Health Insurance Plans for Senior Citizens

Listed below are some features of senior citizen health insurance plans:

• Senior citizen health insurance plans come with higher sum insured options to offer adequate health insurance coverage to the senior citizens during the golden years of their lives.
• There are many senior citizen health insurance plans in the market that offer lifetime renewability benefits. This means that the policy can be renewed as many times as the insured individual wants, provided he/she timely pays the required premium.
• Senior citizen health insurance plans offer wide coverage benefits. These include cover for an emergency ambulance, cover for specific illnesses, etc.
• Cover for pre-existing diseases is provided after a specific waiting period. Note that the waiting period may differ from one insurance company to another.
• Under a senior citizen health insurance policy, the insured can avail cashless treatment or reimbursement treatment as per their convenience in case of hospitalisation.
• There are some senior citizen health insurance plans that offer cover to senior citizens as well as their spouse under the single policy. This keeps the insured individuals at ease.
• Generally, there is an option of co-payment under senior citizen health insurance policies. If you opt for co-payment, then you can enjoy paying lesser health insurance premium.

Health insurance is designed in a way that offers several benefits to the insured senior citizen. Some of them include:

• Pre-Medical Screening: Under most health insurance policies, it is not mandatory to undergo pre-medical screening.
• Cover for Domiciliary Treatment Expenses: Most senior citizen health insurance plans offer coverage for domiciliary treatment expenses. This is when the treatment is taken at home which otherwise would have required hospitalisation.
• Choice of Second Opinion: Typically, people look for a second opinion in case of an illness. Senior citizen health insurance policies offer a second opinion (usually one) in a year.
• No Claim Bonus: No Claim Bonus is an amount that the insured gets as a reward for not making a claim during a year. In most senior citizen health insurance plans, you can avail No Claim Bonus ranging between 20%-100%.
• Cover for Hospitalisation Expenses: Senior citizen health insurance plans not only cover you for in-patient hospitalisation expenses, but also for pre-hospitalisation and post-hospitalisation expenses for a specific number of days. This may vary from plan to plan.
• Tax Benefits: Premiums paid for senior citizen health insurance policies are eligible for tax benefits under Section 80D of the Income Tax Act, 1961.

It is important to have a health insurance plan for senior citizens as health-related issues are unforeseen. The huge hospitalisation expenses can prove to be financially and emotionally distressing for them as well as their loved ones. Here are some of the reasons why it is important for a senior citizen to purchase a health insurance plan:

• Meeting the Increasing Healthcare Expenses: A suitable health insurance is necessary to meet the hospitalisation expenses of senior citizens. Due to the ever-increasing healthcare expenses, owing to medical inflation, purchasing a senior citizen Mediclaim plan becomes vital for elderly individuals in order to assist them in availing the top healthcare facilities.
• Facility for Medical Check-Up: Medical Check-ups can be availed by senior citizens on a yearly basis, as they require to go through medical screening frequently. Henceforth, yearly health check-up facilities can help in minimizing the cost incurred on the same.
• Critical Illness Insurance: With the increase in age, the chances of getting diagnosed with a critical illness such as kidney problems, cancer, heart ailments, etc gets higher. To protect yourself against the expensive treatment cost, you should consider buying a senior citizen health insurance policy as you can easily avail of critical illness add-on cover for individuals aged 60 years and above.
• Peace of Mind: Meeting the expensive hospitalisation cost can cause a strain on the pockets of the senior citizens, especially with the increase in treatment expenses for both major as well as minor diseases. Therefore, getting yourself insured under a senior citizen health insurance policy can give you the much-needed peace of mind in the situation of emergency.

The number of members covered under a senior citizen health insurance plan varies as per the type of the plan as well as from health insurance company to company.

Some health insurers may offer cover to Self and Spouse on an individual basis, whereas some may also include other family members (Self, Spouse, Father, Mother) on a family floater basis. The premium in the latter is based on the age of the eldest member of the family.

Although, a majority of health-related diseases are covered under the health plan yet at certain times senior citizen health insurance cover gets denied. Some of the common exclusions are mentioned below:

• Cosmetic surgery: Senior citizen health insurance plans do not cover you for treatments related to cosmetic surgery required for the enhancement of looks. But in case cosmetic surgery is required due to an accident, then the insurance company might cover you for the same.
• Self-inflicted injuries: Injuries caused due to an act of self-harm or due to an attempt of suicide are not covered under health insurance plans.
• Participation in adventure sports: Health insurance plans for senior citizens do not cover them for any injury caused or treatment required due to participation in adventure sports such as paragliding, etc.
• Intoxication: Health insurance plans for senior citizens do not cover them for illnesses caused due to intoxicating substances such as alcohol, smoking, tobacco chewing, etc.
• Weight-control treatments: Senior citizen health insurance plans do not cover you for weight control treatments including surgical procedures like bariatric surgery, treatment of obesity, etc.

With a pool of senior citizen health insurance plans in the market, it can be tedious to shortlist the best one for yourself or your parents. To simplify the process, you can consider the following points before purchasing a senior citizen health insurance plan:

1. Entry Age

While shortlisting a senior citizen plan, go for the one that allows the maximum ages above 60 years.

2. Renewal Age

Check the maximum age until which the plan can be renewed. Choose a plan with maximum renewal age.

3. Coverage

Coverage is the essence of the plan. Do check if the plan covers all your requirements such as cover for pre-existing diseases, OPD treatment, critical illness cover.

4. Sum Insured Options

Public insurance companies offer a higher range of sum insured options. A plan with a higher sum insured is preferred as it offers greater coverage.

5. Premium

The premium of the plan is also one of the features to consider while buying a senior citizen's health insurance plan. Make sure the plan is worth the premium.

6. Network Hospitals

Choose a plan with the maximum number of network hospitals, preferably in your locality.

7. Co-Payment Clause

Co-payment is a clause that requires the insured to pay a share of the claim amount from their own pocket. When choosing a senior citizen health insurance policy, you must take care of two things related to this clause, these include checking if the insurance policy comes with a co-payment clause or not, and second if there is any waiting period linked to the co-payment clause under the policy. Note that if the waiting period is less, the part of co-payment will rise, and vice versa. Usually, the percentage of co-payment ranges between 10% and 30% under senior citizen health insurance plans.

It can be a daunting task to choose the best health insurance policy for senior citizens, from a pool of senior citizen health insurance plans in the market. It would be easier for you if you keep the following things in mind when choosing one:

• Know the medical history: You must be aware of the medical history of your parents or senior citizens for whom you wish to get the policy. Sometimes, even they might not be aware of health conditions they may be suffering from, and hence, only relying on their knowledge of medical history may not be a good idea. So, before providing any such information to the insurance company, you must cross-check the same.
• Compare and choose a plan: There are several existing and new senior citizen health insurance plans in India that you must compare before shortlisting anyone. When comparing different senior citizen health insurance plans, you must consider several factors such as inclusions, exclusions, riders/add-ons, premium, etc.
• Fill proposal form: When selecting a senior citizen health insurance policy, you must fill in the accurate and relevant information. Any misinformation could lead to rejection of your application form and may even cause trouble in case of a claim in the future.
• Do a medical check-up: You will be required to undergo a medical check-up after submitting the proposal form. The doctors would verify the information related to the policyholder’s health conditions. On the basis of that, the doctor will conduct some medical tests. Some of these tests may include sugar, urine routine, sonography, and liver and kidney function.

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.

A health insurance plan for senior citizens will cover expenses incurred by a person for his/her medical treatment who is aged 60 years and above. This type of health insurance policy provides cashless hospitalization for the elderly at any of the network garages and also offers preventive health check-up facilities for the elder people. This health insurance policy can be very useful at times of medical emergencies.

A health insurance policy is essential for everybody nowadays because of rising health issues and it’s expensive treatment. A senior citizen's health can be purchased by people who are 60 years and above because this type of health insurance policy helps in dealing with expenses for a medical treatment of a pre-existing disease, critical illness, pre/post hospitalization, coronavirus treatment etc. Anybody between the ages of 60 years or above can purchase a senior citizen health insurance policy. This policy can be purchased for parents, business men/women, elederly family members, retired teachers etc. by their children.

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.

Elderly people require more medical attention due their increasing age and a senior citizen health insurance policy can provide good coverage to an elderly person. A senior citizen health insurance policy covers expenses incurred by a person for his/her medical treatment who is aged 60 years and above. Your parent’s sudden hospitalization for treatment can be overwhelming; financially and emotionally. Senior citizen health insurance policy can help you manage finances for expenses of the hospitalization.

Below mentioned are some other reasons that justify the need to have a senior citizen health insurance policy:

1. Peace of Mind: Health care treatments can be very expensive and can exhaust a person’s savings. With rising health issues the cost of their treatment has also risen, especially if the treatment is for a critical illness. A senior citizen's health insurance can help in providing peace of mind to the senior citizen under such a situation because such a type of health insurance policy provides coverage for expenses incurred by a person for his/her medical treatment who is aged 60 years and above.

2. Critical Illness Cover: As the age increases the possibility of being diagnosed with a critical illness also increases. A critical illness can be cancer of any stage, heart ailments, kidney failure, stroke etc. With help of a senior citizen health insurance company one can avail coverage for the diagnosed critical illness.
Health Check-up Facility: Under senior citizen health insurance policy annual preventive health check-up facility is provided. One can avail free health check-ups on a yearly basis under a senior citizen health insurance policy.

3. Health Care Expenses: With rising health issues the cost of their treatment has also risen and having a senior citizen health insurance policy can be very beneficial as under this policy a senior citizen can avail cashless hospitalization for treatment. This health insurance policy provides coverage for expenses incurred for the medical treatment of a person who is aged 60 years or above.

Under senior citizen health insurance policy, the policyholder can file a claim in case of sudden hospitalization or emergency medical treatment. The policyholder can register a cashless claim for treatment at a network hospital or for reimbursement of treatment expenses incurred by the policyholder for treatment at a non-network hospital. Below mentioned are the steps file a reimbursement or cashless claim under a senior citizen health insurance policy:

Senior Citizen Health Insurance Cashless Claim Procedure

Below mentioned are the steps that you can follow to file a cashless claim for medical treatment taken at a network hospital, under a senior citizen health insurance policy:

Step 1: Hospitalization at a network hospital of the insurance company.

Step 2: Duly fill and acknowledge the pre-authorisation form which will be available at the network hospital and submit the form.

Step 3: The hospital authorities will send the pre-authorisation request to the Third Party Administrator (TPA) which will be approved by the insurance company or claims team to initiate the cashless hospitalization of the insured senior citizen.

Step 4: Insured senior citizen will receive treatment and the treatment expenses shall directly be settled by the insurance company.

Senior Citizen Health Insurance Reimbursement Claim Procedure

Below mentioned steps can be followed to file a reimbursement claim under a senior citizen health insurance policy:

Step 1: Notify the insurance company immediately in case the insured senior citizen is hospitalized for immediate medical treatment.

Step 2: Collect all the medical records and bills at the time of discharge of the insured senior citizen.

Step 3: Duly fill and sign the claim form. Submit the claim form along with all the supporting documents such as prescriptions, chemist bills, medical reports, hospital admission and discharge certificate etc. to the third party administrator (TPA).

Step 4: Claim will be evaluated by the insurance company and the reimbursement shall be provided to the policyholder.

One major benefit of having a senior citizen health insurance policy is that premiums paid for it qualify for tax exemptions under Section 80D of the Income Tax Act, 1961. Premiums paid towards a senior citizen health insurance policy qualify for tax exemptions for upto Rs. 50,000.

Under senior citizen health insurance policy one can avail tax rebate of Rs. 5,000 for expenses made for the annual preventive health check-ups of the insured senior citizen in addition to the tax benefits available under this policy, under the Section 80D of the Income Tax Act, 1961. On top of that a tax rebate of Rs. 1 Lakh is provided under this health insurance policy in case the senior citizen requires treatment for a critical illness.

A senior citizen who is still earning and paying health insurance premium, can avail income tax benefits for upto Rs. 25,000 under Section 80D of the Income Tax Act, 1961.

There are certain aspects that shall be kept in mind to determine if the health insurance policy is correct for you or not. If you are a senior citizen or you are looking for a health insurance plan for your parents or elderly family member then you should consider the below mentioned aspects while purchasing one:

1. Renewability: It is always a good idea to purchase a senior citizen health insurance policy that offers a lifetime renewability option so that you don’t have to purchase a new health insurance policy all over again. A policy that does not provide the option to renew after 60 years, will not be an ideal option.

2. Coverage: Elder people are most likely to have pre-existing medical conditions. While purchasing a health insurance policy for senior citizens, always choose a health insurance plan that has a short waiting period for pre-existing medical conditions and provides comprehensive coverage.

3. Network Hospitals: Every health insurance company in India has a wide network of hospitals where one can avail cashless hospitalization. Before purchasing a health insurance policy, go through the list of network hospitals under the insurance company to know if any good hospitals in your locality fall under the list of network garages.

4. Sum Assured: While purchasing a senior citizen health insurance policy prefer a plan that has an option to choose a high sum assured. A health insurance policy with high sum assured can be very useful at the time of medical emergencies.

While purchasing a senior citizen health insurance policy, it is important to first recognize the insurance requirements of an individual, take his/her pre-existing and current medical condition into account, compare several health insurance policies and lastly, carefully read the policy documents carefully to ensure the policy suits your requirements perfectly.

It is very important to explore and compare several senior citizen health insurance plans that fit in your budget to determine which plan is best suitable according to your coverage requirements. There are some things that you should keep in mind while comparing senior citizen health insurance plans:

1. Claim settlement ratio: While purchasing a senior citizen health insurance policy one should always consider the claim settlement ratio of the health insurance company. If you choose a health insurance company that offers less claim settlement time and has a high claim means that the insurance company is reliable and will settle without any hassles.

2. Coverage for Day Care Treatments: Nowadays a lot of treatments and surgeries can be done via day care procedure with the help of advanced medical technology. Under a regular health insurance requires an individual to be hospitalized for at a minimum 24 hours to be able to raise a claim for the same but under senior citizen health insurance an individual can avail coverage for day care procedures such as eye surgery, dialysis, radiotherapy, chemotherapy, piles etc.

3. Co-Payment Clause: Most senior citizens health insurance plans come with a co-payment clause under which a part of the claim amount has to be paid by the policyholder. While purchasing a senior citizen’s health insurance plan look for a plan that has less to no co-payment clause.

4. Domiciliary Hospitalization: While purchasing a senior citizen health insurance policy, look for a plan that covers domiciliary expenses/hospitalization as sometimes the situation or condition of the senior citizen may not allow them to be hospitalized. Domiciliary hospitalization is a situation under which an individual receives hospital like treatment for an illness at home.

Below mentioned are some reasons why you should purchase a senior citizen health insurance plan from InsuranceDekho:

1. Availability of Best Plans: At InsuranceDekho you will be able to find health insurance policies offered by some of the leading health insurance companies in India. You can easily compare several health insurance plans that fit your requirements and budget on one platform. We have partnered with some of the top health insurance companies in India to offer the best plans to our customers.

2. Quick and Easy Policy Issuance: At InsuranceDekho you can purchase a senior citizen health insurance policy in a matter of a few minutes. The entire purchasing process is digital, no paperwork is required, you can easily upload the documents online and purchase a health insurance policy within 5 minutes.

3. Robust Customer Care Team: Our customer care team is available 7 days of the week and are well equipped with knowledge to help you in the best way possible. Our customer care team strives to provide the effective solutions and best information to help you make an informed decision.

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.