health insurance for senior citizens

Health Insurance For Senior Citizens – The Why, How, and What

Being a retired bank manager from a reputed PSU bank, Mr Sudarshan understands how senior citizens’ needs are transformed over the years.

With lifestyle diseases and medical expenses at an all-time high, it can become increasingly difficult for senior citizens to afford basic healthcare. Mr Sudharshan by virtue is a meticulous person, always looking to educate himself on various topics.

In his quest to find the perfect insurance for himself, he made a few observations:

Even though many health insurance companies offer senior citizen plans as part of their product offerings, there are plenty of senior citizens who aren’t beneficiaries of such policies. 

Some important questions to be asked here are: 

  1. Why should senior citizens have health insurance?
  2. How to select the best senior citizen insurance policy? 
  3. What are the best health insurance plans for senior citizens in India?

What is a Senior Citizen Insurance Plan? 

A senior citizen plan refers to a health insurance policy that provides medical coverage to citizens over the age of 60 years. As per the IRDAI (Insurance Regulatory and Development Authority of India) individuals up to the age of 75 years should be able to purchase senior citizen plans. 

Under this policy, older men and women can schedule free medical check-up regularly, and avail financial protection against pre-existing ailments. Having faced his share of health challenges in his retirement years, it seemed to be a must-have for Mr. Sudarshan.

6 Reasons to Buy a Senior Citizen Plan

Here’s why senior citizens must have their medical needs insured:

Medical coverageSenior citizen plans generally cover the medical needs of individuals between 60 to 80 years of age; standard plans only cover upto 65 years. They are also eligible for lifetime renewals.Treatment expensesThis included expenses associated with-Pre-hospitalizationPost-hospitalizationDomiciliary hospitalizationAmbulanceIn-patient & out-patient needsMental health care
Cashless treatmentIf a patient is hospitalised for a minimum of 24 hours at a hospital in their insurer’s network, their medical fees, day care expenses, room charges, etc are covered under the insurance policy. Pre-medical test policySenior citizen plans do not require pre-medical screening; pre-existing illnesses are covered by default. This makes enrollment easier.
No-claim bonusA claim-free term is eligible for discounts ranging from 20% to 100%.Income tax benefitsSection 80D of the IT Act 1961 offers tax exemption benefits of Rs 50,000 or more on the cost of premium. Preventive check-ups make the elderly eligible for an additional rebate of Rs 5,000 per year. 

8 Points to Consider When Buying Senior Citizen Health Insurance Plans

Mr Sudharshan found out that senior citizen plans are usually accompanied with a set of constraints when it comes to premiums, copayments, coverage limits, and waiting periods. He believes it is important to look out for some key points before you buy a senior citizen plan: 

Entry ageFor better coverage, it is advisable to buy a plan at an early age. Generally, the entry age of senior citizen plans falls in the 60 to 80 years range. Medical history & CoverageOpt for comprehensive coverage, keeping past illnesses, current conditions, and potential health risks in mind. Preventive health check-ups, new-age diseases, etc are other factors to consider.
Co-pay & deductiblesLook for plans with the lowest coinsurance, deductibles, and copayments. With no regular income, it can be difficult to afford a large claim sum otherwise. A 10% copayment is standard on average. Waiting periodAn ideal plan would be one where the waiting period for pre-existing conditions is shortest. There is 2-4 years waiting period in most insurance plans.
Sum Insured– Someone with a medical history requires greater coverage. – If you live in a metropolitan area, your expenses will be higher.- Consider the number of insured persons.ExclusionsEvery policy comes with certain exclusions such as self-inflicted injuries, sports injuries, non-allopathy treatments, etc. Go through the policy terms carefully before making a decision.
Hospital networkPick a plan whose network of hospitals are nearby and offer cashless treatments. This is beneficial in cases of emergencies, plus transportation is easier.Claim-settlement ratioAnalyse the claim-settlement ratio of insurers in the last 3 to 5 years to assess their performance. 

5 Best Health Insurance Plans For Senior Citizens in India

Entry AgeMax Sum InsuredWaiting PeriodClaim-settlement ratioBenefits
Bajaj Allianz — Bajaj Allianz Silver Plan46 to 70 years5 lakhsCovered from second year onwards92.24%5% family discount on adding new members
HDFC Ergo — Health Insurance Plan For Senior CitizensAbove 455 lakhsCovered after two years86.52%Tax benefits upto Rs 75,000,Free health checks
Star Health — Senior Citizens Red Carpet Insurance Plan60-75 25 lakhsCovered from second year onwards78.62%Coverage for new-age treatments like robotic surgeries, deep brain stimulation
Tata AIG General Insurance — Medi Senior61 and above50 lakhsCovered after 12 months76.04%Tax benefits upto Rs 75,000,Organ donor coverage
Oriental Insurance — Hope60 and above5 lakhsCovered after 24 months93.96%20% copayment

Senior Citizen Insurance Plans

As an elderly person, Mr Sudharshan realizes that old age is most prone to deteriorating health conditions. He believes it is best that your medical needs are insured when regular income is hard to come by. He’s determined to make an informed decision and encourages you to do so as well.

Do not wait; buy a policy much before you enter senior years. Even though health insurance is available for senior citizens at a late entry age, why wait until one reaches that age? Why not buy health insurance at a younger age? It is advisable that every individual buy health insurance as early as possible.

The reason: with age, the premium will increase. Therefore, if one buys a plan before entering senior years, it is not only more cost-efficient, it also reduces mental stress about health related uncertainties and the financial burdens that it may bring with it.

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2 thoughts on “Health Insurance For Senior Citizens – The Why, How, and What

  1. I was thinking about buying insurance for my grandparents and this helped a lot. Thank you for publishing this awesome article.

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