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Benefits of Buying a Senior Citizen Health Plan Early

If you are a working professional, your healthcare needs are most likely covered under a group health insurance. But what about when you retire? After all, employer-sponsored plans cease to cover you once you stop being an employee in an organisation. 

So, what can you do? Go with a senior citizen plan, ofcourse. 

A senior citizen health insurance is a type of insurance that provides coverage to people above the age of 60. The policy can be purchased directly by individuals or by children for their aging parents.

In any case, if you are looking to buy a senior citizen health insurance policy, we suggest you do it early. Here’s why:

  1. Low premiums 
  2. Full Coverage 
  3. Greater options 
  4. Minimal chances of rejection  
  5. Coverage for pre-existing diseases
  6. No-claim bonus
  7. Short waiting period 

Another option is that you opt for an individual health plan but since they have strict age limits, beyond which entry is almost impossible, there is a good chance that your application will be rejected.

What all is covered under Senior citizen health insurance?

The policy covers the below-mentioned expenses. However, the inclusions may differ from one insurance provider to another.

  1. Hospitalization:

If you have a valid senior citizen insurance plan and fall ill thereby requiring immediate professional treatment and being admitted into a hospital. The expenses incurred while being hospitalized are covered under the insurance policy. The insurance policy offers you the option of cashless as well as reimbursement options. Cashless treatment can be opted for in case the insured is admitted to the insurance company’s network of hospitals. In case not, then you can opt for the reimbursement method.

  1. Pre-hospitalization:

Before getting hospitalized and beginning treatment the various expenses incurred by you on various tests and antibiotics are covered under the insurance plan. Pre-existing expenses spent 60 days before hospitalization are also covered under the policy.

  1. Post-hospitalization:

After getting yourself treated, in some cases, you may require regular doctor’s treatment post-discharge too. In such a case, the expenses are covered under post-hospitalization costs. Such expenses incurred up to 180 days post-discharged are covered.

  1. Mental Health:

The Insurance Regulatory and Development Authority of India (IRDAI) has asked insurance companies to cover costs related to mental health as an outcome of COVID. The IRDAI also asked the insurers to treat mental health as a regular disease as it’s equally important for one to be healthy and fine. The coverage of this condition is allowed now due to the awareness and action taken under the Mental Healthcare Act, 2017.

  1. Day-care procedure:

In case you need to get yourself treated but do not require 24 hours hospitalization, yet the costs incurred will be covered by the insurance company under day-care treatment. The benefit of such an option allows oneself to receive speedy treatment without worrying about the costs to be excluded.

  1. Home treatment:

In case, the doctor recommends you to receive treatment at home rather than getting cured in a hospital environment then such expenses will be covered by the insurance company. While availing home treatment option, you can also choose for cashless facility.

  1. Ambulance expenses:

If you are facing a medically challenging situation and need to reach the hospital as quickly as possible then you can call for an ambulance. In such a stressful situation, the insurance company will grant ambulance charges incurred.

  1. AYUSH treatment:

AYUSH stands for Ayurveda, Yoga and Naturopathy, Unani, Siddha, and Homeopathy treatment. AYUSH treatment is considered an alternative to scientific treatment offered by various hospitals. One can opt for such treatment in case their health insurance policy covers them. If you undergo the treatment without any coverage and face any side-effect that requires hospitalization, the insurer will not be liable to accept your claim.

  1. Lumpsum payment:

The insurance company provides lumpsum pay-out as a recovery benefit. It means that if the insured is admitted to a hospital for more than 10 days then to manage the household expenses a lump-sum payment would also be made.

What is not covered under the Senior citizen health insurance policy?

  1. War:

In case of a war breaking out and the death or any harm is caused to the insured, yet the insurance company will not be liable for the treatment expenses.

  1. Cosmetic surgeries:

Any surgery incurred for self-benefit or improvement of appearance that is not required involuntarily is called cosmetic surgery. An example can be liposuction surgery. The expenses incurred for such surgeries are not covered under the insurance policy.

  1. Self-harm:

It is a fact that elderly people tend to suffer from depression or have a mental breakdown. In a situation where the individual has harmed themselves or committed suicide then no treatment cost or death benefit will be granted by the insurance company. It is because the incident did not take place naturally and was caused due to self-harm.

  1. Adventurous activities:

If the insured takes part in any adventurous activity that may cause them any physical damage, then such expenses will not be cleared by the insurance company.

Benefits of buying a Senior citizen health insurance plan at an early stage:

 The various benefits one can enjoy by purchasing a senior citizen insurance policy at a younger age are as under:

  1. Low premiums

There is an assumption that the younger you are, the chances of contracting a disease are lower, and as we grow older, we may fall prey to diseases. If you purchase a senior citizen health insurance plan at a younger age, the premium estimation will be lower. It is a fact that the premium charged and treatment costs incurred for senior citizens are 3.8 times higher.

  1. Coverage

As the premium charged is low, it does not relate to the coverage being offered. The coverage offered remains the same, despite the lower premium.

  1. More options are available

At a younger age, the availability of various schemes is more. It means one does not have to compromise and can be selective about the insurance plan they need. You do not need to settle for any compromise as there are plenty of options available to you.

  1. Minimal rejection

Younger age means lesser health issues, and thus the risk associated with per insured individual is less. In such a case, the insurance company is at a profit as they understand that the chances of a claim being made by the insured are less and that leads to lower chances of rejection by the insurance company. If a policy purchaser is suffering from a serious medical condition that the insurance company believes is very risky, they can reject such a case.

  1. Pre-existing diseases

As you are young and do not have any critical condition being faced, it increases the chances of getting a better senior citizen health insurance policy at a lower cost.

  1. No-claim bonus

The number of years one does not claim after purchasing the policy leads to an increase in the sum insured. Almost all insurance policies provide the benefit of a no-claim bonus. The NCB can increase the sum insured amount up to 100% and more.

  1. Waiting period

No pre-existing diseases means no diseases-specific waiting period needs to be served. The initial waiting period of 30-90 days is normal amongst all insurance policies.


Is pre-medical check-up mandatory under a Senior citizen health insurance plan?

No, all insurance companies do not insist on making the customer undergo a pre-medical test. It varies from one insurance provider to another. In the case of regular insurance policies, a pre-medical check-up is compulsory after the age of 45 years. In my personal opinion, it would be better if one opted for such a check-up as it helps the insurance company to give a better estimate of the premium chargeable. If one does not give a pre-medical check-up then the insurance company cannot evaluate the risk clearly and may end up charging more premiums to protect the risk.

What are the best health insurance policies for senior citizens?

The best senior citizen plans may vary as it depends upon what the insured’s objective is. Although based on the goodwill and attractive features of some insurance policies, they would be:
Senior Citizens Red Carpet Health Insurance Policy.
Care Senior Plan.
Oriental HOPE (Health of Privileged Elders) Insurance plans.
HDFC ERGO Health Optima Senior.
ICICI Lombard Health Insurance for Parents.

Are there specific age limits set for entering senior citizen policies?

Yes, some senior citizen insurance plans set specific age limits until when the policy purchaser can opt for coverage. Usually, the entry age is 60 years of age, and the maximum age until when one can enter into a contract with the insurance company is 75 years of age. In some senior citizen plans, the insurance company does not set a maximum age limit that allows individuals to purchase a policy anytime. Another feature offered is also lifelong renewability.

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