Senior Citizen Health Insurance

Senior Citizen Health Insurance is a medical insurance policy that offers medical coverage to individuals between the age group of 60 and 75 years. Some of the unique benefits of senior citizen mediclaim policy include cashless hospitalization cover, day care expenses, pre-existing and disease cover.

As per the IRDAI regulations, every health insurance provider  now offers coverage to individuals, up to the age of 65 years. These updated guidelines help individuals to get coverage at later stages of their life. Moreover, the insurers allow the policyholders to switch insurers if they’re not satisfied with their current insurance provider. There is no dearth of insurance providers for elderly people in India. However, the challenge is to choose the right  senior citizen health insurance plan.

Benefits of Senior Citizen Mediclaim Policy

A senior citizen mediclaim policy offers a range of insurance benefits to elderly people who are more vulnerable to ailments. Such a mediclaim policy requires a person to be at least 60 years old to avail the coverage benefits. Below are some of the primary benefits of buying 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 a basic health plan only provides coverage up to 65 years of age
• Pre-medical screening- Most of the plans do not require any pre-medical screening. In some plans pre-medical tests may be required
• Cashless Treatment- Senior citizens can avail the cashless medical treatment in some of the top hospitals provided the patient is admitted for a minimum of 24 hours. This facility includes medical bills, doctor fees, charges of the room, etc.
• Medical Treatment Expense Cover- Pre-hospitalization, post-hospitalization expenses and in-patient hospitalization expenses are covered in this policy
• No-claim-Bonus- It is the discount that the insurer offers for all the claim-free years. It can range from 20% to 100% in some plans
• Tax-Benefits- Another important benefit is that senior citizen health insurance policy offers tax exemption benefits u/s 80D of the IT Act. The cost of premium that is paid is eligible for tax exemption benefits for every financial year

Top Mediclaim Policies for Senior Citizens

Why do you Need Health Insurance for Senior Citizens?

Senior citizens need to have health insurance cover as health issues are unpredictable.  Hospitalization can be both emotionally and financially distressing for them and their families. Some of the other prominent reasons why senior citizens need health insurance cover are given below:

• Meet the Rising Healthcare Costs- Adequate health insurance is essential for senior citizens and the entire family to meet the healthcare costs. With the spiraling medical expenses and hospitalization costs, buying a senior citizen health insurance policy becomes imperative for elderly people to help them avail the best healthcare services.
• Critical illness cover- With 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 get critical illness add-on cover people for people above the age of 60-years.
• Annual Health Check-up Facilities- Senior citizens can avail health check-ups on yearly basis, as they need to undergo medical screening on a regular basis. Therefore, annual health check-up facilities can help minimize expenses incurred on the same.
• Peace of Mind- Paying off hospital bills can be strenuous for elderly people, especially with an up rise in treatment costs for both minor and major illnesses. A health insurance policy can bring peace of mind for senior citizens and the entire family in the present situation.

Inclusions of Senior Citizen Health Insurance Plans

Senior citizen health insurance plans include a range of medical coverage benefits from home treatment to hospitalization expenses. Some of the common inclusions under senior citizen mediclaim policies are enumerated below:

• Hospital Expense Cover: Hospitalization expenses, including room charges, doctor fees, nursing fees, cost of medicine and drugs, ICU charges, fees charged by the medical practitioner, surgeon, consultants, anesthetist, and specialists are recompensed. The cost of surgical appliances, blood, anesthesia, medicines, operation theatre charges are covered as well
• Other Medical Expenses- It further includes the cost of radiotherapy, chemotherapy, dialysis, cost of artificial limbs, orthopedic implants, and cost of other prosthetic devices such as a pacemaker, vascular stents etc. Expenses incurred on diagnostic tests, x-ray, blood tests, and similar procedures that are required during the hospitalization are also taken care off, depending on the policy purchased
• Day care Treatments- Specific day care treatments that require less than 24 hours of hospitalization or procedures like chemotherapy, dialysis, etc. are also covered under most of the plans
• Pre and post Hospitalization Cover- Medical costs prior and post hospitalization are also included under a senior citizen mediclaim policy
• COVID-19 Cover- The policy also pays the insured person for coronavirus treatment up to the specified limit
• Organ Donor Expenses- Most of the senior citizen mediclaim policies cover organ donor expenses 
• Ambulance chargesAmbulance charges for transporting the insured person are recompensed up to a specified limit
  
• Pre-Existing Diseases- Pre-existing diseases are also covered, subjected to the policy terms and conditions
• Ayush Treatment Cost- Ayush treatment taken in a government recognized hospital or Institute is also paid under some senior citizen mediclaim policies
• Domiciliary Hospitalization Cover- If the doctor suggests home treatment then the policy includes domiciliary hospitalization expenses as well
  

Exclusions of Senior Citizens Health Insurance

Although a health insurance policy covers most of the health hazards when diagnosed, there are times when mediclaim cover for a senior citizen is denied. Below is a list of common exclusions under a senior citizen health insurance policy:

• Pre-existing diseases or injuries are not covered
• Expenses arising out of self-inflicted injuries
• Expenses arising from drug abuse and related treatment
• One or more medical condition diagnosed within 30 days of purchasing the policy
• Expenses related to non-allopathic treatment
• The treatment cost of injuries caused due to an act of foreign army or a civil war
• A cosmetic surgery is also not covered
• The cost of dental treatment or lenses/spectacles unless arising from an accident
• Treatment cost of AIDS is excluded as well

Things to Consider While Buying Mediclaim Policy for Senior Citizens

A senior citizen mediclaim policy offers health insurance cover to elderly people who are vulnerable to serious illnesses that may require expensive treatment. Scores of young individuals are on pins and needles when talked about the health requirements of their parents, peculiarly when their parents are the senior citizens.

• Day-care Treatments

  Many of the health insurance policies do not cover daycare treatments. Also, in order to make a mediclaim, hospitalization is mandatory for at least 24 hours. However, you must be grateful to several modernizations, today; many methods do not need any hospitalization. Therefore, it is better to choose a plan covering the highest number of day-care techniques and procedures like dialysis, chemotherapy, radiotherapy, etc.

• Cashless Hospitals

  Check out the list of network hospitals where you can avail cashless treatment. Every health insurance company has a broad network of hospitals registered under their network. You can check which ones are covered under your senior citizen health insurance policy. In case of medical emergencies, you can get your parents treated from any of these network hospitals. And everyone prefers to go to the hospital close to their vicinity and avail specialized treatment.

• Efficacy of Health Insurance Claims

  Claim settlement ratio and claim settlement time should be the two most significant factors taken into consideration. Faster the claim settlement time and higher the claim settlement ratio usually means that the insurer is doing a great job in meeting the policyholder’s claim requests.

• No-Claim Bonus

  A lot of insurance companies provide a no-claim discount or a no-claim bonus if no claim is lodged by the policyholder. In such a case, either the premium decreases or the sum insured increases or both.

• Free Medical Health-Check Facility

  Hunt for a best health insurance plan that allows the policyholders to avail medical check-up for free on annual basis. This usually is offered after completion of certain policy years. The check-up or tests have no impact on the premium while the policy comes up for the renewal.

Claim Settlement Process for Senior Citizen Health Insurance

Senior Citizen Health Insurance allows the policyholders to file a health insurance claim when they get hospitalized or have to avail emergency medical treatment. These policies facilitate raising a mediclaim to avail cashless treatment at a network hospital or get reimbursement of expenses incurred on the treatment. In any case, the policyholder must inform their insurer about the same within 24 hours of hospitalization for both cashless and reimbursement claims:

Senior Citizen Health Insurance Reimbursement Claim Procedure

The following steps are involved in general for lodging and settlement of senior citizen health insurance claims:

• In case of hospitalization immediately notify the insurer
• Collect the health claim form from the office or download it online
• Fill and sign the claim form
• Now submit the claim form to the TPA or the insurer
• Submit all the documents like doctor’s prescriptions, hospital reports, pathological reports,
• chemist bills, Receipts from the doctor and surgeon, certificate of admission and discharge, as the case may be
• A surveyor might be appointed to refer the case to panel doctors (as the case may be)
• The claim is settled by the issuing office and the amount is reimbursed

Senior Citizen Health Insurance Cashless Claim Process

If you avail medical treatment in a network hospital then you can file cashless claim for a senior citizen policy as listed under:

• In order to file mediclaim, fill out the claim form obtained online from the respective insurer's website or obtained from the insurer's office, and then submit it back to the insurer
• A pre-authorization request needs to be approved by the insurance company or the TPA department to initiate cashless hospitalization process
• For planned hospitalization, it is mandatory to inform the insurance company before hospitalization
• Attach the medical bills and reports given by the doctor/hospital as the supporting documents

Make sure to meet all the requirements for faster claim processing and settlement

Tax Benefits of Senior Citizen Health Insurance

This health policy not only provides you with an assurance for health benefits when you might actually need them but also entitles you to avail tax exemption under section 80D of the Income Tax Act, 1961. You are eligible for an income tax rebate of Rs. 30,000 if you hold a mediclaim policy for senior citizens for your elderly parents. You can also avail am additional rebate of Rs. 5,000 for preventive health checkups annually.

If you're still earning and also paying 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 max up to Rs. 60,000 under section 80D.

*Tax benefit is subject to changes in tax laws

*All savings are provided by the insurer as per the IRDAI approved insurance plan. Standard T&C apply.

Will Health Insurance for Coronavirus be provided for Senior Citizens?

Taking into consideration the way Coronavirus is permeating in India; buying health insurance for coronavirus is the need of the hour. And like everyone knows the worst affected by COVID-19 are the elderly people and those with weaker immunity. For this reason, senior citizens are also considered to be at a higher risk.

As per the data nearly 95% of deaths have been in people above the age of 60 years.

So, it makes sense to secure your elderly parents with a senior citizen health insurance plan that would cover up the treatment cost as it is not a pre-existing condition. However, the sum insured and coverage limit pertaining to the medical tests, quarantine expenses, waiting period, etc. can vary from one insurer to another. You can also buy Corona Kavach and Corona Rakshak policies for senior citizens up to the age of 65 years. These two plans also cover the cost of PPE kits, gloves, masks, oximeter, ventilator, etc. that are not covered under a basic health insurance policy.

Benefits of Buying Senior Citizen Health Insurance from Policybazaar

Are you an older person stuck in a health insurance crisis? Policybazaar is your savior.

Backed with a team of experts, we at Policybazaar facilitate a quick and easy comparison of available health insurance mediclaim policies and thus, help in saving your time and money. There are various IRDAI approved insurance companies offering senior citizen health insurance plans to old people and thus, an online comparison will ensure that you only fall to the right plan.

All you need to do is fill a simple form with information about yourself and your insurance requirements. Once you submit it, you will soon get quotes for affordable these senior citizens health insurance plans. The best part is that our insurance experts are standing by to talk with you and answer your query, if any.

Senior Citizen Health Insurance FAQ’s