You need health cover regardless of what you take two at a time - pills or stairs.
You need health cover regardless of what you take two at a time - pills or stairs.
  • Senior Citizen Health Insurance

    Old age brings with itself several ailments that are expensive to treat and care for. Health insurance for Senior Citizens is offered by various insurance companies, specifically for people who are aged 65 years and above. These health insurance schemes readily cover any kind of medical expenses incurred by customers.

    The older we get, the more our physical and mental stress over finances and the ability to afford good healthcare. A senior citizen health insurance plan is designed to offer financial aid for medical treatments to individuals over 60 years of age in their hour of need. Senior citizen health insurance plans offer critical illness cover, cashless hospitalisation, pre-existing disease cover, and a higher sum assured.

    With increasing age comes the additional risk of contracting diseases and falling sick. Since, the later years of an individual’s life are physically more challenging and financially less sound, having a medical insurance scheme to take care of any urgent medical expenditure is a clever move.

    Health insurance schemes for senior citizens/parents offer, various special features like cashless hospitalization, critical illness coverage, specific coverage for diseases like Cancer, Stroke and so on.

    Key Features of Senior Citizen Health Insurance:

    Some of the most significant features of health insurance plans for senior citizens in India are as stated below-

    • Hospitalization cover including medical bills and room charges
    • Cashless Hospitalisation
    • Day Care expenses which arise out of technological advancements
    • Ambulance Charges are covered
    • Pre-existing diseases are covered based on the insurance provider
    • No medical test required before availing medical insurance. This is based on insurance provider
    • Higher sum insured coverage
    • Pre-existing disease coverage
    • Faster and hassle-free settlement

    Best Health Insurance Plans for your Parents:

    Following are the most popular senior citizen health insurance plans in India:

    Insurance Company Plan Name Features Link to Plan Details
    Bajaj Allianz Silver Health Plan
    • Cashless facility in all of the network hospitals, under the Silver Health plan.
    • Bajaj Allianz Diagnostic centres can be used for a free health check-up after a period of 4 years which are claim free.
    • Extra 5% discount for the family, and a bonus which is cumulative at a 5% rate for every claim free year.
    • Individuals within the age group of 46 years - 75 years are eligible for this plan, after required medical tests
    Details of Silver Health Plan
    New India Assurance Senior Citizen Mediclaim Policy
    • Eligibility for this policy, the individuals should be between the ages of 60 years - 80 years. This can continue up to 90 years if renewed without a break.
    • Pre and post hospitalization charges are covered up to 30 days for pre hospitalization and 60 days post hospitalization.
    • Hospitalization for illness and injuries will be covered and all treatments conducted will be covered as well.
    • All pre-existing ailments and diseases will be covered after the completions of 18 months with the continuous involvement with the company.
    Details of Senior Citizen Mediclaim Policy
    Oriental Insurance HOPE - Health of Privileged Elders
    • The policy will provide the room rates, expenses related to nursing, to the limit of 1% of the sum insured.
    • The policy will include ambulance charges up to Rs. 1000/- or the actual expenses incurred.
    • All doctors, anaesthetist, surgeon, specialists charges are covered under the policy. As well as all the costs related procedures they will need to perform. Example, blood, oxygen tanks, surgical appliances, Dialysis, Chemotherapy, Radiotherapy etc.
    • If the insured individual will need intensive care, then intensive care unit will be covered to a limit of 2% of the sum insured per day.
    Details of HOPE
    United India Insurance Senior Citizens
    • The policy will cover hospitalization for room and boarding expenses and expenses related to nursing to the limit of 1% of the sum insured or the actual expenses incurred whichever is less.
    • All doctors, anaesthetist, surgeon, specialists charges are covered under the policy. As well as all the costs related procedures they will need to perform. Example, blood, oxygen tanks, surgical appliances, operation theatre charges, x-rays etc.
    • Pre and post hospitalization charges are covered up to 30 days for pre hospitalization and 60 days post hospitalization.
    • For Cataract, Hernia, and Hysterectomy – the coverage will be 25% of the sum insured or the actual expenses incurred whichever is less.
    Details of Senior Citizens
    Star Health Insurance Senior Citizens Red Carpet
    • Individual eligible for this policy is anyone between the age group of 60 years - 75 years. And they will not require a pre medical test for this policy.
    • Sum assured ranges from Rs.1,00,000 to Rs.10,00,000 lakh.
    • A minimum of 24 hours of hospitalization at the in-patient, including expenses related to the room rent, nursing, boarding, doctors, anaesthetist, surgeon, specialists charges etc.
    • Pre and post hospitalization charges are covered, as well as ambulance costs, as specified.
    Details of Senior Citizens Red Carpet
    Religare Care Freedom
    • Minimum entry age is 18 years for adults and upper age has no limit. The scheme offers life-long renewability
    • All customers, irrespective of their age are eligible to avail this medical insurance policy without going for a medical check-up. Medical screening is not mandatory to avail this insurance scheme
    • All members of the scheme are eligible to get coverage for annual health check-up
    • Cashless treatment and quick claim settlement are major highlights of the Care Freedom Policy
    • Sum assured gets recharged automatically if the coverage limit is exhausted as a result of any claim made
    • Any pre-existing disease disclosed attracts a waiting period of just 2 years
    Details of Care Freedom

    Myths about Senior Citizen Health Insurance:

    There are several myths surrounding health insurance for senior citizens. Even at this age, many people do not purchase health insurance for their parents or in case of a senior citizen, for themselves because of certain misconceptions. Given below are some myths about health insurance that need to be broken and rules that need to be followed while purchasing health insurance for your parents:

    • Group insurance is sufficient:

      This is a very common misconception many people have about health insurance. Many believe that the mediclaim group insurance offered by the company will provide enough cover for their parents. Many employees have been rationalising the cover in order to reduce the steep premium and some of them have taken a step further to exclude parents from the policy. It is very important to not rely on just mediclaim policies to offer health cover to your parents.

    • Pre-existing conditions:

      It is true that most of the health insurance policies do not cover pre-existing ailments, especially when it senior citizens. Because of this very reason, many shy away from opting for a health insurance policy as they are under the impression that a pre-existing ailment might make their parents ineligible for a health insurance policy. But a lot of health insurance policies still offer cover if the ailment is not critical or terminal.

    • Insufficient coverage:

      Many consider health insurance policies to be useless as they do not offer cover for certain existing conditions. While this is true, almost all of the health insurance policies have a waiting period of four years after which existing diseases are covered. But your parents will still be covered for hospitalisation charges in the first four years for other ailments and accidents.

    • Higher cost:

      It is true that health insurance can be slightly more expensive for senior citizens but that should not discourage one from purchasing a health insurance policies. There are many senior citizen health insurance policies in the market that won’t pinch your pocket and offer adequate health cover to your parents.

    • Healthy and fit:

      Though your parents might be in their best shape and have no existing ailments, unforeseen circumstances such as age related ailment or a certain illness can hamper their health any time. It is very important to have health insurance for your parents even if they are fit and healthy.

    Key Points to Follow while Buying Health Insurance for Parents:

    Listed below are some of the key points that one needs to follow while purchasing senior health insurance policy for their parents.

    • Medical history:

      It is important not to rely on your parent’s knowledge of their medical history when it comes to opting for health insurance. Your parents might not be aware of certain ailments or medical conditions that they might be suffering from. Health insurance providers require you to provide information about existing health ailments that your parents have and are aware of. Hence, it is very important to be thorough with the information you provide regarding the medical history of your parents.

    • Choosing the plan:

      There are several factors that go into choosing the right health insurance policy. It is important to compare between the various health insurance plans available in the market and consider factors such as cover, cost and exclusions before zeroing in on the final right plan.

    • Filling the proposal form:

      Once you’ve chosen the right policy, you’ll need to fill in the proposal form for the policy. It is imperative that you provide correct and relevant information while filling in the form. Providing incorrect information will not only lead to complications but it might also lead to rejection of the application.

    • Medical check-up:

      Once you’ve submitted the proposal form, a doctor on the panel of the insurance company will go through it will conduct an interview to verify the information on the form regarding the medical conditions mentioned on it. Next comes the medical check-up, the doctor will conduct about 11-13 tests depending on the health condition of the individual. Blood routine, lipid profile, sugar, urine routine, liver function test, kidney function test, serum creatinine, PSA (for men), sonography (for women) are some of the tests conducted.

    Who Should Buy Health Insurance Plan for Senior Citizens?

    Health insurance plans for senior citizens are aimed basically at individuals who are above 60 years of age and are retired with no regular income. This type of health insurance can also be availed by children for their ageing parents.

    What to do if the proposal is declined?

    In case the insurance company rejects the health insurance proposal for your parents, there are two things you can do:

    1. If you have doubts about the medical check-up conducted, you can get another medical check-up done by another doctor and submit the reports to the insurance company. If the insurance company is satisfied with the results the insurer might reconsider your application.
    2. In case of rejection, you can always approach another health insurance provider. If you apply for health insurance with the second insurer within thirty days of applying for the first one, you can provide the medical check-up documents obtained from the first insurer to the second insurer.

    Advantages of a Senior Citizen Health Insurance Plan:

    Following are the benefits of availing a senior citizen health insurance scheme for your parents –

    • Tax benefit on medical insurance premium
    • Avail treatment and medical facilities across a host of hospitals across the nation
    • Enjoy Cashless treatment and daily allowance (depends on insurer)
    • Renewal of policy option
    • Domiciliary Hospitalization cover
    • Enjoy free-look period
    • Avail health check-ups annually
    • Reload of sum insured

    Exclusions - What is not covered under Senior Citizen Medical Insurance?

    Here are some of the most frequent clauses that are not covered under the senior citizen health insurance plans –

    • Any pre-existing injuries/diseases
    • Any diseases contracted within 30 days of availing the policy
    • Any non-allopathic treatment
    • Expenses related to self-inflicted injuries
    • Expenses as a result of drug abuse
    • Cost of spectacles/lenses and dental treatment (except arising out of accident)
    • Medical expenses incurred for treatment of AIDS
    • Certain ailments like joint replacement etc. are covered only after 2 years of availing the policy
    • Cosmetic surgery
    • Injury due to war, act of foreign army etc.

    An Example:

    Ashok is a software engineer with regular income of Rs. 90,000 per month. His parents are aged above 60 and are healthy except for certain mild ailments. However, Ashok has two kids who are studying in school. Ashok’s wife is a homemaker with no income of her own. Considering Ashok’s position it would be best for him to take a health insurance plan for his parents so as to avoid any sudden medical expense that might arise. On the other hand, he also needs to be aware that hefty premium amounts is not something that he can afford. It would be best if Ashok goes for a medical insurance that will take care of all old-age related issues like diabetes, blood pressure and coronary diseases. A plan that requires a payment of around Rs.5,000-6,000 per month is ideal for Ashok.

    On the other hand we have Ashok’s colleague, Suresh who has availed health insurance for his father at Rs.9,000 per month. However, the total monthly income of Suresh is almost double the income of Ashok since Suresh’s wife also has a job. Also, Suresh has just his father to take care of while his mother had passed away when he was quite young. To sum up, it would be safe to say that while health insurance for senior citizens is a compulsory thing to have, the type of insurance one avails is dependent on several factors like –

    • Financial Status
    • Regular income amount
    • No. of dependents
    • Health of dependents

    Popular Senior Citizen Health Insurance Plans Available in India:

    Looking for a suitable health insurance plan for individuals over 60? Here is a list of popular senior citizen health insurance plans available in India:

    Senior Citizen Health Plan Features
    Star Health's Red Carpet
    • Sum insured - Rs.1 lakh to Rs.5 lakh
    • Entry age - 60 to 75 years
    • Renewability - Lifetime renewability
    • Co-payment - 30-50%
    • Critical Illness cover - available
    • Waiting period for pre-existing disease cover - 1 year
    Apollo Munich's Optima Senior Health Plan
    • Sum insured - Rs.2 lakh to Rs.5 lakh
    • Entry age - Minimum 61 years
    • Renewability - Lifetime renewability
    • Co-payment 15-30%
    • Waiting period for pre-existing disease cover - 3 years
    New India's Senior Citizen Mediclaim Policy
    • Sum insured - Rs.1 lakh to Rs.1.5 lakhs
    • Entry age - 60 to 80 years
    • Renewability - Up to 90 years
    • Co-payment - Voluntary payment
    • Critical Illness cover - available
    • Waiting period for pre-existing disease cover - 18 months
    ICICI Lombard's iHealth Plan
    • Sum insured - Rs.1 lakh to Rs.10 lakh
    • Entry age - No maximum entry age limit
    • Renewability - Lifetime renewability
    • Co-payment - Voluntary payment
    • Critical Illness cover - available
    • Waiting period for pre-existing disease cover - 4 years
    National Insurance's Varishtha Mediclaim
    • Sum insured - Rs.1 lakh to Rs.2 lakh
    • Entry age - 60 to 80 years
    • Renewability - Up to 90 years
    • Co-payment - 10%
    • Critical Illness cover - available
    • Waiting period for pre-existing disease cover - 1 year

    Things to Keep in Mind When Buying Senior Citizen Mediclaim Policy for Your Parents:

    If you are a senior citizen or you want to buy a health insurance policy for a parent who is a senior citizen, keep the following 5 things in mind when choosing a suitable health cover for people over 60:

    • Compare the features of various plans: The chosen health insurance policy must cover the individual's specific needs such as chemotherapy, organ donation, dialysis, etc. Make sure to check for features such as sub-limit on room rent and consultation charges, and co-pay. If the sub-limit is low or the co-pay is high, you may end up paying a higher amount out of your pocket.
    • Choose a high sum assured: Take medical inflation and medical uncertainties into account when choosing the sum assured which is the total amount for which you or your parent will be insured.
    • Make a note of the waiting period: Considering the age of the senior citizens, it is safe to say that a lower waiting period for pre-existing disease cover is more conducive. Choose a plan with a lower waiting period so that the insurance cover can come in handy when the life insured needs it the most.
    • Separate policies for parents: It is advisable not to include parents who are senior citizens in the family floater plan as the premium is based on the eldest member of the family. Not only that, even the renewal age is dependent on the age of the eldest member. While the entire family shares the sum assured, it could be utilised by a parent in one claim.
    • Co-payment: Most insurers offer senior citizen health insurance plans with a co-payment option which essentially means, the policyholder will bear a part of the medical expenses. Co-payment is usually minimum 20% of the claim amount. However, some insurers offer a reduction in co-payment for every renewal.

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

    With the steady rise in healthcare costs, it can be difficult for senior citizens to pay their medical bills. Over the years, life expectancy of an average Indian citizen has increased with improved and advanced healthcare products and services. Senior citizens who don't have a stable income may not be able to afford timely and adequate healthcare. This is why, a senior citizen health insurance policy will come in handy. Here is a guide on how to select the right mediclaim policy for people over 60:

    • Entry age: When comparing various health insurance policies, choose one that has an entry age of 60 to 80 years, so that you can buy a health cover for your parents even after they have crossed 60.
    • Renewal age: Check the maximum renewal age of the policy which is the age till which one can renew the health insurance policy. Choose a policy with the maximum renewal age.
    • Insurance coverage: Ensure the health insurance policy offers coverage against a large number of illnesses including pre-existing conditions. Such illnesses are covered after a long waiting period, so choose a policy with a lower waiting period and a wider coverage of illnesses including medical conditions like diabetes, cancer, etc.
    • Sum assured: Private insurance companies offer a higher sum assured on mediclaim policies for senior citizens compared to public sector insurers. A higher sum assured is preferable as it will largely cover the individual against medical emergencies.
    • Network hospitals: Choose an insurer with a high number of network hospitals, particularly in your location. In the case of a medical emergency, your parent can avail cashless hospitalisation in one of the network hospitals in the vicinity.
    • Insurance premium: As the insurance premium of a policy is dependent on the age of the individual, the insurance premium for a senior citizen will definitely be high. Opt for an individual senior citizen health insurance plan instead of a family floater plan.

    When selecting a health insurance policy, it is important to first assess the insurance requirements of the individual, take his or her medical condition into account, compare various policies from top insurance providers in the country, and finally, read the policy document carefully for inclusions, exclusions, waiting period, and claim process.

    Understanding Health Insurance for Senior Citizens - FAQs:

    1. What is meant by health insurance for senior citizens?

      Getting health insurance as one becomes old is increasingly difficult, hence companies have come up with separate health insurance categories for people above 60 years of age. These insurance schemes are costlier than the regular health insurance policies.

    2. What should I watch out for before availing health insurance for senior citizens?

      Here are a few significant points to note to before availing health insurance for senior citizens –

      • Renewal Age limit
      • Entry-Exit age
      • Co-pay option
      • Domiciliary Treatment Option
    3. Why do senior citizens need health insurance?

      With increasing age, health tends to deteriorate at a more rapid rate while regular income tends to decrease as a result of retirement. To take care of medical expenses during this stage of life health insurance for senior citizens is an important tool.

    4. Are premiums for senior citizen health insurance schemes costlier than normal health insurance policies?

      Yes. Since the age of the insured matters while purchasing health insurance, insurance for the elderly comes at a higher premium.

    5. Why do I need health insurance?

      With the steady rise in healthcare costs and lifestyle diseases, it can be difficult to pay medical bills out of your pocket. This is why, a health insurance policy will come in handy, so that you and your family can get timely and adequate healthcare for planned and emergency hospitalisation and various medical treatments.

    6. What is the difference between a family floater and critical illness or hospital cash insurance?

      • Family floater plan: This type of plan covers the hospitalisation costs of the entire family which includes self, spouse, children, and dependent parents during the policy term.
      • Critical illness plan: This type of plan pays a lump sum amount to the policyholder upon the diagnosis of a specified critical illness of the insured member regardless of whether treatment is taken for the critical illness.
      • Hospital cash plan: This type of plan offers a daily cash of up to Rs.4,000 per day to the insured member for non-medical expenses for the duration of his or her hospitalisation.
    7. Why is it necessary for me to disclose my current health status correctly and accurately while I buy a health insurance policy?

      It is important to disclose the medical condition such as a pre-existing disease or condition of the insured member at the time of policy inception in order to avoid any hassle when making a claim at a later date. Insurance companies have the right to terminate a policy or reject a claim on the basis of the policyholder’s misrepresented or falsified data.

    8. What is beneficial for me - floater insurance or an individual insurance?

      Depending on your age and medical condition, you can opt for either an individual insurance or a floater plan. If you are young and the eldest member in your family is below 60 years of age, then opt for a family floater plan to cover the entire family under a single policy. If you or your parents are above 60 years of age, opt for an individual policy so as to get a higher sum insured/coverage against medical emergencies.

    9. How does a floater cover work?

      An entire family is covered under a single policy in the case of a family floater plan. Insured members can be self, spouse, children, and dependent parents who share the sum insured while paying a single premium. The premium and maximum renewal age is dependent on the age of the eldest member.

    10. How does the auto-recharge work?

      If the sum insured is exhausted by an insured member in one claim in a policy year, then the insurer will automatically recharge the base sum insured at the time of renewal. Auto-recharge happens only once in a policy year.

    11. Do I need to undergo a medical checkup while buying a health insurance policy?

      Individuals above 45 years of age have to undergo a pre-policy medical test. Pre-policy medical checkup is necessary for all senior citizen health plans.

    12. How do I cancel my health insurance policy?

      During the free-look period, if you have any objections to the terms and conditions of the policy, you can return the policy and get a refund of the premium paid with certain deductions like stamp duty charges. Submit a duly-filled surrender form at the nearest branch office along with the policy documents.

    13. What is co-payment?

      Co-payment is the portion of the claim amount that has to be paid by the policyholder. A co-payment percentage is decided upon at the time of policy inception. Co-payment can bring down the insurance premium amount. However, a high co-payment suggests that you will end up paying more out of your pocket for medical expenses. Most senior citizen health insurance plans come with co-payment option.

    14. Do companies offer free annual health checkups in health policies?

      Yes, most insurers offer a free health checkup for every block of claim-free year.

    15. Who will bear the cost of pre-insurance medical checkup and where will it be conducted?

      Some insurance providers bear a part of the pre-insurance medical checkup and arrange for the test to be conducted at one of their medical facilities. However, in most cases, the policyholder will have to bear the cost of the pre-policy medical checkup.

    16. What are continuity advantages available in health insurance?

      Waiting period for pre-existing disease cover and no-claim bonus are the continuity benefits available in health insurance. Health insurance portability allows a policyholder to port a policy from the existing insurer to a new insurer without losing out on the continuity benefits.

    17. Do all insurance companies offer cashless hospitalisation?

      With the robust competition between public, private and standalone health insurance companies in India, almost all insurers provide cashless hospitalisation at one of their network hospitals.

    18. What are the things to look out for in a senior citizen health insurance plan?

      Entry age, renewability age, sub-limit, pre-existing disease cover, specified illness cover, sum insured, co-payment, and premium are some of the important things to look out for in a senior citizen health insurance plan.

    19. Do I need to go through medical screening before purchasing a health plan?

      Medical test is not required for individuals below 45 years of age with no medical history. However, it is advisable to have medical test done before purchasing the policy in order to disclose your medical condition to the insurer and assess your insurance requirements.

    20. What is senior citizen health insurance plan? Why do I need it?

      Senior citizen health insurance is designed for individuals above the age of 60. It covers hospitalisation expenses of the insured member during the policy term. With the steady rise in healthcare costs, it can be difficult for senior citizens to pay their medical bills. Over the years, life expectancy of an average Indian citizen has increased with improved and advanced healthcare products and services. Senior citizens who don't have a stable income may not be able to afford timely and adequate healthcare. This is why, a senior citizen health insurance policy will come in handy.

    21. Documents required for senior citizen health insurance?

      • Pre-policy medical checkup documents
      • Duly-filled proposal form
      • Supporting documents for any pre-existing condition
      • Age proof

    You may also be interested about:

    Health Insurance Plans for Individuals
    Family Floater Health Insurance Policies
    Group/Corporate Health Insurance
    Critical Illness Insurance Plans
    Cashless Health Insurance Policies

    News About Senior Citizen Health Insurance

    • Government working on a health insurance scheme for senior citizens

      Government is planning on introducing a cashless health insurance scheme for the senior citizens which will be announced in the forthcoming budget. The scheme will help in meeting secondary and tertiary health care needs. EPFO and small saving scheme will be used to provide health cover to the senior citizens. The coverage for the persons above 60 years will be more than Rs.50,000. The scheme will be administered by the Department of Financial Services under the finance ministry. Premium will be subsidised for those below the poverty line.

      24th February, 2016

    GST rate of 18% applicable for all financial services effective July 1, 2017.

    Disclaimer: Premiums may vary depending upon factors like age, location and prevailing taxes/GST.

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