Senior Citizen Health Insurance – A Comprehensive Guide

All About Senior Citizen Health Insurance - BimaBandhu

Amidst the rising healthcare problems paired with medical inflation, a health insurance policy is the need of the hour for every individual. However, we all know that the risk of health problems increases as we age. That is why, older people who are more prone to certain diseases, need senior citizen health insurance.

With suitable health insurance for senior citizens, you need not worry about the financial side of medical expenses arising due to age-related health problems. Before you buy senior citizen health insurance for yourself or your elderly parents, you must know about various related facets. Let’s cover them all in detail. 

What is Senior Citizen Health Insurance? 

It is a specific type of health insurance plan that provides coverage to people above the age of 60. The common inclusions related to senior citizen health insurance are preventive health checkups, hospitalization expenses, pre-existing diseases, critical illnesses, and Covid-19 treatment*. 

What are the Benefits of Buying Senior Citizen Health Insurance? 

A senior citizen health insurance policy is highly advantageous to elderly people. Some of the primary benefits of a senior citizen mediclaim policy in India are: 

  • Adequate medical insurance coverage after the age of 60 
  • No need to undergo medical screening (in most cases) 
  • Pre-, post-, and in-patient hospitalization cover 
  • Cashless medical treatment at network hospitals 
  • No Claim Bonus (NCB) for every claim-free year 

Why Do You Need Health Insurance for Senior Citizens? 

The simplest reason – the elderly people are most likely to face medical problems due to their old age. A healthcare emergency can be financially and emotionally challenging for them and their family members. With senior citizen health insurance, you can plan to manage the financial side of the required medical treatment.  

Here are some other reasons why buying the best health insurance for senior citizens makes sense: 

  • To meet the increasing cost of quality medical treatment 
  • To benefit from critical illness cover (as a built-in feature or add-on) 
  • To avail of free annual health checkups without worrying about the cost involved (as covered under the chosen plan) 

Also Read: All About Coronavirus Health Insurance 

What is Covered Under Senior Citizen Health Insurance Plans? 

Given below are some of the most common inclusions related to health insurance for senior citizens: 

  • Various hospitalization expenses, like room rent, doctor’s fees. ICU charges, medicine cost, etc. 
  • Day-care treatment expenses 
  • Pre- and post-hospitalization expenses 
  • Covid-19 cover as defined under the chosen senior citizen mediclaim policy 
  • Ambulance charges 
  • Organ donor expenses 
  • Pre-existing disease cover 
  • Cost of AYUSH treatment 
  • Coverage for domiciliary hospitalization 

What is not Covered under Health Insurance for Senior Citizens? 

Here are some common exclusions related to senior citizen health insurance plans: 

  • Expenses related to self-inflicted injuries or suicide 
  • Medical expenses related to drug or alcohol abuse 
  • Pre-existing injuries 
  • Medical conditions diagnosed during the first month after buying the policy (except accidental treatment) 
  • Cosmetic surgery 
  • Dental treatment or lenses cost unless required after an accident 
  • Cost of AIDS treatment, and many others 

The list of exclusions may vary from one senior citizen health insurance plan to another. 

What Should You Consider While Buying the Best Health Insurance for Senior Citizens in India? 

A senior citizen health insurance policy can be highly useful for elderly people who are at high risk of critical illnesses. While buying this type of health insurance policy is easier these days, you should keep in mind the following factors: 

  • Select senior citizen health insurance that also covers day care treatments like dialysis, radiotherapy, etc. 
  • Check the list of network hospitals where you can avail cashless treatment, especially the ones located nearby 
  • Check for the availability of No Claim Bonus 
  • Ask about free periodic medical checkup facility related to the available health insurance plans for senior citizens 
  • Look for a plan that offers lifetime renewability option 
  • Check the waiting period related to pre-existing diseases; you can select the plan that comes with a minimum waiting period 
  • Dig deeper into the details of co-payment clause which specifies the part of the claim amount to be borne by you 
  • Check for the coverage of domiciliary hospitalization 

You May Also Like to Read: A Complete Guide to Health Insurance Portability 

How to File a Claim for Senior Citizen Health Insurance? 

All senior citizen health insurance policies require the policyholders to file a claim in case of a healthcare emergency or to avail of medical treatment. This claim can be filed in the following ways: 

  • Senior Citizen Health Insurance Reimbursement Claim 

It involves the following steps in lodging a reimbursement claim under health insurance for senior citizens: 

  • Notify the insurance company at the earliest 
  • Gather all the documents at the time of hospital discharge 
  • Fill and submit the claim form to the TPA or insurer along with the required documents 
  • After careful review, the claim amount will be reimbursed and settled.  
  • Senior Citizen Health Insurance Cashless Claim 

This is related to the instances in which the policyholder avails medical treatment at a network hospital. The steps involved in filing a cashless claim are as follows: 

  • Visit a network hospital and get hospitalized as required 
  • Ask for and fill the pre-authorization form in the hospital and submit it to the authorities 
  • The hospital team will forward the form to the TPA 
  • Once approved, the claim amount will be settled directly with the hospital 
  • Receive the required treatment post approval 

What are the Tax Benefits of Buying Senior Citizen Health Insurance? 

Along with providing the much-needed coverage, a senior citizen health insurance policy can also help you save tax under Section 80D. It makes you eligible for an income tax rebate of up to Rs. 50,000 by buying the best senior citizen health insurance policy for your parents.  

In addition, you can also save taxes of up to Rs. 5,000 for expenses related to preventive health checkups in a financial year. To get better clarity on the tax implications and benefits, you are advised to consult a tax professional. 

Senior Citizen Health Insurance at a Glance – Features 

Parameter  Specification 
Cashless claim facility  Available at network hospitals 
Preventive health checkups  Covered 
Lifetime renewability  Available 
Minimum age at entry  60 years or above 
Maximum age at entry  No limit 
Tax benefits  Savings of up to Rs. 75,000 in a specific financial year 

Also Read: What is Health Insurance for Parents?

List of Popular Health Insurance Policies for Senior Citizens 

  • Bajaj Allianz Silver Health Plan 
  • Bharti AXA Smart Health Insurance Plan 
  • Aditya Birla Activ Care Plan 
  • Care Senior Health Plan 
  • Edelweiss Health Insurance Plan 
  • Future Generali Health Suraksha Plan 
  • IFFCO Tokio Individual Medishield Plan 
  • Kotak Mahindra Health Care Plan 
  • New India Senior Citizen Mediclaim Policy 
  • Oriental HOPE Insurance Plan, and many others 

Disclaimer: We do not endorse or recommend any specific insurance plan or company. 

Why Buy Senior Citizen Health Insurance Online? 

Buying senior citizen health insurance online is considered a better alternative to buying the same plan offline because: 

  • Of the convenience of purchase from the comfort of your home 
  • Of the availability of multiple secure payment methods 
  • Of the instant quotes and policy issuance 

How to Select the Best Senior Citizen Health Insurance for People Above 60? 

Keep the following points in mind while buying health insurance for senior citizens: 

  • Know and cross-verify their medical history 
  • Compare different plans based on their features and benefits; do not rely solely on peer recommendations 
  • Fill in accurate information in the application form while buying a plan 
  • Undergo medical screening to know more about the health specifics 

How to Compare Senior Citizen Health Insurance Plans? 

You must consider the following factors while comparing different health insurance plans for elderly people: 

  • Minimum and maximum entry age 
  • Budget to pay the premium without facing any challenge 
  • Premium in comparison to the sum insured and other benefits 
  • Coverage for specific diseases 
  • Network hospitals 
  • Waiting period – initial waiting period and the one related to pre-existing diseases 
  • Inclusions and exclusions 
  • Co-payment clauses 

Senior Citizen Health Insurance FAQs 

What should I consider at the time of buying a senior citizen health insurance plan? 

You should consider several factors, such as adequate sum insured, co-pay clause, sub-limits, waiting period, premium, and network hospitals. 

Do I need to undergo medical screening while buying senior citizen health insurance? 

It may vary from case-to-case basis, and depending on the insurer you select to buy this type of policy. 

How is a senior citizen health insurance plan beneficial? 

It is designed to provide the required financial support in case of medical emergencies that are quite common in old age. The policy also helps in keeping your savings intact. 

How to select the right sum insured under health insurance for senior citizens? 

Consider the approximate medical expenses in your area, the existing medical condition of senior citizens, and their lifestyle to select the right sum insured. 

Can senior citizens forward the continuity benefits on porting their senior citizen health insurance plans? 

Yes. When you port the policy to a similar one from one insurer to another, the continuity benefits like NCB and waiting periods, will be carried forward. You can also ask the chosen insurance company about the related terms and conditions. 

Do insurers offer free health checkups under health insurance for senior citizens? 

This benefit is offered based on the chosen policy. You can find out more by reading the policy wordings carefully. 

Should I submit claim documents to TPA or the insurer? 

You need to submit the required documents to TPA of your health insurer. However, if there is no TPA and the insurer processes in-house claims, then the documents are to be submitted to the insurer. You can also get the option to change the TPA wherever possible. 

Are senior citizen health insurance plans available with a family floater or individual cover? 

Most of such plans offer insurance cover on an individual basis. 

Why Read BimaBandhu to Gain Knowledge About Senior Citizen Health Insurance? 

BimaBandhu, being an information portal for insurance buyers, provide detailed guides that cover various aspects related to buying the right type of insurance policies. Here’s why you should read BimaBandhu before buying any plan: 

  • To know about different policies in an unbiased manner to choose the most suitable senior citizen health insurance 
  • To develop an understanding of how insurance policies work before buying them 
  • To make an informed decision of insurance purchase which will benefit you in the long run 

Read More at BimaBandhu


Blog Post Information Last Updated on: December 1, 2021

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