 20% per claim
Niva Bupa Senior First 5L, 10L, 15L, 20L, 25L 61 - 75 Years Individual and Family Floater No mandatory check-up Covered up to the sum insured 50% per claim (Modification Available)
Aditya Birla Platinum Essential 5L - 1 Cr 60 Years - Lifelong Individual and Family Floater Depends on Medical History 586 Daycare Treatments 20% per claim
What is Sum insured?

Sum insured is the maximum monetary coverage that a health insurance policy provides you. You should decide your sum insured based on the cost of medical treatments, your health, income, and lifestyle habits.

What is Entry age?

The age (last birthday) at which you buy an insurance policy is your entry age to that policy. Insurance policies usually come with a minimum and maximum age at entry which means that you must attain a specific age or should be less than the maximum age to buy a policy.

What is Pre-medical check-up?

The medical tests that you undertake before buying an insurance policy as asked by the insurer are called pre-medical check-ups.

What is OPD and Daycare coverage?

OPD covers the cost of doctor consultations and prescribed medical tests that may not require hospitalization. Treatments that can be treated in less than 24 hours of hospitalization like blood dialysis, cataracts, etc. come into daycare treatments.

What is Co-payment

A clause in insurance where the policyholder has to pay a certain part of the hospitalization expenses and the insurance company pays the rest. Co-payment is imposed when you buy an insurance policy in the old age.

Exclusions of Senior Citizen Health Insurance Plans

Senior citizen plans do not cover the following conditions:

  • Plastic or cosmetic surgery
  • Breach of law
  • Sex change operations
  • Self-inflicted Injuries
  • War and Acts of Terrorism
  • Unproven/experimental treatments

What will be the Cost of Health Insurance For Senior Citizens?

The cost of health insurance may vary from plan to plan. In the following table, you can get an idea about the premiums you need to pay every year to get coverage of approximately Rs 5 lakhs in a metro city.

Senior Citizen Plans Annual Premium in Rs. (1 Year) Annual Premium in Rs. (2 Years) Annual Premium in Rs. (3 Years)
Star Senior Citizen Red Carpet 21,240 41,094 60,664
Care Senior Plan 23,474 43,427 63,379
ManipalCigna Prime Senior Elite 28,432 53,773 80,242
Aditya Birla Platinum Essential 21,798 41,952 63,602

* The premiums may vary from person to person and the above table is showcased to give a rough idea of the premiums.

* You can also check the senior citizens premium calculator on PolicyX for a better idea.

Claim Process

There are two ways by which a policyholder can raise a claim. The following are the ways to raise claims, provided the company offers both claim options:

Cashless Claim Reimbursement Claim
Definition Cashless claims refer to the treatment where the policyholder gets admitted to a network hospital. The insurance company then settles the claim directly with the network hospital once the claim is raised and approved. Reimbursement claims are claims that you have to raise after getting treatment at non-network hospitals. In this case, you have to pay for the expenses at first and the insurance company will reimburse the expenses once the claim is approved.
Step 1 Intimation - Inform the company about your planned hospitalization before 72 hours. Intimation - Intimate the insurance company within 7 days of your hospital discharge.
Step 2 Submit the documents - Submit the authorization form, medical reports, and other requested documents to the TPA desk at the hospital. Submit the documents - Collect your hospital invoices, reports and all the requested documents and submit them to the insurer within a month.
Step 3 Approval and admission - The hospital will send these documents to the insurance company for approval. Once it's approved, your claim will be settled directly with the hospital. Verification and Approval - The insurer will verify all the information and process the claim. If approved, you will receive the reimbursement amount in your registered bank account.

Documents Required

These are the documents you need to keep handy while filing a claim-

  • Photocopy of the policy document.
  • Claim form with complete details
  • Attending physician's or doctor's statement
  • Medical records (test results)
  • Other documents requested by the company

Health Insurer Network Hospitals

How to Choose the Best Health Insurance Policy for Senior Citizens?

There are a few checklists you need to consider while purchasing health insurance for senior citizens. Here are the things you should consider:

  • Coverage Options
    Check for all the coverage options while selecting the policy for senior citizens. Make sure that your policy should cover in-hospitalization, pre-existing conditions, in and out-patient coverage, ambulance coverage, pre-hospitalisation, post-hospitalisation, and much more.
  • Network Hospital
    The plan should cover a maximum number of hospitals in your area and have the options for both cashless and reimbursement claims.
  • Check for the exclusions
    You need to review the inclusions and exclusions very carefully. Check out whether your policy covers ambulance charges, medical tests, day-care procedures and other important things. Also check the diseases covered, and how much is the waiting period.
  • Affordability of the Premiums
    Obviously while buying a health insurance policy for senior citizens you need to be very specific about the budget. With PolicyX Premium Calculators, you can get an idea about the premiums.
  • Customer Reviews
    Carefully review the reputation of the insurer by comparing the reviews given by the existing users. As it is very important to know whether the company is faking the promises or keeping them while claim settlements.
  • Waiting Period
    You have to understand the waiting period for pre-existing conditions. Opt for the senior citizens policy with the shorter waiting period.
  • Sum Insured and No Claim Bonus
    Choose a policy with an adequate sum insured to accommodate potential medical expenses. Do enquire about the no-claim bonus and other benefits against your policy.
  • Renewability and Age Limit
    When choosing the policy for senior citizens, must ensure that there should be no age limit. So, that it will give coverage at the later stages of life.

How PolicyX Can Help?

PolicyX is the trusted aggregator that can help you with the end-to-end process for your senior citizen health insurance policy. We provide safe, efficient, user-friendly, and time-saving support that can help you with different processes for your policy. You can buy, renew, and claim from the comfort of your homes.

You just need to follow these steps-

  • Step 1

    Get quotes from top insurers by filling up a form given at the top of this page.

  • Step 2

    Compare quotes from different insurers and select the desired plan as per your requirements.

  • Step 3

    Submit all the required details and documents.

  • Step 4

    Make the online payment and congratulations! Your health is now secured.

End Note

Senior citizen's health insurance plans can be an important aspect of any financial planning. So consider getting a health insurance policy for senior citizens of your family, whether it is you or your parents. Trust me, it will give a huge relief in times of emergency. Ageing is a natural process, but having insurance for your health in old age can make this ageing beautiful and mentally peaceful. PolicyX cares for the well-being of society.

You can reach out to us for any kind of senior citizen's health insurance query by calling or emailing. We are there for you, always.

Senior Citizen Health Insurance: FAQ's

1. Best senior citizen health insurance plans in India?

Following are the best senior citizen health insurance plans in India:

  1. Star Senior Citizen Red Carpet
  2. Care Senior Plan
  3. ManipalCigna Prime Senior
  4. Niva Bupa Senior First
  5. Aditya Birla Platinum Essential

2. Why is it important to buy senior citizen insurance plans?

Elderly people are more likely to have pre-existing diseases whose treatment can exhaust all their savings. Therefore, you should opt for a senior citizen health insurance plan with a minimum waiting period for pre-existing diseases.

3. Do all senior citizen health insurance plans come with a co-payment clause?

Yes, co-payment is mandatory in all senior citizens' health insurance plans. One can opt for a higher co-payment to lower their premiums, or add a co-payment waiver rider for higher premiums.

4. Are pre-existing diseases covered under senior citizen health insurance?

Pre-existing conditions are covered after waiting periods in senior citizen health policies.

5. Is there any need for medical checkups while buying health insurance for senior citizens?

Yes, to purchase a health insurance policy for senior citizens you need to undergo a medical checkup.

6. Does medical insurance for senior citizens offer coverage against critical illnesses?

Yes, critical diseases are covered by senior citizens' insurance policies.

7. Will I get tax benefits on the premiums paid towards health insurance for senior citizens?

Senior citizens can claim a tax advantage of Rs.50,000 to 1 Lakh per year on premiums paid under Section 80D of the Income Tax Act 1961. Children who are paying health insurance premiums for their parents can also get this benefit.

8. Do insurance companies offer annual health checkups under senior citizen health insurance?

Yes, most of the senior citizen health policies offer free health check-ups annually or as per individual plan features.

Health Insurance Companies

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February 28, 2024

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February 28, 2024

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February 28, 2024

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Simran Saxena

Written By: Simran Saxena

An explorer and a curious person, Simran has worked in the field of insurance for more than 3 years. Traveling and writing is her only passion and hobby. Her main agenda is to transform insurance information into a piece that is easy to understand and solves the reader’s query seamlessly.