Health Insurance for Senior Citizens

The need for adequate health insurance is not just important during the working life, it is also quite essential after one retires. The chances of contracting diseases also become higher with the old age that requires the medical care on a frequent basis. The medical treatment could be expensive for senior citizens, as the regular income usually stops and they have to pay the medical bills as out of pocket expenses payable from their savings. To cope up with this scenario, senior citizen health insurance plans come in handy.

A senior citizen health insurance plan is designed to cater to the health-related needs of elderly people.  It serves as a financial guard against medical expenses that incur due to unforeseen medical emergencies. You only need to pay the premium each year to the insurer to get the sum insured which will meet high medical costs during hospitalization. This type of health plan can be availed by the ones who have acquired at least 60 years of age.

Reasons to buy a Senior Citizen Health Insurance Plan

There are some compulsive reasons that urge you to go ahead for buying a senior citizen health plan for your own self (if you are 60 years) or for your kids.

Prone to illnesses: Growing older comes with serious illnesses that require urgent and frequent medical attention that may cost huge. Having a senior citizen health plan helps you to cover the medical expenses and ensures financial guard against medical exigencies as well.

Focused health plan: A regular health plan may not be able to cover the health care needs of seniors. Buying a senior citizen health plan helps to take care of all the health care needs of those aged 60 years and above.

Alarming health care cost: The medical treatment cost is rising at a rate of around 15% annually, which shoots up the medical bills. When a senior citizen goes for medical care, it requires him/her to pay a huge amount towards the treatment cost. A senior citizen health plan pays the medical expenses incurred and you don’t need to worry about the medical bills.

Financial freedom: People at the age of 60 years and above have no or limited source of income. They may become financially dependent on their children. In case of sudden illness, they have to rely on their children to pay off the medical bills. By having a senior citizen health plan, seniors can easily pay off their medical expenses and make them feel a sense of financial independence.

No health cover from employer: During the working life, you must have covered by a group health policy from your employer. However, after retirement, you would not be covered by any health plan from the employer. Having a senior citizen health plan comes to the rescue. It covers the medical expenses in the event of medical emergencies when you don’t have an employer based medical insurance support.

Health Insurance for Senior Citizens

Coverage under Senior Citizen Health Insurance:

In-patient hospitalization expenses: A senior citizen health plan offers coverage towards the medical expenses incurred upon hospitalization for more than 24 hours. It usually covers room rent, ICU charges, nursing, medical practitioner, surgical appliances, operation theater charges, etc.

Pre-hospitalization expenses: Expenses related to your medical treatment when incurred before the actual hospitalization is covered for 30 days to 60 days, as specified under the plan. It may include doctor’s visit, cost of medicines, laboratory tests, etc.

Post-hospitalization expenses: Expenses related to your medical treatment incurred after discharge from the hospital is covered for 60 days to 180 days, as specified under the plan. It usually includes, follow up with doctor, medicines, diagnostic tests, etc.

Day care procedures: Certain procedures/ treatments don’t require 24 hours of hospitalization because of technological innovation, are also covered. Every insurer specifies the number of day care treatments covered under the senior citizen health plan.

Domiciliary treatment: The medical treatment when taken at home under medical advice which otherwise requires hospitalization is covered under the senior citizen health plan.

Hospital daily cash: A fixed amount as hospital cash allowance is payable on a daily basis, depends on the policy terms. This cash benefit can be utilized to meet expenses that are not covered under the health plan.

Organ donor: Medical expenses incurred towards the treatment of the organ donor during an organ transplant are covered.

Ambulance cover: Expenses incurred towards ambulance service, when used to carry the insured to the hospital for hospitalization. The amount covered depends on the terms specified under the policy.

(The benefits specified may differ and it depends on the terms specified under the plan chosen.)

Tax Benefits under Senior Citizen Health Insurance Plan

Upon paying the premium amount under the senior citizen health plan, you can avail a tax deduction of Rs 50,000 (w.e.f 1st April 2018). Till financial year 2017-18, this limit was Rs 30,000. If you are paying the premium for a senior citizen (yourself, spouse & parents), you are eligible to avail the tax benefit under section 80D of the Income Tax Act 1961.

How to choose the best Health Insurance Plan for Senior Citizens?

Adequate sum insured: Due to ill health, senior citizens need frequent medical attention that increases medical bills. So when you are seeking a senior citizen health plan, it is essential to primarily assess the health condition of the person you are buying the plan and also consider the factor of health uncertainty while judging an adequate sum insured for a senior citizen. It is advisable to choose a right sum insured under the plan, considering health condition, treatment & surgery costs, medical inflation, etc.

Illnesses covered: People at an old age have higher chances to have some pre-existing illnesses. When going to buy a health plan for seniors, firstly you should get a medical screening to ascertain the illnesses they are suffering from and then check the number of illnesses that are covered under the health plan, you want to buy. Make sure the health plan you choose, offers coverage for all existing illnesses and major illnesses as well.

Age limit: Most of the insurers offer senior citizen health plan who are aged 61 years or above. Some insurance companies offer health plans for senior citizens aged up to 80 years. Some plans have restricted entry age and some plans put no age restriction for buying the health plan. It’s thus advisable to compare different health plans and choose the one which fulfills your criteria. You should choose a senior citizen health plan that offers coverage from your current age to the maximum number of years possible.

Renewal: For senior citizens, health policy renewal is a crucial factor that you should consider before buying. You need to check the age up to which the health plan you want to buy can be renewed. Different plans have different age limits for renewal. You need to choose the one, considering your age and health conditions. It’s advisable to pick a health plan that offers lifetime renewability, so you remain covered for your entire life.

Co-payment: It refers to a percentage of the claim amount that will be borne by the insured and the rest of the amount will be paid by the insurer. People usually opt for co-payment while buying the policy, as it will reduce the premium amount. However, with a co-payment clause you might not get a complete coverage against specific illnesses.

Waiting period: Insurers usually offer coverage for pre-existing illnesses or other specified illnesses after some waiting period. When it comes to buying a health plan for senior citizens, you need to check the waiting period and pick a plan that has a lesser waiting period.

Senior Citizen Health Insurance Plans from Insurers

Plan Name Entry Age Sum Insured Pre Existing Diseases Co- Payment Pre & Post Hospitalization
Star Health Senior Citizens Red Carpet Health Plan 60 to 75 years 1 Lakh to 10 Lakh Covered after 1 year Applicable Post hospitalization as lump sum
Apollo Munich Optima Senior 61 years & above 2 lakh to 5 lakh Covered after 3 years Applicable 30 & 60 days
Tata AIG MediSenior 61 years & above 2 lakh to 5 lakh Covered after 4 years Applicable 30 & 60 days
Bajaj Allianz Silver Health Plan 46 to 70 years Rs 50,000 to 5 Lakh Covered after 1 year Applicable Up to 3% of admissible hospitalization expenses
Religare Care Freedom 46 years & above 3 Lakh to 10 Lakh Covered after 2 years Applicable Up to 10% of payable Hospitalization expenses

Premium for Senior Citizen Health Insurance Plans

The cost of senior citizen health insurance plan is usually higher as compared to a normal health insurance plan. The reason being that the probability of getting a claim in a policy is higher for the people beyond 60 years of age. Also, it is a customized health insurance plan for senior citizens with special peculiar benefits and features. So, the pricing or premium is done accordingly by the insurers. However, another aspect is that in the absence of a health insurance at advanced age will put drench your accumulated savings in case of any illness for the medical treatment and allied expenses.

Plan Name Premium (in Rs)
SI: 5 lakh SI: 7 lakh SI: 10 lakh
Star Health Senior Citizens Red Carpet Health Plan 21,240 24,780* 26,550
ICICI Lombard Complete Health Insurance 31,743 34,245 36,897
Religare Care Freedom 23,939 31,102 36,846

(Premium is calculated for age band of 60-65 years based on different sum insureds of 5, 7 and 10 lakh. * This premium amount is calculated for 7.5 lakh SI.)

Final Thoughts

Senior citizen health insurance plans offer coverage against medical expenses incurred by individuals over 60 years of age. When you are buying a health plan for senior citizens, it is essential to check whether the insurance company offers cover for pre-existing illnesses and critical illness. You should also disclose all your medical condition at the time of buying the policy that would help you to avoid any hassle while making a claim.

Harjot Singh Narula

Harjot Narula is founder and CEO of ComparePolicy.com, an IRDAI approved insurance web aggregator focussed on selling online insurance for companies. Harjot has more than a decade of experience in software development and has also spent 5 years in US working for the mortgage and risk management industry.

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