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What is Senior Citizen Health Insurance

It is common knowledge that senior citizens, i.e. individuals over the age of 60, are at a higher risk of falling ill. And falling ill, especially when you no longer have an active income, can be financially difficult on a person. This problem hits in addition to their bodies being weaker. Therefore they are increasingly incapable of bearing the burden of illness without immediate treatment.

This is the reason meaningful and comprehensive health plans for senior citizens exist. These plans mainly apply for individuals between 60-75 years of age. And they offer a unique set of benefits, including:

  • Cashless Hospitalisation
  • Covering Pre-existing Conditions
  • No Medical Tests
  • No day-care expenses, i.e. every procedure is covered no matter how short it is

With the IRDA’s new guidelines in place, it is dictated that every single healthcare provider has to offer insurance for people up to 65 years of age. Therefore, opting for citizen health insurance is an option. Not to mention, if you want to switch insurers at a later age, that also becomes possible.

Therefore, the top three reasons citizen health policies are important are:

  • The number of benefits that come with these health policies, as stated above.
  • The fact that there are more options along with better, cheaper care. This makes both medical expenses as well as hospitalisation and treatment costs easier on the citizens.
  • You can beat medical inflation and get insured while the prices are still lower.

At Cover360, we help you choose the ideal health policies for senior citizens that suit the needs perfectly so that you are completely safe and secure in your old age!

Who Can Take Senior Citizen Health Insurance?

Senior citizen health insurance is available to all individuals between the ages of 60-75. It is a must-have since it offers full coverage with multiple benefits. Senior citizens require more comprehensive plans that cater to their needs and ensure their maximum comfort. This is what health plans for senior citizens promise.

So, what are the benefits of these plans?

Cashless Hospitalisation

Not having to worry about paying in the hospital. All you need to do is claim insurance, and your insurer directly transfers the amount for treatment to the hospital.

A lot of health insurance schemes do not cover pre-existing conditions. Senior citizen health policies do because they understand the importance that pre-existing conditions have later in life. They become an increasing burden, and more hospitalisation is required for them. This is why these plans cover them.

A lot of health insurance schemes do not cover pre-existing conditions. Senior citizen health policies do because they understand the importance that pre-existing conditions have later in life. They become an increasing burden, and more hospitalisation is required for them. This is why these plans cover them.

Getting annual medical tests is free under most of these health plans. Similarly, expenses for day-care procedures, i.e. procedures where you are in and out of the hospital on the same day are usually covered. Day-care procedures often include dialysis, cancer treatment etc. – anything that requires an individual to be hospitalised for a day. And these usually cost more, therefore needing coverage.

Getting senior citizen health insurance early gives you an edge since you get it when medical inflation has not hit yet. Additionally, with the new guidelines, health insurance now has to be provided for individuals up to 65 years. Getting insurance early on also ensures lower premiums which makes your life easier.

A primary reason a lot of people opt for insurance is that it is tax-deductible. This means that you can save up to Rs. 75,000 through health plans for senior citizens. This is very desirable and makes insurance a must-have for many people.

At Cover 360, we compare and contrast the benefits of various senior citizen healthcare plans. This allows us to determine the best possible plan for every individual, so they get the best care!

Benefits of Senior Citizen Health Insurance

Senior citizen health policies are a kind of health insurance specifically for the elderly in our society. They are meant to look after them in their old age and ensure they are medically and health-wise comfortable. They deserve the highest standard of care. That's what the full range of health plans for senior citizens give them with the multitude of other benefits they offer.

So, what are the benefits they offer?

  • Covering hospitalisation expenses is the most crucial benefit of this insurance policy. Senior citizen health insurance covers hospitalisation for more than 24 hours with cashless treatment, covering nursing fees, doctor fees, room fees, medicine and drugs cost etc.
  • They cover medical costs, both pre-hospitalisation and post-hospitalisation, by focusing on treating pre-existing conditions in-hospital and out of the hospital. This is under the provision of the days being variable.
  • They cover ambulance charges for transporting the insured patient to the hospital. However, this coverage may be subject to a maximum limit.
  • As stated previously, pre-existing conditions and diseases are covered and, therefore, keep the insured safer and make hospitalisation more accessible.
  • They cover day-care costs arising from more specialised treatments like chemotherapy, dialysis etc.

Therefore, the kind of benefits offered under senior citizen health plans is not negligible. They consider everything and keep the insured’s comfort in focus when determining the best course of action. This makes these policies excellent safety nets that every insurer should consider a necessity.

Our expert team at Cover360 aims to bring you such safety nets that give you coverage and keep you good and healthy for your senior years to come!

Features of Senior Citizen Health Insurance

Senior citizen health insurance is a must-have for every individual over the age of 60. Its extensive benefits ensure that you get the most out of it if you purchase it for your parents or senior citizens purchase it for themselves. Either way, it is the ideal solution for health insurance policies that do not offer several significant benefits.

It also has a lot of features. These include:

  • Availing cashless hospitalisation services if the patient is admitted for over 24 hours. This kind of cover is usually included in all health plans for senior citizens. It includes doctor fees, medical bills, charges of the room etc.
  • Both pre-hospitalisation and post-hospitalisation are covered under this plan based on the number of days.
  • Most plans do not require any pre-medical screening.
  • Anyone over the age of 60 can get health coverage under senior citizen health policies, which makes it universally available.
  • The plans often offer a free lock-in period.
  • Senior citizens have access to annual health check-ups which ensures that they stay ahead of the curve and keep an eye on their health.
  • Most health plans for senior citizens cover pre-existing diseases or medical conditions.

All these features make this insurance plan very attractive. Especially by offering annual health check-ups and other such benefits, the plan truly helps senior citizens keep an eye on their health. This is also accomplished by accounting for pre-existing conditions. Such conditions usually manifest as threats only later in life. Therefore, having healthcare plans that account for it makes the lives of senior citizens much better.

At Cover 360, we identify such plans since our goal is to make your life easier. The elderly deserve all the help we can give them, and it is our privilege to contribute by identifying the best healthcare plans for them!

Top Plans for Senior Citizen Health Insurance

Senior citizen health policies are a kind of health insurance specifically for the elderly in our society. They are meant to look after them in their old age and ensure they are medically and health-wise comfortable. They deserve the highest standard of care, and that's what the plethora of health plans for senior citizens hope to give them with the multitude of benefits they offer.

With some expert comparing and contrasting, we came up with a list of the best senior citizen health insurance policies in India for your consideration:

Bajaj Allianz - Silver Health Senior Citizen Health Plan
  • Age range: 46 – 70 years
  • Sum assured: Rs. 50,000 – 5 lakhs
  • Pre-existing conditions: Coverage begins from the 2nd year of the policy
  • Pre and Post Hospitalisation Expenses: Policy covers up to 3% of admissible hospital expenses
  • Medical Check-Up: The complete list of procedures covered are: Fasting BSL, ECG, Urine R, Liquid Profile, HbA1c, SGPT, CBC, SGOT, CBC, Sr. Creatinine
Star Health – Senior Citizen Red Carpet Health Insurance Plan
  • Age range: 60 – 75 years
  • Sum assured: Rs. 1 – 10 lakhs
  • Pre-existing conditions: Coverage begins from the 2nd year of the policy
  • Pre and Post Hospitalisation Expenses: Only covers post hospitalisation expenses up to Rs. 5000, excluding nursing charges, diagnostic charges, consultation fee, and medicine.
  • Medical Check-Up: No pre-acceptance medical test required
National Insurance – VARISHTHA Mediclaim Policy for Senior Citizens
  • Age range: 60 – 80 years (renewable up to 90)
  • Sum assured: Rs. 1 lakh (Mediclaim); Rs. 2 lakhs (Critical Illness)
  • Pre-existing conditions: Coverage begins after1 claim-free year while the policy
  • Pre and Post Hospitalisation Expenses: 30 days (Mediclaim) and 60 days (Critical Illness) post-hospitalisation covered
  • Medical Check-Up: Not required if the individual has been covered for the last 3 years; Required if this condition is not fulfilled.
New India – Senior Citizen Mediclaim Policy
  • Age range: 60 – 80 years (renewable up to 90)
  • Sum assured: Rs. 1 – 1.5 lakhs
  • Pre-existing conditions: Coverage begins after18 months of the policy
  • Pre and Post Hospitalisation Expenses: Covers 30 days pre-hospitalisation (max: 5% of hospital bill) and 60 days post (max: 10% of hospital bill)
  • Medical Check-Up: Required
United India – Senior Citizen Mediclaim Policy
  • Age range: 61 – 80 years
  • Sum assured: Rs. 1 – 3 lakhs
  • Pre-existing conditions: Covered after 4 years of non-stop renewal
  • Pre and Post Hospitalisation Expenses: Covers 30 days pre-hospitalisation and 60 days post (max: 10% of hospital bill based on which bill is less)
  • Medical Check-Up: Required with 50% reimbursement after proposal acceptance
HDFC ERGO Health Optima Senior (formerly called Apollo Munich Health Optima Senior
  • Age range: 61 and above
  • Sum assured: Rs. 2 – 5 lakhs
  • Pre-existing conditions: Covered after 3 years of non-stop renewal
  • Pre and Post Hospitalisation Expenses: Covers 30 days pre-hospitalisation and 60 days post
  • Medical Check-Up: Required with 50% reimbursement after proposal acceptance
Oriental – Senior Citizen HOPE Health Insurance
  • Age range: 61 and above
  • Sum assured: Rs. 1 – 5 lakhs
  • Pre-existing conditions: Covered after 2 years of non-stop renewal
  • Pre and Post Hospitalisation Expenses: Covers 30 days pre-hospitalisation and 60 days post
  • Medical Check-Up: Requires medical tests from specific diagnostic centres
SBI – Arogya Top Up Policy
  • Age range: 65 and above
  • Sum assured: Rs. 1 – 5 lakhs (without deductibles); Rs. 1 – 10 lakhs (with deductibles)
  • Pre-existing conditions: Covered after 4 years of non-stop renewal
  • Pre and Post Hospitalisation Expenses: Covers 60 days pre-hospitalisation and 90 days post
  • Medical Check-Up: No medical test required up to 55 years of age if there are no pre-existing medical conditions, i.e. no medical history
Tata AIG – MediSenior Health Insurance
  • Age range: 61 and above
  • Sum assured: Rs. 2 – 5 lakhs
  • Pre-existing conditions: Covered after 4 years of non-stop renewal
  • Pre and Post Hospitalisation Expenses: Covers 30 days pre-hospitalisation and 60 days post
  • Medical Check-Up: Required with 50% reimbursement after proposal acceptance

This list is not in order of best – they are all good policies and offer various benefits. However, you may still require a different plan, depending on your needs. And this is why our team at Cover 360 exists! Consider these as an introductory guide to what to look for when buying senior citizen health insurance.

And then, with our help, we can introduce you to the best health plans for senior citizens so you can make a completely informed decision!

Factors to Consider When Comparing Senior Citizen Health Insurance

It can be very confusing to buy the best offer when there is a huge choice of senior citizen health policies out there.

This is why, at Cover 360, we came up with a comprehensive list of factors. These will help you, especially in the decision-making process. These are the broad parameters along which you should compare different healthcare policies:

First and foremost, you need to analyse the kind of coverage you get under your health plan of choice. This means that you also have to do some homework. Take into account the following aspects:

  • Your medical history
  • Your medical requirements
  • Your health concerns
  • If you have a spouse, your spouse’s health concerns
  • Your age
  • Your financial situation

And anything else that could affect the premium you have to pay on your insurance. The idea is to choose a plan with the maximum benefits at the minimum limitations. So, compare and contrast your desired policies based on sub-limits, co-payment clauses, room rent capping etc.

This way, you can account for everything and choose the policy best suited to your needs!

Does the plan you want, come with a lifetime renewal option, or do you stop having a renewal option after a certain age? You need to check these details carefully. Choosing a plan with a lifetime renewal option, especially in senior citizen health insurance, is a better idea. As you grow older, your health issues increase. So have a plan in place.

Most policies also offer a grace period in case the renewal date is missed. This makes the process much easier. Most insurance providers also send their clients reminders about renewal so that the date is not missed. Renewing on time saves a lot of trouble during the claiming process.

As your age increases, the number of pre-existing conditions also increase. Choosing an insurance provider who accounts for pre-existing conditions is, therefore, always a better idea. And you also need to look at the list of conditions they cover. Some insurers require you to take a health check-up and submit the results before applying for insurance. These are all aspects you need to account for when choosing your provider.

Coverage for pre-existing conditions also usually begins later than the start of the policy. This waiting period can be anywhere between 24-48 months! Apply as early as possible and weigh your pros and cons accordingly!

The co-pay clause denotes how much money you pay for your procedures out of your pocket. Most health plans for senior citizens come with a co-pay clause. Therefore, the ideal policy to choose is one with the least percentage of co-pay.

Some senior citizen health policies have periods after the commencement of the policy during which the insured can end the policy without any penalties. This is considered a free-look period. It is usually for 15 days, giving the insured time to decide whether they want to stay with the policy or not. During this time, if they are unsatisfied with their plan, they can discontinue and get a full refund.

The waiting period is the time between applying for insurance and the commencement of the policy. During this period, you are not covered by insurance and have to pay for any illnesses yourself. You cannot file a claim.

In some cases, your insurer may give you coverage for pre-existing conditions if you pay some extra premium. But since these illnesses are usually very expensive to treat, we recommend choosing the policy with the smallest waiting period.

When you approach the insurance experts at Cover360, we use all these factors to judge your best options. It is by accounting for each of these that we can present your best options. Then it becomes your turn to use the same factors and decide which senior citizen health insurance appeals most to you.

With Cover360, you never get anything less than the maximum benefits for the minimum limitations!

Things to Keep in Mind While Buying Senior Citizen Health Insurance

Deciding to purchase senior citizen health insurance, like any other insurance decision, is significant. It is contingent upon several factors. This is because different health plans for senior citizens offer various benefits. You need to choose what is best for you since you are paying for it and, therefore, deserve the best care.

Therefore, when deciding to go ahead and purchase your health insurance, you need to keep in mind certain things. Keeping these factors in mind help, you make the best decision for yourself.

One of the main things you should look for when purchasing senior citizen health insurance is the claiming process. A lot of times, the process for claiming insurance pre or post hospitalisation can be challenging and inefficient. Learning the process beforehand makes a choice easier.

You need an insurer with a fast claim settlement time and a high claim settlement ratio. Then you are guaranteed that you get good, efficient coverage under your policy.

A lot of insurers have deals with certain hospitals. This means that you can only claim insurance if you go to that specific hospital. Therefore, you need to check their catalogue of network hospitals to see if they include the services you require. This is also a vital factor when it comes to travelling and needing those specific hospitals.

If you are purchasing a policy for your parents, they should get a separate plan. They should not be on the family floater plan if they are over 60 years, no matter how attractive an option that is. This is because the premium and highest renewal age for the family floater plan depends on the eldest member covered by the plan. This means that the family could stop getting covered faster, and a new policy would have to be purchased.

A lot of insurers reduce the premium or increase the sum insured if hospitalisation is not claimed. Sometimes they offer both. This is called a no-claim bonus. Depending on your financial situation, the no-claim bonus can be very desirable.

Medical expenses incurred before and after hospitalisation are called pre- and post-hospitalisation expenses, respectively. Post-hospitalisation expenses include regular check-ups and other such necessities stipulated by the doctor. If you or the person you are buying insurance for requires such treatments, ensure that the senior citizen health insurance you choose covers these expenses. Covering these costs significantly reduces financial burdens during treatment.

For a lot of insurers, to claim insurance, hospitalisation for at least 24 hours is necessary. This means that small, day-care procedures (procedures done in a day, i.e. under 24 hours) are not covered under this policy. Luckily, with the progress of medical technology and science, a lot of day-care procedures do not require additional hospitalisation. However, it is still better to choose a policy that covers the highest number of day-care procedures.

Regular medical check-ups are a must for the elderly. However, they can also be very expensive. Some policies cover check-ups for free. They do not add to the premium when the plan needs renewal. Choosing a policy with this is better than choosing one where the premium increases.

Always account for the nature of the premium. Senior citizen health policies tend to have much higher premiums since their health is at a higher risk. Sometimes the premiums may also increase due to pre-existing conditions. These are all aspects you need to account for when making a decision.

Luckily, you do not have to make this decision alone! Our expert analysts at Cover360 have spent countless hours comparing and contrasting different health plans for senior citizens so we can choose the ideal and most efficient one for you!

Exclusions in Senior Citizen Health Insurance

Senior citizens have had specific health policies tailored to their needs for a long time now. And something we need to understand is that every health insurance policy has certain exclusions that would be too big a burden on the insurer. Health plans for senior citizens are no different. They need to exist just as much as the inclusions to ensure you get the best from the insurers.

The exclusions are very important to note since you should always know what your plan covers before choosing it. And that’s why we are here to help! We put together a list of the most common exclusions from senior citizen health policies :

  • Pre-existing diseases or injuries
  • Expenses arising from drug abuse
  • Expenses related to non-allopathic treatment
  • A cosmetic surgery
  • One or more medical condition(s) diagnosed within 30 days of purchasing the policy
  • The treatment cost of injuries caused due to an act of foreign army/civil war
  • Expenses arising out of self-inflicted acts
  • HIV/AIDS treatments
  • The cost of dental treatment or lenses/spectacles unless this condition arises from an accident

Excluding such treatments allows insurers to include certain other treatments. And covering these treatments is only possible because of such exclusions.

Therefore, knowing the full extent of your policy’s inclusions and exclusions is necessary. Our job is to put together the list and choose the ideal policy for you. And, with our extensive knowledge of the various senior citizen health insurance policies, we assure that our recommendations are completely tailored to meet your needs!

How to Claim under Senior Citizen Health Insurance

Nearly every major insurance provider now offers health plans for senior citizens. Their rampant popularity has allowed these policies to blossom and become more intricate. This means that they benefit the elderly community even more now. Every policy has its inclusions and exclusions, waiting period etc. just like regular health insurance.

There are several things to keep in mind when choosing your senior citizen health insurance. And a brief perusal of our website tells you what exactly to look for. Now, suppose you have bought this insurance policy. Now what?

A lot of agencies that help you choose your insurance and nothing more. But what about claiming your insurance? After undergoing treatment and hospitalisation, what is the next step? How do you claim insurance?

The first thing you need to know is when you can claim insurance. You can only claim insurance if you have been hospitalised for 24 hours or avail medical emergency treatment.

What are you claiming for? You are claiming insurance, so your provider transfers money for your treatment to the hospital. This means that your treatment is a cashless treatment sometimes through expense reimbursement. Regardless of the mode your provider follows, you need to place your claim within 24 hours of hospitalisation.

You can usually find the claim form at the insurer’s office or, since we live in the digital age, on their website. Once you fill the form, submit it to the insurer. Always remember to attach medical bills and reports given by your doctor and the hospital. Any other supporting documents are also necessary. Your insurer usually provides a list of documents you need to submit. Follow this process, and the claim goes much faster.

At Cover360, we believe in helping you along each step of the insurance process. This includes helping you to claim insurance when necessary. We want your insurance journey to be smooth and simple!

Tax Benefits of Senior Citizen Health Insurance

Like every health insurance policy, senior citizen health policies also have numerous tax benefits. This is due to the active government intervention that regulates health plans for senior citizens.

These regulations began in 2006/2007 when the government capped the amount that premiums could be raised on this health policy. This was in response to several insurers making premiums on these policies inexplicably high.

Finally, the IRDA put down various rules for this health insurance policy. And, like other health insurance policies, it also offered tax benefits.

Under this plan, you can even avail tax exemption under Section 80D of the Income Tax Act. You become eligible for a tax rebate of Rs. 30,000 if you applied for senior citizen health insurance for your parents. You can avail an additional rebate of Rs. 5000 for preventive health check-ups as well.

If you are an earning member of your family and also have applied for health insurance for your children, you get an even greater rebate of Rs. 25,000.
Therefore, the total tax rebate you get under this section is 30000+25000+5000 = Rs. 60,000!

Although this should not be the primary incentive for this health policy, it is an attractive feature. A lot of people opt for this insurance policy because of this benefit, and it truly pays off!

At Cover360, we bring you such benefits by choosing the most ideal senior citizen health insurance policy. Our recommendations are always suited to your needs, keeping you and your necessities in mind!

Benefits of Buying Senior Citizen Health Insurance from Cover360.in

If you are an older person in need of medical insurance, you are in the right place! At Cover360, our team of specialists knows all the ins and outs of senior citizen health policies. Our job is to help you compare and contrast different policies, so you get the best of the best.

So how do we ensure you get the full benefits of your policy?

  • With such a thorough understanding, we also have comprehensive knowledge of what comparison factors to prioritise.
  • We believe that you need insurance catered to your needs. So while the insurance you get from your employer may feel like security, as a member of the elderly, you need more than that. We ensure you get the additional benefits that health plans for senior citizens provide.
  • We stress this importance because we know how difficult life can get. We all have had parents and grandparents with health problems, and so we understand the significant role age plays and account for it.
  • We understand that the rewards of senior citizen health insurance outweigh the risks that old age brings. This is why our dedicated experts diligently track down the ideal healthcare policies for you!
  • We believe that customer satisfaction goes beyond the initial sale and that reliable customer service is the backbone of any company.
  • We are always here to answer additional questions and help you even after purchasing the insurance.
  • With us, paper work for policy and claims is not a hassle at all. We are there for all the assistance you need.

Therefore, we are always here to answer any questions and ensure you are completely satisfied with your policy at every stage!