best-health-insurance-for-senior-citizens

What are the Best Health Insurance for Senior Citizens?

The lifestyle of people all around the world has changed, the environment has changed, life choices have revolutionized, and amongst all this, one of the main things that has been overlooked is the health of people. In the earlier days, humans lived for an average age span of 90 to 100 years. Those people managed to maintain themselves with all the limited agricultural products available back then, even though there has been an upgrade in farming today the health yet keeps deteriorating. 

In today’s time, the eating habits of people have changed from healthy to junk food thus directly affecting their health. To protect oneself from such health hazards it is necessary to get yourself under the coverage of a health insurance plan. Taking a slightly longer perspective, a senior citizen plan is an absolute necessity in these times 

A senior citizen plan is a policy that covers individuals above the age group of 60 years. The policy is quite similar to a regular health insurance policy. IRDAI (Insurance Regulatory and Development Authority of India) indicates that insurance companies must allow an individual of up to 75 years of age to buy a senior citizen plan. 

Health insurance + Senior citizen benefits = Senior citizen health insurance. 

 Why one must have a senior citizen policy: 

  • Safeguard your savings: 

You have struggled your entire life to save money for various occasions like your child’s MBA, marriage, a foreign trip, and so on. It is very much likely that you would not like to spend this money on hospital bills, medicines, etc. So, to protect your savings, you can purchase a senior citizen insurance plan that will help you safeguard your hard-earned wealth.

  • Limited income:

Once you have retired you will be receiving a fixed income from your pension plan or a similar kind of arrangement that you would have made. At such a time, it is difficult for you to pay medical bills as you will be restricted to a certain amount. Insurance plays an important role in such situations. 

  • Medical inflation:

There have been rapid developments in the field of science and technology which has led to the emergence of better medical care and treatments. Due to the improved medical services, the cost of such treatments has increased dramatically making it almost impossible for the common man to afford it; thus leading to the increasing demand for insurance, especially for senior citizens as they face more problems with an increase in their age.

  • Plenty of coverage: 

If you have health insurance along with senior citizen plans, it leads to a wide coverage available for medical emergencies. It makes medical treatment affordable. 

Features of a Senior Citizen Policy

1) In-patient hospitalization: 

On admission into a hospital, the doctor needs to know if you are suffering from a pre-existing sickness or emergency health deterioration. That normally determines the policyholder is given coverage under the insurance policy. 

2) Pre- and post-hospitalization: 

Various tests taking place before serious treatment such as x-rays, blood tests, etc; are coverable under the policy. On the other hand, post-hospitalization costs are incurred for doctor’s appointments, medicines, and so on. 

3) Tax benefits:

Under section 80D of the Income Tax, 1960, senior citizens can enjoy the benefit of additional tax exemption of up to INR 50,000. If you are not a senior citizen and if your parents are senior citizen, then you can avail total exemption to the tune of Rs.75,000 per year including Rs.50.000 for your aged parents.

4) Pre-existing diseases:

The waiting period that one has to serve to receive coverage for pre-existing disease shall be taken into consideration. 

5) Health check-ups: 

Many insurance policies provide their policyholders the benefit of health check-ups, as this helps in understanding the flexibility and illness of the senior citizens. The medical check-ups are provided by the insurance company on an annual basis. 

6) Easy claims:

The claiming process shall be quick and hassle-free, making it easy for the insured to file a query quickly. 

7) Ambulance charges: 

In cases of emergency, ambulance charges are also coverable by the insurance company. 

8) Medical tests:

Depending on the age that you are purchasing a senior citizen insurance plan, it will be decided if one has to undergo a health check-up. Most insurance companies do not ask individuals to take up a medical test. It varies from one insurance company’s terms and conditions to another. 

Points to keep a check on while purchasing a senior citizen insurance policy: 

  • Entry age:

It is advisable for every individual for to purchase such an insurance policy at the earliest as it has many benefits such as receiving a large amount of coverage at lesser premiums, cheaper premium payments, and so on. As time passes by, one is more prone to fall prey to hazardous diseases that are called pre-existing diseases as per insurance companies thus making policies expensive to purchase.  

  • Cap or sub-limit:

While purchasing an insurance policy, the company underwriting the policy pre-decides, and sets a sub-limit of the total sum insured on each disease. It means that a particular disease will be receiving a particular proportion of the entire claimable amount. For example, in the case of heart disease, the sub-limit is set of Rs.400,000 out of the entire sum insured Rs.12,00,000. Now if the policyholder suffers from heart disease and has a hospitalization bill of Rs.550,000; yet the insurance company will release funds of up to Rs.400,000 as that was the pre-decided sub-limit. The balance needs to be paid from the insured’s pockets. That is why it is very necessary that one should look out for the sub-limit clause while purchasing a senior citizen plan. 

  • Geography:

The benefit of cashless benefit by insurance companies makes it easier for the policyholder to go through the hospitalization phase and so while choosing a senior citizen plan one shall look for a network hospital within the residential area of the insured. It helps one enjoy the benefit. And in emergencies, one is most likely to choose the hospital closest to their house. 

  • Co-payment:

Co-payment is the clause under which on hospitalization or during the phase of filing and clearing a claim, the policyholder needs to contribute and chip in a part of the bill. From 100% of the entire claim, the policyholder needs to pay the pre-decided ratio of co-payment. It can be 10:90, 20:80, or so on. For example, the co-pay was set at 15:85, and the bill is Rs.4,00,000; this means Rs.60,000 needs to be paid by the policyholder and the remaining majority will be paid by the insurance company. Senior citizens usually enjoy the benefit of a lesser co-payment ratio, and thus it is necessary to check such a clause. The general bracket of co-payment is 10-30% but in practice it can vary from company to company.

  • Medical history:

The medical history of the policy purchaser shall be looked into, in case if any illness can be hereditarily induced. The insurance company also takes a call on whether such a hereditary issue is a major concern for the health insurer or not. Critical illnesses are an example of hereditary sickness, and thus one shall look out for a plan that will cover such illnesses. 

  • Renewal:

Easy renewal and hassle-free claim procedures always are a plus point while choosing the best insurance plan. 

  • Claim settlement ratio: 

The company’s credibility and loyalty towards the protection of its clients can be assumed after taking a quick look at the company’s claim settlement ratio. A claim settlement ratio indicates the number of claims received by the company and the number of claims that the company has successfully repaid or reimbursed. A company with a good ratio of settling claims must be chosen over others as there is greater probability of your claim being processed quickly. 

Best Indian health insurances for senior citizens

1. New India Health Insurance for Senior Citizen

The New India company promises a tailor-made insurance plan for every senior citizen and proposes maximum coverage to them in the later years of their lives. The policy covers critical areas by providing lucrative benefits such as no claim bonus or NCB, free medical check-ups, and so on. 

Features: 

  • Day care treatments.
  • No claim bonus.
  • 10% co-payment. 
  • Free look-up period. 
  • Lifelong renewability.
  • Claim Settlement Ratio – 95.92%

2. Silver Health Plan

Bajaj Allianz provides the Silver Health plan. The plan states that it will not only help one decrease their health expenses but will also help to provide the best treatment. It allows one to enjoy their retirement life. 

Features:

  • Free health check-up if no claim has been made in the past 4 years. 
  • Providing day-care procedure coverage. 
  • Ayurvedic and homeopathic coverage available – AYUSH coverage
  • 10% cumulative bonus for every claim-free year. (Up to 100%)
  • Claim Settlement Ratio: 85% 

3. Senior Citizens Red Carpet Health Insurance Policy

The Star health insurance company provides all the financial safety and security along with this plan. It is considerably known as the optimum plan. The policy is available for individual as well as family floater basis. 

Features:

  • Lifetime renewability.
  • No pre-medical tests. 
  • Emergency hospital services.
  • Health check-up costs are covered up to a certain limit.
  • Outpatient consultation charges are coverable. 
  • Claim Settlement Ratio – 63%

4. HDFC ERGO Optima Senior Health Insurance

The plan offers an affordable base plan that can be easily opted for by the senior citizens. It offers lifelong cover and covers all types of health issues. HDFC ERGO senior citizen helps one get lifetime renewability and helps save up on big amounts or premiums. 

Features: 

  • Waives off room rent limits.
  • No restriction on entry age. 
  • Individuals above the age of 80 years have to pay a 10% co-payment.
  • Claim Settlement Ratio – 62%

5. Care Senior Citizen Insurance Plan

Care senior citizen plan helps ensure the elderly to enjoy a better lifestyle and receive quality care. It helps protect senior citizens from hefty medical expenses. 

Features:

  • Pre-medical check-up is required. 
  • Annual health check-ups.
  • Auto-renewal policy.
  • Hassle-free claims procedure. 
  • Claim Settlement Ratio – 55%

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What is the right age for buying a senior citizen plan?

The earlier you purchase a senior citizen plan, the greater the benefits they provide. It is advisable to buy an insurance policy at an early age as it helps you to enjoy the benefit of getting vast coverage with minimal premium payments. And if you buy a policy at an early stage in your life, it is most likely that you won’t be undergoing any serious medical condition and thus will not have to pay hefty payments for covering such diseases and also you will not have to serve a waiting period.

Can one opt for a cashless claim facility?

A cashless claim facility means getting admission to a hospital and getting treatment without shelling out any upfront money from one’s pocket. It is an adjoining benefit of having an insurance plan. No extra amount is payable for availing of the cashless facility benefit. For getting this benefit one needs to get admitted to one of the network hospitals with the insurance company. Network hospitals are those medical providers that are associated with the insurance company, and thus it is advised to the policy purchaser that while purchasing an insurance plan, they shall look out to find out if the network hospital is situated in a close setting near to one’s residence. Most insurance companies provide cashless facilities, you must check up on the terms and conditions stipulated in the contract by the insurance company.

Any income tax benefit on senior citizen plans?

Income tax benefits are available on general health insurance as well as senior citizen plans. Under section 80D of the Income Tax Act, senior citizens above the age of 60 years enjoy the maximum tax exemption of Rs.50,000 per financial year. Individuals or families having insurance coverage for an age limit of below 60 years can enjoy a tax benefit of Rs.25,000.

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