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Senior Citizen Health Insurance

Health insurance for senior citizens

Previously, not many options for health insurance for senior citizens were available for people aged 60 and above. Also, there used to be limited options for people with chronic or persisting ailments. Ho

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Written by

Alok Mishra

Insurance Writer

Alok Mishra is a Digital and Content Marketing specialist with 10 years of experience. He has spearheaded Web Content, Social Media & Branding, and Community Building initiatives to drive growth for prominent brands.

Reviewed by

Bhaskar Sinha

Insurance Expert

8+ years of experience in Life Insurance with expertise in Developing Life and Health Products, Digital Sales, Conducting effective trainings and Key Account Management.

What is a Health Insurance Plan for Senior Citizens?

Senior citizen health insurance plans are exclusively offered to individuals aged 60 and above. Some insurance providers set a maximum entry age, such as 65 or 85 years; however, insurance providers offer lifelong coverage with their senior citizen plans.

With such a policy, senior citizens can avail coverage for critical illnesses, treatment of pre-existing diseases, and free annual health check-up facilities. In today’s era of rising healthcare costs, a health insurance plan is definitely a boon for all.

What are the Features and Benefits of Senior Citizen Health Insurance?

Here are the features and benefits of health insurance for senior citizens that you should be aware of:

• Entry & Exit Age

It allows older people to get insurance coverage for a longer period than usual. For example, several senior life insurance policies provide coverage up to the age of 85 or even 100 years. The term of the plan can be renewed for a lifetime.

• Renewability

There are many health insurance companies that limit renewals for aged policyholders; this prevents them from renewing their coverage after a certain period of time. Senior citizens should take this point into consideration when deciding between health insurance plans.

• Cashless Claim

The existence of a cashless claims service provides older adults and their families with a significant sense of financial stability. This is due to the fact that insurance companies significantly reduce the financial burden of seniors by paying the majority of hospitalisation costs.

• Waiting Period

The waiting period in a health insurance policy is the time period for which a policyholder is supposed to wait before availing any of the benefits. The waiting period for senior citizen health insurance plans is kept to a minimum; this way, they can quickly apply for coverage of medical expenses without having to endure long waiting times.

• Pre-Existing Diseases Coverage

Shorter waiting times for pre-existing conditions, including hypertension, diabetes, and asthma, among others, are the biggest benefit of senior health insurance. Pre-existing waiting periods for these insurances typically range from one year to a maximum of three years.

• Hospitalisation Coverage

Most hospitalisation expenses, including ambulance service expenses, in-patient and out-patient expenses, modern medical treatments, and other expenses such as room rent, nursing services, fees for doctors, and medication costs (up to the pre-determined limits), are fully covered by health insurance for the elderly.

• Tax Benefits

According to Section 80D of the Income Tax Act, the elderly can get tax benefits for premium payments made towards health insurance. Senior citizens are eligible for an annual tax deduction of up to Rs. 75,000 in a fiscal year on the premiums paid.

• Pre and Post Hospitalisation Expenses

The senior health insurance covers medical expenses incurred before and after a hospital stay, unlike in the case of a normal mediclaim policy which only covers hospitalisation expenses.

• Added Perks

It includes other benefits like AYUSH treatment coverage, food and nutrition counselling, online counselling, and telemedicine consultation, which can be very helpful for seniors who prefer alternative health practices.

A senior health insurance plan also offers a number of cost reductions, such as no-claim bonuses, renewal incentives, savings on long-term plans, and discounted physical health costs. These benefits help reduce the price of health insurance premiums for senior citizens.

How to Choose the Right Senior Citizen Health Insurance Plan?

While planning to purchase a suitable senior citizen health insurance policy, you should consider the following aspects:

1. Sum Insured

Keeping in mind the rising cost of healthcare, you should choose a higher sum insured when choosing your coverage limit. Your funds may get depleted if you do not have sufficient health insurance to cover medical expenses. Therefore, it is recommended to start with a higher sum insured.

2. Waiting Period for Pre-Existing Ailments

When choosing senior health insurance, choose policies without medical exams and those with short waiting periods for pre-existing conditions. This guarantees financial stability in retirement and ensures peace of mind.

3. Wide Hospital Network

Choose insurance with a wide network of hospitals for better future healthcare alternatives and quick access to treatment. Check whether the hospitals in your locality are covered before purchasing.

4. Critical Illness Coverage

For the most benefits with the least restrictions, seniors should choose a health insurance plan that offers complete coverage, including critical illness.

5. Co-Payment/ Deductibles

A deductible is when the insured and the insurer split the cost of an approved claim, with the insured paying a portion and the insurer footing the bill for the remainder. This provision is included in many insurance policies for seniors.

Some insurance plans provide the insured with the option of choosing a deductible. The insurance premium is reduced when the deductible is chosen, but part of the risk of the insured event must be borne by the insured. Deductible policies vary from insurer to insurer, so it's important to choose the plan that best suits your needs.

6. Out Patient Coverage

Many individuals focus on inpatient insurance, but outpatient costs such as tests and consultations are just as significant as inpatient. These costs can be very expensive, especially for seniors who often pay out of pocket.

That's why choosing insurance that includes outpatient care is essential, especially for people with chronic conditions who need to see a doctor often.

7. Premium

Health insurance premiums are affected by an individual's health, with seniors often paying more due to greater health risks. Although some features can lower premiums, coverage and prices vary among insurance companies. To get more affordable insurance, it is important to compare contracts from multiple providers.

What are the Inclusions & Exclusions of Health Insurance for Senior Citizens?

Not all medical-related expenses are usually covered under a senior citizen health insurance. Check out the inclusions and exclusions below and stay informed:

What is Covered in a Senior Citizens Health Insurance?

Day-care procedures include treatments requiring less than a 24-hour hospital stay, such as radiotherapy, chemotherapy, and dialysis
Costs associated with hospitalisation, including expenses such as room charges, physician charges, ICU charges, nursing services, and drug costs
Cost of AYUSH (Ayurvedic, Yoga and Naturopathy, Unani, Siddha, and Homeopathy treatment) in a recognised medical facility
Innovative treatments such as immunotherapy, stem cell therapy, robotic surgery, and balloon sinuplasty
Costs incurred before and after hospitalisation
Financial expenses associated with organ donors
Charges for road and air ambulance service for hospital transport
Free annual health check-up services

What is NOT covered in a Senior Citizens Health Insurance?

Injuries during adventure sports/activities
Self-imposed injuries
Injuries related to military service or defence-related activities
Costs associated with hospitalisation that do not have a doctor's consent
Medical procedures to address weight problems or for cosmetic enhancement
Expenses for dental treatment other than those resulting from accidental injuries

FAQs about Senior Citizens Health Insurance

Can a 75-year-old get health insurance?

What is the entry age for purchasing a senior citizen health insurance policy?

Is there any tax benefit when buying a senior citizen health insurance plan?

Does senior citizen health insurance plan offer co-payment options?

ARN No: Dec23/Bg/15P

Source:

incometaxindia.gov.in/tutorials/20.%20tax%20benefits%20due%20to%20health%20insurance.pdf

www.forbes.com/advisor/in/health-insurance/health-insurance-for-senior-citizens/

economictimes.indiatimes.com/wealth/insure/health-insurance/health-insurance-for-senior-citizens-how-to-pick-the-best-insurance-policy/articleshow/88727168.cms?from=mdr

mintgenie.livemint.com/news/personal-finance/6-key-points-to-check-before-buying-health-insurance-for-senior-citizens-151692596100247

www.ndtv.com/business/partner-content/key-things-to-check-before-buying-health-insurance-for-senior-citizens-4101771

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