Health Insurance Plans for Senior Citizens

Senior citizen health insurance plan come with a wide range of coverage:

1. In-patient Hospitalisation

Senior citizen health insurance plans cover inpatient hospitalisation including expenses like room rent, doctor's fees, surgical expenses, and more.

2. Pre and Post-Hospitalisation Expenses

The plan will cover the medical expenses incurred before and after hospitalisation such as diagnostic tests, medications, and consultations.

3. Daycare Procedure

It gives coverage for medical procedures that don't require overnight hospitalisation such as chemotherapy, dialysis, and cataract surgery.

4. Domiciliary Hospitalisation

Coverage for the treatment taken at home due to the unavailability of a bed or mobility issues will be covered by the insurer in the senior citizen health insurance plan.

5. Health Check-ups

There are plans that offer regular health check-ups to monitor overall health and diagnose any diseases early.

Being a senior citizen it is important to focus on health and for that one should have a comprehensive health insurance plan. Following are some factors that should be considered while purchasing a health insurance plan for senior citizens:

1. Adequate Sum Insured

Healthcare costs are increasing faster than inflation and it is essential to have an adequate sum insured so that it is sufficient to cover future medical expenses.

2. Hospitalisation Expenses

Always check that your plan should cover room rent, doctor's fees, nursing charges, surgical expenses, and other related costs.

3. Pre and Post Hospitalisation Expenses
Always opt for the plan that provides coverage for pre and post-hospitalisation expenses so that you don’t have to pay for expenses related to diagnosis and medication afterwards out of pocket.

4. Domiciliary Hospitalisation

Choose the plan that offers domiciliary hospitalisation coverage so that if due to mobility issues you cannot go to the hospital then you can get treatment at home. An insurer will give coverage for the treatment facility such as healthcare setup, doctor's fee, nurse fee etc.

5. Network Hospitals

Before purchasing health insurance for senior citizens check the list and numbers of network hospitals of insurers. Always check where the nearest network hospital is.

Here are the steps to purchase Senior Citizen Health Insurance Plans online through InsuranceDekho:

Step 1: Visit the InsuranceDekho official website on your search engine.

Step 2: Fill the required information and choose the plan.

Step 3: Choose the kind of cover that you are looking for from the two options. The form changes based on your choice/requirement.

Step 4: After choosing your plan and coverage go to the payment option and make payment online for your policy.

Important Documents Required for Policy Purchase

• Identification Proof
• Address Proof
• Age Proof
• Income Proof
• Medical Reports
• Passport-size Photographs

There are two types of claim processes available through which one can file a claim. One is the cashless claim and another is a reimbursement claim.

Cashless Claim

A cashless claim is a claim which is filed at the network hospitals and you do not have to pay during hospitalisation.

To file a cashless claim follow these steps:

STEP 1:

For planned hospitalisation inform your insurer before 48hrs of admission.

For emergency hospitalisation inform your insurer within 48 hrs after admission.

STEP 2:

Go to the hospital desk and ask TPA for a cashless hospitalisation form and fill it out.

STEP 3:

After filling out the form TPA will verify your documents.

STEP 4:

After document verification, if everything checks out, you will get access to cashless hospitalisation.

Reimbursement claim

The policyholder has to pay for all the expenses related to hospitalisation and treatment and afterwards, you have to file a claim and the bill amount will be credited into your bank account by the insurer.

To file a reimbursement claim follow these steps:

STEP 1:

Download the form from the insurer's website by clicking on the claim process.

STEP 2:

Fill out the Form according to the instructions given and attach the required documents.

STEP 3:

Submit all the documents by visiting the insurer's nearest branch.

STEP 4:

After verification of the documents given by you your claim process will start.

Once the process starts your reimbursement amount will be credited to your registered bank account.

Ques 1. Is there an age limit for purchasing senior citizen health insurance?

Ans. In India most insurance companies offer senior citizens health insurance plans to people above the age of 60.

Ques 2. What is the importance of network hospitals in health insurance?

Ans. Insurers have tie-ups with the hospitals and when policyholders visit the network hospitals then they don’t have to pay for the treatment and it will be cashless. The insurance company directly settle the bills with the hospital.

Ques 3. How does one choose the best health insurance plan for senior citizens?

Ans. To choose the best health insurance plan for senior citizens always compare the plans based on coverage, premiums, waiting periods, network hospitals, and claim settlement ratios.

Ques 4. Do senior citizen health insurance plans cover day-care treatments?

Ans. Yes there are insurance companies in India that offer health insurance plans to senior citizens in which day-care treatment is covered.

Ques 5. Can a senior citizen’s family member be included in the plan?

Ans. There are senior citizen health insurance plans in which family members can be added and they will get coverage of health insurance.

You can buy senior citizen insurance plans at InsuranceDekho in two ways, i.e. online or offline modes. To buy the plans online, you are required to follow the steps given below:

1. Visit insurancedekho.com. Then click on the ‘health’ tab.
2. Enter personal details like gender, name, and mobile number. You will receive an OTP on the given number. Please enter that.
3. Answer the simple question ‘When do you want to buy the policy’ from the options in the drop-down menu. Click on ‘View Quotes’.
4. If you want to add your family members under the policy including your spouse, etc., then select them and click on the ‘Continue’ button.
5. Enter the age of the member(s) selected.
6. Enter your Email ID and then your City. Click on ‘Submit and View Quotes’. You will see top senior citizen health insurance plans on your screen as per your requirement. Select the most suitable one from them as per your budget and other requirements.
7. Select the policy term for the shortlisted plan and pay the premium via a secured payment gateway.

You can also buy the plan offline by getting in touch with the customer care executives on the toll-free number 7551196989 or write to us at customersupport@insurancedekho.com in case further support is required.

IRDAI or the Insurance Regulatory and Development Authority of India is responsible to monitor the provisions of government health insurance plans for senior citizens, along with other responsibilities. It regulates the features and benefits offered under these plans from time to time to ensure the welfare of the senior citizens. Some regulatory activities are done by the IRDAI recently are as follows:

• A strict limit on the maximum premium payments was implemented when the premiums were increased by the insurers in the years 2006 and 2007.
• A committee on Health Insurance For Senior Citizens was formed so that the requirements can be implemented seamlessly. The committee made several recommendations, some of which were implemented effectively.
• The insurance regulatory authority has issued a mandate for the insurance companies not to reject the renewal for a senior citizen health insurance policy, except on the grounds of fraud, moral hazard, or misinterpretation of information.
  Following are the features made compulsory for a government-backed senior citizen health insurance policy:
• At least 50% of the expenses arising due to pre-insurance medical examination may be reimbursed if the insurer accepts the risk.
• The senior citizen health insurance policyholders can opt for another Third Party Administrator (TPA) according to their preference and convenience.
• Senior citizens can renew their senior citizen health insurance plans until 65 years of age.
• Every rejection of a senior citizen health insurance plan shall be given in writing, along with reasons for the same.

Health insurance plans for senior citizens offers you financial security in the later years of your life when most probably your income would not be high or not be any at all.

In case the insurance company declines the health insurance application/proposal form for the senior citizen/parents, there are two things that a person can do:

1. In case you have doubts regarding the medical check-ups conducted by the insurance company, you can choose to get another medical check up that shall be conducted by another doctor and submit the reports to the insurance company. If the insurance company is satisfied with the reports, they may reconsider your application.

2. In case your application/proposal form for a senior citizen health insurance policy is declined by one insurance provider, you can always approach and apply with another health insurance provider. In case you apply for health insurance at another insurance provider within 30 days of applying for the senior citizen health insurance policy with the first insurance provider, you can submit the medical check-up documents which were obtained from the first one to the new insurance company.

There are some myths about senior citizens health insurance policy which pulls back people from purchasing a senior citizen health insurance policy. Below mentioned are some myths about senior citizen health insurance that needs to be busted which can help have more clarity and help you in making an informed decision:

1. Group health insurance is sufficient.

Many people have this misconception about the group health insurance policy, they believe that the group health insurance offered by their employer/the company in which they work, will be sufficient and will provide sufficient coverage for their parents. This is a very common misconception which is not true. It is very important to understand that you should not just rely on a group health insurance plan for health health coverage for your parents because some companies may or may not include your parents.

2. Senior citizen health insurance policy will not cover pre-existing medical conditions.

It is a fact that most health insurance policies do not cover pre-existing medical conditions especially for the senior citizens and because of this one reason many people pull back from purchasing a health insurance policy. A senior citizen health insurance will provide coverage for pre-existing medical conditions after a waiting period which differs depending on the terms and conditions of the insurance company.

3. Senior citizen health is quite expensive.

Senior citizen health insurance policies can be slightly expensive but that should not stop a person from purchasing one. There are several senior citizen health insurance policies that are affordable and provide the right amount coverage for the senior citizen.