Senior Citizen Health Insurance

Ageing often brings along numerous illnesses that can be costly to manage and treat. As the body becomes more susceptible to infections and diseases after the age of 56 to 60, health insurance becomes crucial for senior citizens.
To cater to the medical needs of individuals aged 56 years and above, we have designed a senior citizen health insurance plan. This meticulously crafted policy covers unforeseen medical expenses arising from hospitalisation, health check-ups, daycare procedures, and ambulance services, similar to a standard Mediclaim policy.
This plan provides comprehensive coverage at an affordable price point. An ideal senior citizen health insurance plan should include features such as a high sum insured, annual health check-ups, and cashless treatment at a wide network of hospitals to ensure reliability.

What is the significance of having health insurance for senior citizens?

As we age, our healthcare needs tend to increase, and regular health insurance can often become expensive. Senior citizen health insurance plans can help seniors manage their finances during their golden years. Prompt diagnosis and treatment can make a significant difference in a senior's ability to recover from illnesses, as they are more susceptible to diseases and illnesses than younger individuals.
To be eligible for this program, a quick pre-medical tele-screening is required. Your age, residence, and SI (health status) are considered in this screening to determine the insurance premium for your chosen plan. The senior insurance program is designed to provide:

Cost-effective medical care
This health insurance plan covers expenses related to daycare, hospitalization, and advanced medical procedures. Physical therapy and diagnostic testing appointments are also covered.

Coverage for in-home care
When hospitalization is not possible, patients receive care at home. Our senior health insurance plan, subject to the terms and conditions of the plan, covers in-home medical care and hospitalization expenses.

Health examinations and medical consultations
Seniors should undergo routine medical examinations to identify potential illnesses. This senior health insurance plan covers an annual health examination at any hospital within the network for covered individuals.

Encouragement and maintenance of optimal health
The medical needs of seniors may go beyond what standard insurance covers. Additionally, the insurance policy includes the Care Management Plus Program as an add-on benefit. This program provides a dedicated healthcare professional to assist with concerns regarding wellness, diet, and physical fitness. It also covers home nursing, pharmacy costs, standard diagnostics, and minor procedures. Therefore, having senior citizen health insurance is essential.

Senior citizens can enjoy various advantages by purchasing health insurance

Affordable premiums for medical coverage:
As individuals age, their health risks increase, resulting in higher insurance premiums. Senior health insurance can provide coverage for unexpected medical emergencies at reasonable costs.

High sum insured with the option to reset:
Senior health insurance plans offer a maximum insured amount of up to ₹50 lakh. In case of exhausting the sum insured due to unforeseen events, the policy can be reset subject to policy terms and conditions.

Coverage for pre and post-hospitalisation expenses:
Health insurance plans for seniors also cover medical expenses incurred before and after hospitalisation, including consultations, diagnostics, and medications related to the hospitalisation.

Coverage for pre-existing diseases:
Pre-existing conditions listed in the policy are covered after a waiting period of 24 months. An ideal senior health insurance plan has a short waiting period.

Cashless treatment facility
Senior citizens with health insurance can avail cashless treatment at any network hospital across the nation in compliance with the network hospital agreement.

Tax benefits:
Policyholders purchasing senior health insurance policies can receive tax benefits of up to 50,000 under Section 80D of The Income Tax Act of 1961 for individuals over the age of 60.

What does Senior Citizen Health Insurance Plan Cover?

Hospitalization Expenses
This includes room charges, doctor fees, nursing fees, cost of medicine and drugs, ICU charges, cost of surgical appliances, operation theatre charges, and other medical expenses required during hospitalization. It also covers the cost of artificial limbs, orthopedic implants, prosthetic devices, and diagnostic tests.

Day Care Treatments
Most plans cover specific daycare treatments that require less than 24 hours of hospitalization, such as chemotherapy and dialysis.

Pre and Post-hospitalization Expenses
Medical costs before hospitalization and after discharge are also covered under senior citizen mediclaim policies.

COVID-19 Cover:
The policy pays for the cost of coronavirus treatment up to a specified limit.

Organ Donor Expenses:
Most mediclaim policies cover donor expenses incurred during organ transplants.

Ambulance Charges
It covers ambulance charges incurred on transporting the insured to the nearest hospital up to the specified limit.

Pre-existing Diseases:
Any pre-existing diseases of the insured senior citizen are covered after a fixed waiting period.

AYUSH Treatment Cost
Some senior citizen mediclaim policies cover AYUSH treatment taken in a government-recognized hospital or institute.

Domiciliary Hospitalization Cover
If the doctor recommends home treatment for the elderly person, then their insurance company will pay for domiciliary hospitalization expenses.

What Does a Senior Citizen Health Insurance Plan Not Cover?

The following medical expenses are typically excluded from senior citizen health insurance plans:

Pre-existing diseases or injuries

Expenses arising from self-inflicted injuries or suicide

Expenses arising from drug or alcohol abuse and related treatment

Medical con ditions diagnosed within 30 days of purchasing the policy (except for accidental injuries)

Expenses related to non-allopathic treatment

Treatment cost of injuries caused due to an act of foreign army or a civil war.

Cosmetic surgery

The cost of dental treatment or lenses/spectacles, unless arising from an accident.

Treatment cost of AIDS

Please note that the list of exclusions may vary among different insurance plans.

Things to Consider While Buying a Mediclaim Policy for Senior Citizens

When buying a health insurance policy for senior citizens, there are several factors to consider to ensure that the policy covers all necessary medical expenses. Here are some things to keep in mind:

Day Care Treatments:
Choose a plan that covers a wide range of day care procedures like chemotherapy, dialysis, and radiotherapy, which can be done without the need for hospitalization.

Cashless Hospitals:
Check the list of network hospitals of the insurance company to ensure that the hospital you prefer is included in the list.

Efficacy of Health Insurance Claims:
Look for an insurance company with a high claim settlement ratio and a quick claim settlement time.

No Claim Bonus:
Many insurers offer a no-claim bonus discount if no claims are made during the previous year.

Free Medical Health Check-up Facility:
Opt for a policy that allows policyholders to have free medical check-ups on an annual basis.

Co-payment:
Look for a plan with low to zero co-payment so that you are not burdened with additional out-of-pocket expenses.

Policy Renewability:
Choose a policy that offers a lifetime renewability option.

Pre-existing Diseases Waiting Period:
Look for a plan with a minimum waiting period for pre-existing diseases.