What is Senior Citizen Health Insurance?
Old age brings with it deteriorating health, physical challenges and financial limitations. Hence it is essential to have adequate health insurance to take care of medical expenses in the ‘golden years’. Senior citizen health insurance plans offer a much-needed solution to our senior citizens or people aged 60 years or more. A health insurance cover to those over 65 years of age, these plans have come as a boon to a large percentage of India’s seniors.
Why is Senior Citizen Health Insurance necessary in India?
With advancements in medical sciences, the average life expectancy in India has increased to over 70 years. But the retirement age has remained constant. Hence, as one gets older, there is less and less money available to take care of regular expenses. On top of it, medical costs are rising. So, if one falls ill, the family budget goes for a toss. If one has medical insurance for senior citizens, these expenses are taken care of.
Most insurance companies offer regular health insurance plans where parents can be covered. But these plans allow a maximum entry age of 65 years. However, health insurance for seniors allows entry age till almost 80 years. These plans offer special benefits and have exclusive features targeted solely at senior citizens. In India, there is a large population of senior citizens who are either not covered by any health insurance policy or are inadequately covered. Senior citizen health insurance is an answer to all these issues.
Click the link below, enter a few details & sail away with the most appropriate senior citizen health insurance policy.
Features of senior citizen health insurance plans
Senior citizen plans offer a wide variety of features apart from just reducing your physical and financial stress. Some of the features are-
- The senior citizen health insurance plans offer higher coverage amounts that would be adequate for the golden years of your/ their lives.
- Most senior citizen health insurance plans come with renewability benefits, which means the plans can be renewed as many times as you want, provided the premiums are paid on time.
- The coverage benefits under senior citizen plans are wide. These include an emergency ambulance, cover for a specific illness, etc.
- The plans cover pre-existing diseases after a certain waiting period and this may differ from company to company.
- You can opt for cashless treatment or even a reimbursement facility as per your choice, under the senior citizen insurance policy.
- Some plans cover the senior citizen as well as their spouse under the same plan. It keeps the insured seniors at ease.
- Many plans offer a co-payment option that allows you to pay a lesser health insurance premium to enjoy the same benefits.
Exclusions In Senior Citizen’s Health Insurance
Some common exclusions in medical insurance for senior citizens are:
- Any claim arising within 30 days of purchase of senior citizen health insurance plans unless they occur due to injury or accident.
- Joint replacements are covered only after a specified time period.
- Some policies cover pre-existing conditions such as diabetes, asthma, but only when the policy has been in force continuously for a specified period.
- Cosmetic surgery/dental treatments except in case of accidents, burns or cancer.
- Drug addiction/AIDS/HIV/Sexually transmitted diseases/self-injury/suicide attempt.
How many members can be covered under the ‘Senior Citizen Insurance Plan’?
Under the senior citizen insurance plan, the total number of people insured varies from policy to policy and depends on the company too. Some plans offer cover to individual or Self and spouse while many plans are there that covers other members of the family like father, mother, self, spouse, etc, depending on family floater basis. For family floater plans, the premium is decided depending on the eldest member’s age.
Why is it important to purchase health insurance for senior citizens?
It is necessary to invest in a health insurance plan for senior citizens because health-related issues come unforeseen and they become distressing both financially and mentally. A few reasons why you should purchase health insurance for senior citizens are-
- Rising Medical Expense
The healthcare expense is ever-increasing owing to inflation. To provide good healthcare facilities and hospitalization, investing in a senior citizen insurance policy is important.
- Critical Illness Insurance
With increasing age, it is very likely to get diagnosed with a critical illness like cancer, heart ailments, kidney problems, etc. To meet the high expenses of treatment, investing in critical illness insurance would be wise. You can invest in an add-on anytime, available for 60 year-olds and above.
- Regular Health Check-ups
Senior citizens can avail routine medical checkups every year as it is required to go through a medical screening frequently. This helps in minimizing the cost incurred on a routine check-up facility.
- Peace Of MindThe ever-increasing medical expense can put a strain both on your pocket and health. To avoid that, you should invest in a plan. It will both your major as well as minor ailments while helping you in emergencies.
Senior Citizen Health Insurance Policies offered by various companies
|Health Insurance Company||Senior Citizen Health Insurance Plan Name||Coverage||Sum Insured Range (in Rs)||Entry age range (years)||Waiting Period|
|HDFC Ergo Health||Optima Senior||Domiciliary, day care, hospitalisation, pre and post hospitalisation, ambulance, donor expenses,||61 and above||5 Lakh||30 days for all, 3 years for pre-existing, 2 years for certain ailments|
|Bajaj Allianz||Silver Health||Domiciliary, day care, hospitalisation, pre and post hospitalisation, ambulance, health check-ups||46-70||50,000 – 5 Lakh||30 days for all, 1 year for pre-existing and certain other ailments, 4 years for joint replacement|
|Care||Freedom||Domiciliary, day care, hospitalisation, pre and post hospitalisation, ambulance, health check-ups, companion benefit, dialysis||46 and above||3 – 10 Lakh||30 days for all, 2 years for pre-existing and certain other ailments|
|Star Health||Senior Citizens Red Carpet||Hospitalisation, pre and post hospitalisation, ambulance, specific day care,||60-75||1 – 10 Lakh||30 days for all, 1 year for pre-existing, 2 years for certain other ailments, 4 years for joint replacement|
|Tata AIG||Medisenior||Domiciliary, day care, hospitalisation, pre and post hospitalisation, ambulance, health check-ups, organ donor||61 and above||2 – 5 Lakh||30 days for all, 2 years for certain other ailments, 4 years for pre-existing|
|New India Assurance||Senior citizen Mediclaim||Domiciliary, day care, hospitalisation, pre and post hospitalisation, ambulance, AYUSH, health check-ups, organ donor||60-80||1 – 1.5 Lakh||30 days for all, 1.5/4 years for certain other ailments, 4 years for pre-existing|
|Oriental Insurance||HOPE||Hospitalisation, pre and post hospitalisation, ambulance, domiciliary, day care, health check-ups||60 and above||1 – 5 Lakh||30 days for all, 2 years for pre-existing and certain other ailments|
|National insurance||Varishtha Mediclaim||Hospitalisation, pre and post hospitalisation, ambulance, domiciliary, day care, health check-ups, organ donor||60-80||1 – 2 Lakh||30 days for all, 1 year for pre-existing and certain ailments|
The above-mentioned are the best senior citizen health insurance policies. You can pick any policy based on your coverage needs from the list of plans offered. The features and benefits of these health insurance plans for senior citizens are as follows –
HDFC Ergo Health Optima Senior
This is a senior citizen mediclaim policy which is offered on an individual basis. The plan has the following salient features –
- The plan allows free e-opinion in case you suffer from a critical illness during the policy tenure
- There is no limit on the maximum entry age. Individuals aged 61 years and above can buy this policy
- There is a discount of 5% in the renewal premium if you do not make any claims in a policy year
- There is no premium loading depending on your claim experience
- Up to 140 day care procedures are covered under the policy
- Co-payment of 15% or 30% would apply on each claim depending on the medical costs incurred and the nature of the claim
- If you buy a two year policy you can earn a premium discount of 7.5%
- There is another premium discount of 5% if you cover your spouse under the policy too on an individual sum insured basis
Bajaj Allianz Silver Health
Bajaj Allianz’s Silver Health is also a senior citizen mediclaim policy which is offered on an individual sum insured basis. The plan comes with a term of one year and can be renewed lifelong. Here are the salient features of the plan –
- The company allows in-house claim settlements which help you get a speedy settlement of your health insurance claims
- You can choose to cover your spouse too under an individual sum insured basis
- Pre and post hospitalisation expenses are covered for up to 3% of the sum insured
- Pre-existing illnesses are covered from the second policy year itself
- 130 day care treatments are covered under the plan
- The sum insured increases by 10% every year if no claim is made. This increase is allowed on a cumulative basis up to a maximum increase of 50% of the sum insured
- Free health check-ups are allowed after 4 claim free policy years
- You can avail a premium discount of 5% if two or more family members are covered under the policy
This senior citizen mediclaim policy is offered without the need of any pre-entrance health check-ups and covers individuals aged 46 years and above. Some of the notable features of the policy are as follows –
- Free annual health check-ups are allowed under the plan so that you can keep a track of your health regularly
- The plan covers more than 170 day care procedures up to the limit of the sum insured
- If your hospitalisation exceeds 10 days, a lump sum amount of INR 10, 000 or INR 15, 000 is paid depending on the plan variant selected
- In case of hospitalisation for 24 hours or more, you get a daily consumable allowance for meeting the ancillary costs of hospitalisation
- Coverage for dialysis is also allowed for INR 1000 per sitting
- Sum insured restoration feature is available under the plan which restores the sum insured if it is exhausted in a policy year on previous claims
- You can choose a coverage tenure of up to 3 years and enjoy a premium discount
- A range of add-ons are also allowed which can be added to the base policy for enhanced coverage.
Star Health Senior Citizens Red Carpet
Star Health offers some of the best health insurance plans in the market. Red Carpet is a plan for older individuals which has the following benefits –
- Coverage can be availed till 75 years of age
- No pre-entrance health check-ups are needed to buy the policy
- Pre-existing illnesses are covered after a short waiting period of 12 months only
- You can choose to avail the policy on an individual basis or on a family floater basis
- Coverage is allowed for medical consultations incurred on an OPD basis if availed in a network hospital
- The premium rate is constant throughout the policy tenure and does not change with a claim
- Though medical check-ups are not required under the plan, if you submit favourable medical reports you can claim a discount of 10%
- The company has in-house claim settlements without any TPAs which allow faster claim settlements
TATA AIG Medisenior
This is a senior citizen mediclaim policy which can be taken either on an individual sum insured basis or on a family floater basis. The features of the plan are as follows –
- 140 day care treatments are covered under the plan which do not require hospitalisation for 24 hours
- If you incur treatments at home, such treatments are also covered subject to certain terms and conditions
- Medical expenses incurred on organ transplant surgeries where an organ is harvested from a donor are covered under the policy
- You can opt for a two year policy tenure and enjoy a premium discount of 7.5% on the aggregate premium amount
- If you do not make claims during a policy year, you get a premium discount of 5% in the renewal premium
- If two or more family members are covered under the plan, a family discount of 5% would be allowed on the premium payable
- Co-payment would be applicable on all claims depending on the type of expenses that you incur
New India Assurance Senior Citizen Mediclaim
New India is a public sector general insurance company which offers different insurance solutions for your needs. Its senior citizen mediclaim policy has the following set of benefits available for policyholders –
- Pre and post hospitalisation expenses are covered for 30 and 60 days up to a maximum of 5% and 10% of the hospital bills respectively
- Coverage for alternative treatments like Ayurveda, Unani, Siddha and Homeopathy is available under the plan for up to 25% of the sum insured
- Organ donor treatments are covered by the policy and the expenses incurred on harvesting the organ from a donor would be covered
- If you include your spouse under the coverage of the policy, you can enjoy a premium discount of 10%
- If you choose a voluntary excess of INR 10, 000 and choose to pay INR 10, 000 of the claim amount yourself, you can earn a premium discount of 10%
Oriental Insurance HOPE
Oriental Insurance offers Health of Privileged Elders (HOPE) as a senior citizen mediclaim policy meant for covering individuals aged 60 years and above. The policy does not have a maximum entry age and the following salient features –
- If you choose a voluntary co-payment, you can enjoy a premium discount. This discount can go up to 50% of the premium depending on the percentage of the voluntary co-payment opted for
- The policy covers specific medical costs some of which include accidental injuries, knee replacement surgeries, cancer, stroke, ophthalmic diseases, etc.
- Inpatient hospitalisation costs are also reimbursed by the company
- Coverage is available for domiciliary hospitalisation if certain terms and conditions are fulfilled
- Pre and post hospitalisation expenses are covered for a period of 30 and 60 days respectively
- There is a waiting period of 48 months for the coverage of pre-existing illnesses
- You get a cumulative discount of 5% in the renewal premium after every claim-free year. The maximum discount that you can claim is up to 20% of the premium
National Insurance Varishtha Mediclaim
National Insurance is a leading public sector insurer which is trusted by many. Its senior citizen mediclaim policy, Varishtha Mediclaim allows the following benefits to senior citizens –
- More than 140 day care treatments are covered under the plan where you do not need hospitalisation for 24 hours
- Hospitalisation and domiciliary hospitalisation expenses are covered for up to INR 1 lakh
- If you don’t make claims under the policy, you get a no claim bonus of 5% increase in the sum insured. This increase is allowed on a cumulative basis up to a maximum increase of 50% of the sum insured
- Free health check-ups are allowed once after three claim-free years. You can get check-ups worth 2% of the sum insured
- Optional critical illness benefit is allowed under the plan for a sum insured of INR 2 lakhs. This benefit covers 8 critical illnesses and pays the sum insured in lump sum if you are diagnosed with any covered illness
Premium paid for senior citizen health insurance is eligible for benefits under section 80D of Income Tax, up to a maximum of Rs 30,000 per year. There is also an additional rebate of Rs 5,000 for preventive health check-up each year.
Also, know everything about critical illness insurance
Benefits of senior citizen health insurance plans
- Annual health check-ups, free-look period, easy renewal and reload options are included.
- Pre-existing diseases are covered after shorter waiting periods.
- These plans are renewable throughout lifetime.
- Most plans allow a high entry age of around 80 years.
What is covered under a senior citizen health insurance plan?
Some of the coverage offered under the senior citizen health insurance plan is as follows
- Hospitalisation Expense
The insurance offers all the hospitalization expenses to the policyholder like doctor’s fee, room rent, nursing fee, etc.
- Daycare TreatmentSome illnesses require less than 24-hour hospitalization like Dialysis, Chemotherapy, etc. Most of the senior citizen plans offer coverage for daycare treatment.
- Pre and Post Hospitalisation Expense
This expense includes the expenses of before and after hospitalization at least for 24 hours. The period may vary from company to company. Some offer 30 days, 60 days while few companies provide the facility for 90 days and even 180 days. These costs include ambulance charges, doctor consultation, etc.
- Organ Donor Expense
Most of the senior citizen plans offers coverage for organ donor expense.
- AYUSH Treatment Expense
If you opt for treatment under AYUSH Health Insurance of medicine from any government recognized hospital or centre, the senior citizen plan also includes that.
- Other Healthcare Expenses
Other healthcare expenses of the senior citizens include a pacemaker, orthopaedic implants, chemotherapy, dialysis, and more. It also covers the cost of a blood test, x-rays, etc., based on the type of policy purchased. However, coverage may depend from policy to policy and such treatments may come with a waiting period.
- COVID-19 Expense
If you suffer from covid-19, you are entitled to a geta compensation for the expenses but up to a certain limit.
- Pre-existing Illness
Coverage to any pre-existing illness depends on the terms and conditions of the insurance. Most companies provide so after a waiting period.
What is not covered under senior citizen health insurance plan?
Although most of the major health-related diseases are covered by the senior citizen policies, there are certain exceptions as well. Some of them are listed below.
- Cosmetic Surgery
The senior citizen insurance plan does not offer coverages for cosmetic surgery to enhance your looks, but in case of an accident, it would be an exception.
- Self-inflicted injuries
Injuries incurred due to self-harm or in the attempt of suicide, won’t be covered under the policy,
- Participation in Adventure Sports
The health insurance for senior citizens does not cover any injury caused due to participating in adventure sports such as skydiving, paragliding, etc.
The insurance does not cover illness caused due to any intoxicating substance like tobacco, alcohol, etc.
Weight-control Treatments- Treatments like bariatric surgery, treatment of obesity, etc are not covered under the policy of weight-control treatments.
Choosing the best senior citizen health insurance plan
There are many plans of medical insurance for senior citizens in the market. So how do you choose the best senior citizen health insurance plan? Here are a few checkpoints to make it easy for you.
- Understand the lifestyle and medical history of the seniors to decide the type of cover needed.
- Consider the covers offered for various diseases and ailments, sub limits, requirements of medical tests, if any.
- Check the waiting period for pre-existing conditions.
- Check the allowable entry age
- Location and network of hospitals – Good hospitals closer home will make it easier.
- Premium and Sum insured.
- Co-payment – Insurers stipulate co-payment for senior citizen health plans, where the insured person pays a share (normally 10%-20%) of the claim amount. Lower co-payment is better.
Compare all available plans of medical insurance for senior citizens for these criteria before deciding. Or just come to Turtlemint. We make it quick, easy and convenient for you.
Lastly, read the fine print. Make use of the free look period. And clarify all doubts, no matter how small.
Things to keep in mind before buying health insurance for your parents if they are 60+
If you are buying a health insurance plan for senior citizens aged more than 60 years, you should consider certain factors. You should ensure that the sum insured under the plan is optimal to cover the expensive medical treatments which might incur in a medical emergency. Moreover, ensure coverage for both your parents as either one of them can need medical assistance due to failing health. The pre-existing waiting period of plans should be checked and if your parents have any pre-existing condition choose a plan which has the lowest waiting period so that they can enjoy coverage sooner. Lastly, ensure that the premiums are affordable so that your parents can enjoy lifelong coverage without worrying about the expensive premium payments.
For more tips when buying health insurance plans for senior citizens, refer to this link
How to claim health insurance for senior citizens?
There is a claim process which you need to follow if you suffer a claim in health insurance plans for senior citizens. This process is as follows –
- Inform the insurance company immediately of the claim that you incur
- If you are seeking treatments in a networked hospital, you can avail cashless claim settlements. In such cases, you have to fill and submit the pre-authorization claim form.
- The pre-authorization claim form should be submitted at least 3-4 days before a planned hospitalisation or within 24 hours of an emergency one.
- Based on the pre-authorization form, the cashless claim is approved
- Avail cashless treatments and the insurance company would settle your medical bills with the hospital
- After discharge, fill up a claim form and submit it with all your original medical documents to complete the claim settlement process
- In case you seek treatments at a non-networked hospital, you would have to pay the medical bills yourself. Once you are discharged, submit the claim form and the bills to the insurance company and the company would reimburse the medical expenses which you have incurred.
Will Coronavirus health insurance be provided for senior citizens?
Health insurance plans for senior citizens do cover COVID related hospitalisations if the insured suffers from COVID. The costs incurred on an inpatient basis would be covered by the plan. However, the cost of consumables would not be covered which would be considerable in COVID cases. These costs include costs incurred on PPE kits, face masks, gloves, sanitizers, etc. Moreover, if you are suffering from COVID and you buy a health insurance plan for senior citizens, the illness would be considered a pre-existing condition and would not be covered during the pre-existing waiting period. So, you can opt for alternative COVID specific health insurance plans too to avail complete coverage against COVID related hospitalisations.
For more information on COVID health insurance plans, you can refer to this link (interlinking with COVID health insurance article)
How to buy a senior Citizen insurance plan online at Turtlemint?
Follow the steps to buying a senior citizen insurance plan online at Turtlemint:
- Visit ‘Turtlemint’ and click on the ‘Health’ tab from the menu. Then click on the option of ‘Buy a New Policy’ and specify your gender
- Next, choose who would you like to get insured under the plan (Self/ Husband/ Mother/ Father/ Daughter) and click next. Select age and also if you’re planning to have a child.
- Next select Yes/No to mention if any of the members suffer from any disease.
- Enter your Pincode, preferred hospital nearby, and the income bracket.
- To save your quote, provide your name, email address, and phone number, and click Next. A range of policies would pop up on your screen. Select the most suitable one for your budget and choose the policy term.
- Review every information and then pay the premium for the policy via a secured payment gateway. The policy papers would be mailed to your mail address within a few minutes.
Rules and regulations of IRDAI on government senior citizens health insurance plans
The Insurance Regulatory and Development Authority (IRDAI) is responsible for regulating and monitoring the provisions of government health insurance plans. It ensures the welfare of the senior citizen by regulating the benefits and features offered under the policies.
- Maximum premium payments were implemented strictly by the insurers in the years 2006 and 2007 when the premiums were increased.
- A Senior Citizen Health Insurance Committee was formed to look after the requirements and make recommendations. Some of the recommendations were implemented effectively.
- The insurance regulatory authority made it mandatory to offer renewal of senior citizen policies except for grounds of forgery, moral hazard, or misinterpretation of information.
Following features were mandated under the government-backed senior citizen health insurance policies:
- At least 50% of the expense would be reimbursed that would arise from pre-medical examination, provided you are ready to take the risk.
- You can opt for any other Third Party Administrator(TPA) of your choice.
- The health insurance plans can be renewed up to 65 years of age.
- If any plan is rejected, that should be given in writing along with the reason.
Senior citizen health insurance plan turns out to be fruitful for your golden years of life when you relax and maybe the income won’t be that high.
Why Choose Turtlemint?
In the twilight years of life, it is extremely important to opt for a health insurance plan that will take care of all your medical needs. Turtlemint helps you do this quickly, simply and conveniently.
- Compare all plans from the top insurance companies in India with one click and find the best senior citizen health insurance plan in India. Check all details and calculate the premium to take an informed decision.
- Contact our experts to resolve all your queries through online chat or telephonic discussions
- Get 24/7 claims assistance
- Once you have finalised on a policy, you can download all relevant documents, buy the policy and renew it, all at one place!
Know how to renew your health insurance policy online
You can buy senior citizen’s health insurance online or offline. For offline purchases, you can go to a bank or an insurance company’s branch office near you. For online, you can either directly go to the company’s website or go to an insurance aggregator’s website (like Turtlemint), compare the different available products and make the best choice.
Senior Citizen’s Health Insurance policy can be renewed either online and offline. Online is faster and easier.
You need to be above 60 years of age to buy Senior Citizen’s plan.
The maximum age for renewal varies with the insurance companies. It varies between 69-90 for most companies. A few companies have no upper age limit.
You are eligible for a tax exemption of up to Rs 30,000 under section 80D of Income Tax Act. You can also avail additional exemption of Rs 5000 for annual health check-ups.
Insurance companies tie up with hospitals to provide cashless hospitalization to people who have bought policies from them. These hospitals are called network hospitals.
Pre-existing diseases are the chronic diseases that you have before buying a health insurance policy.
As per Insurance Regulatory and Development Authority of India (IRDAI), people over 60 can purchase a new senior citizen’s health insurance policy. If any company rejects a proposal, it has to give the reason in writing. Renewal proposals also cannot be rejected without a valid reason. Half of the medical investigation costs before buying a policy also has to be paid by the insurance company.
Once you buy a policy, there is a certain period before which you can’t make any claims. This is called the waiting period. However, in case of accidents you can make a claim within the waiting period.
The free-look period is the period immediately after buying a health insurance policy. During this time, you can return the policy and get a refund. Generally, this is around 15 days for most companies.
Most insurers insist on a co-payment for senior citizen’s health insurance policies. This is a percentage of the total treatment cost and the policy holder has to pay this amount.
There are a range of health insurance plans for senior citizens. You can choose the best policy by comparing the available plans on their coverage benefits and premium rates. The best medical insurance for senior citizens would be a policy which allows a high level of sum insured, comprehensive coverage benefits, low co-payment ratio, low waiting period for pre-existing illnesses, ease of cashless claim settlements and an affordable rate of premium.
Free health insurance check-ups are allowed in almost all health insurance plans. However, the period after which such check-ups are allowed varies. Some companies allow free health check-ups annually while others allow check-ups once after 2-4 policy years. So, check the frequency of free health check-ups allowed by the company when buying the health insurance plan.
Yes, all insurance companies offer cashless hospitalisation provided you seek treatment at a hospital which is networked with the insurance company.
Under a senior citizen mediclaim policy senior citizens can avail coverage specific to their needs. For instance, most health insurance plans for senior citizens provide coverage for cataract, knee replacement surgeries, pre-existing medical illnesses, etc.
Senior citizen health insurance plans are the best health insurance plans for individuals over 65 years of age. Some of the best senior citizen mediclaim policies include Star Health’s Red Carpet Senior Citizen Plan, Oriental Insurance’s HOPE, Care’s Freedom Plan, HDFC Ergo Health’s Optima Senior and National Insurance Varishtha Mediclaim among others.
The average cost of a senior citizen mediclaim policy depends on your age, sum insured chosen, medical conditions of the insured and the insurance company offering the policy. The average premium might start at INR 10, 000 and go up to INR 40, 000 and above depending on the age and the sum insured selected.