Health Insurance Plans for Senior Citizens

What is Senior Citizen Health Insurance?

Senior Citizen Health Insurance is a type of health insurance plan that covers medical expenses incurred by people above 60 years old. It offers preventive health check-up facilities to the elderly and cashless hospitalization at network hospitals of the insurance company. It covers pre-existing diseases, hospitalization expenses, critical illness, and pre and post hospitalization expenses and coronavirus treatment.

Senior Citizen Health Insurance Plans at a Glance

The following table shows the characteristics of most senior citizen health insurance plans that are available to buy on Policybazaar.com:

Benefits of Senior Citizen Mediclaim Policy

A senior citizen mediclaim policy offers a variety of benefits to elderly people.  Below are some of the primary benefits of buying a senior citizen mediclaim policy in India:

• Medical Coverage to Elderly People- People above the age of 60 years get health cover under senior citizen health insurance plans as regular family health insurance plans mostly provide coverage to people up to 65 years of age.
• Pre-medical Screening- Most healthplans do not require elderly people to undergo any medical screening before buying the policy, unlike regular plans.
• Hospitalization Expense Cover- These plans cover senior citizens against a range of medical expenses, including pre-hospitalization, post-hospitalization, and in-patient hospitalization expenses.
• Cashless Treatment- Senior citizens can avail the cashless medical treatment at networkhospitals of the insurance company, provided they get admitted for a minimum of 24 hours.
• NoClaim Bonus- It provides a No Claim Bonus to the senior citizens that allows them to avail a discount on renewal premium for every claim-free year. It can range from 20% to 100% in some plans.
• Lifetime Renewability –Most health plans for senior citizens come with a lifetime renewability option.
• Tax-Benefits- Senior citizen health insurance policy offers tax exemption benefits every financial year on the paid premium undersection 80D of the IT Act.

Health Insurance Plans for Senior Citizens

The following table shows the various senior citizens health insurance plans that you can buy from Policybazaar.com online:

*Disclaimer: Policybazaar does not endorse, rate or recommend any particular insurer or insurance product offered by an insurer.  

Why Do You Need Health Insurance Plans for Senior Citizens?

Senior citizens need to have health insurance coverage as they can face severe health issues due to their increasing age.  An emergency hospitalization of your parents can be both emotionally and financially distressing. Health insurance for parents can help you to manage the financial implications of hospitalization. Some of the other prominent reasons why you need to buy a senior citizen health insurance plan are given below:

• Meet the Rising Healthcare Costs- With medical treatment and hospitalization costs getting costly due to medical inflation, buying a senior citizen health insurance policy becomes imperative for elderly people to avail the best healthcare services.
• Critical Illness Cover- With old age,the possibility of being diagnosed with critical illnesses like heart ailments, kidney problems, cancer, etc. becomes higher. With a senior citizen health insurance policy, you can also get coverage for critical illnesses in your basic plan or as an add-on cover.
• Annual Health Check-up Facilities- Senior citizens can avail free health check-ups on a yearly basis under most senior citizen health plans. As they need to undergo medical screening on a regular basis, this facility can help minimize out-of-pocket expenses. However, some plans may offer this facility after every two or three claim-free years.
• Peace of Mind- Paying off hospital bills can be distressing for elderly people, especially with an increase in treatment costs for both minor and major illnesses. A health insurance policy can bring peace of mind to senior citizens in such situations.

What is Covered in a Health Insurance Plan for Senior Citizens?

Some of the common coverage provided under senior citizen health insurance plans are given below:

• HospitalizationExpenses: Hospitalization expenses, including room charges, doctor fees, nursing fees, cost of medicine and drugs, ICU charges, cost of surgical appliances, and operation theatre charges are covered under this plan. It also covers the cost of artificial limbs, orthopedic implants, prosthetic devices, diagnostic tests,  required during the hospitalization of the senior citizen.
• Day Care Treatments- Specific daycare treatments that require less than 24 hours of hospitalization,like chemotherapy, dialysis, etc. are covered under most plans.
• Pre and Post-hospitalization Expenses- Medical costs before getting hospitalized and after getting discharged are also included under a senior citizen mediclaim policy.
• COVID-19 Cover- The policy also pays for the cost of coronavirus treatment up to the specified limit.
• Organ Donor Expenses- Most mediclaim policies cover the donor expenses incurred during organ transplants. 
• Ambulance Charges- It covers ambulance charges incurred on transporting the insured to the nearest hospital up to the specified limit.
• Pre-existing Diseases- Any pre-existing diseases of the insured senior citizen are also covered after a fixed waiting period.
• AYUSHTreatment Cost- AYUSH treatment taken in a government-recognized hospital or institute is also covered under some senior citizen mediclaim policies.
• Domiciliary Hospitalization Cover- If the doctor suggests home treatment for the elderly person, then his/her insurance company will pay for domiciliary hospitalization expenses as well.

What is Not Covered in a Health Insurance Plan for Senior Citizens?

Below is a list of medical expenses that are not covered under a senior citizen health insurance plan:

• Pre-existing diseases or injuries
• Expenses arising out of self-inflicted injuries or suicide
• Expenses arising from drug or alcohol abuse and related treatment
• Medical conditions diagnosed within 30 days of purchasing the policy (except for accidental injuries)
• Expenses related to non-allopathic treatment
• The treatment cost of injuries caused due to an act of foreign army or a civil war.
• Cosmetic surgery
• The cost of dental treatment or lenses/spectacles unless arising from an accident.
• Treatment cost of AIDS

Please note that the list of exclusions varies from one plan to another.

Things to Consider While Buying a Mediclaim Policy for Senior Citizens

A senior citizen mediclaim policy offers health insurance coverage to elderly people who are vulnerable to serious illnesses that may require expensive treatment. You can easily buy a health insurance plan for senior citizens online from Policybazaar.com. Take a look at the things that should be considered while buying a mediclaim policy for senior citizens:

1. Day Care Treatments

With the advancement in medical technology, a lot of treatments and surgeries can be done through day care procedures. But under a regular health insurance policy, a senior citizen must be hospitalized for at least 24 hours to raise a claim. Therefore, it is better to choose a senior citizen plan that covers a lot of day care procedures like dialysis, chemotherapy, radiotherapy, etc.

2. Cashless Hospitals

Every health insurance company has a broad network of hospitals where you can avail cashless hospitalization facilities. You must check the list of network hospitals of your insurance company before buying a plan. This will help you to know if a good hospital in your locality falls under the list. You can check the network hospitals list by different insurance companies and buy the best senior citizen health insurance policy online at Policybazaar.com.

3. Efficacy of Health Insurance Claims

Claim settlement ratio and claim settlement time taken by the insurance company should also be taken into consideration while buying a senior citizen health policy. If an insurance company’s claim settlement time is less and the claim settlement ratio is high, it means that the chances of your claim getting settled quickly are more.

4. No Claim Bonus

Almost all insurance companies provide a no claim bonus discount if no claims are lodged by the policyholder in the previous year. In such a case, either the policy premium decreases or the sum insured amount increases.

5. Free Medical Health Check-up Facility

The best health insurance plans for senior citizens allow the policyholders to avail medical check-up for free on an annual basis. This usually is offered after the completion of certain policy years or after every two/three claim-free years.

6. Co-payment

Several senior citizen health plans come with a co-payment clause in which a part of the claim amount has to be paid by the policyholder. Only the remaining portion of the claim amount is paid by the insurance company. Hence, you must opt for a plan with low to zero co-payment.

7. Policy Renewability

Always look for a best health insurance plan that offers a lifetime renewability option so that you won’t have to buy another health plan in your old age. A policy that ceases to renew, especially after 60 years, is not the right plan for a senior citizen.

8. Pre-existing Diseases Waiting Period

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

9. Domiciliary Hospitalization

There can be situations where an elderly person’s health condition may not allow him/her to get admitted to a hospital. In such a case, health plans with domiciliary hospitalization cover will pay for home treatment expenses as long as it has been advised by a qualified doctor.

Claim Settlement Process for Senior Citizen Health Insurance

Senior Citizen Health Insurance plans require policyholders to file a health insurance claim if they get hospitalized or avail an emergency medical treatment. A claim can be raised either to avail cashless treatment at a network hospital or get reimbursement of expenses incurred at a non-network hospital. The process to file a reimbursement and cashless claim are given below:

1. Senior Citizen Health Insurance Reimbursement Claim Procedure:

The following steps are involved in lodging a reimbursement claim under a senior citizen health insurance plan:

• In case of hospitalization, immediately notify the insurance company
• Collect all the medical documents during hospital discharge
• Fill up and sign the claim form
• Submit the claim form to the TPA or the insurer along with all the required documents like doctor’s prescriptions, pathological reports, chemist bills, certificate of hospital admission and discharge,
• The claim is settled by the claims team after careful review and the claim amount is reimbursed.

2. Senior Citizen Health Insurance Cashless Claim Process:

If you avail medical treatment at a network hospital, then you can file for a cashless claim under a senior citizen health policy. Take a look at the steps listed below:

• Get hospitalized at a network hospital of the insurance provider
• Fill out the pre-authorization form available at the hospital and give it to the hospital authorities
• The hospital will send the thepre-authorization request to the TPA that needs to be approved by the insurance company or the claims team to initiate cashless hospitalization of the insured elderly person.
• Obtain the treatment after approval and get discharged
• The insurance company will settle the claim with the hospital directly.

Tax Benefits of Senior Citizen Health Insurance

A senior citizen health policy not only provides assurance to cover medical expenses but also allows you to avail tax exemption under section 80D of the Income Tax Act, 1961. You are eligible for an income tax rebate of up to Rs 50,000 if you hold a mediclaim policy for senior citizens for your elderly parents.

You can also avail an additional tax rebate of Rs 5,000 on payments made towards preventive health check-ups every financial year. Moreover, you can also get a rebate of up to Rs 1 lakh if the senior citizen undertakes a critical disease treatment.

If you are a senior citizen who is still earning and also paying the health insurance premium on behalf of your son or daughter, then you can avail an additional income tax rebate of Rs 25,000. This means that you can avail tax deduction of up to Rs 75,000 in a financial year under section 80D.

Benefits of Buying Senior Citizen Health Insurance from Policybazaar

Policybazaar Insurance Broker Private Limited offers multiple benefits to the policyholder on buying a senior citizen health insurance policy. Take a look at them below:

• Online Comparison- Policybazaar.com helps you to make an unbiased online comparison of various senior citizen health insurance policies available in the market so that you find the most suitable policy as per your health needs.
• Senior Citizen Health Insurance Calculator- They offer the facility of a health insurance calculator that allows you to check the premium for different policies before making the actual purchase.
• Savings on Premium- Policybazaar.com offers up to 12.5% savings on your premium if you opt for a 2-year policy tenure while buying your senior citizen health policy. Thus, you end up saving a lot of money.
• Expert Advice- A qualified team of experts are available to answer your queries and help you to buy the best senior citizen health insurance policy.
• Instant Policy Purchase- They help you to save a lot of time as you can purchase an insurance policy on Policybazaar.com in less than two minutes.
• Claim Assistance– It also offers claim assistance after you have purchased the policy.

Senior Citizen Health Insurance FAQ’s