Health insurance is a must for senior citizens, because health risks increase substantially with seniority. Increased health related risks and expenses associated with it, coupled with lower income during retirement, make health insurance one of the most necessary aspects of financial planning for senior citizens.

Health insurance plans for senior citizens are basically for 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 senior citizens or by their children on behalf of them.

How to compare and purchase senior citizen health insurance plans?

Listed below are some of the key points that one needs to follow while choosing and purchasing senior health insurance policy. They are:

Sum Insured:Health cover or sum insured is an important consideration in choosing a health insurance policy. Senior citizens need higher cover to protect their health, as they are at a higher risk of health related disorders.

Premiums: Premiums are an important thing to consider.Premiums charged by the private sector insurers are generally higher compared to the premiums charged by the public sector insurers.

Co-payment:Health insurance for senior citizens comes with a co-payment clause. In other words, the insured needs to share a portion of the medical expenses incurred by them. Co-payment policies differ for insurer to insurer.

Waiting period for pre-existing medical conditions:This is the waiting period before a claim can be made for a pre-existing medical condition (recognized in the policy). This is an important factor for senior citizens because the risk of illness and consequent hospitalization due to a pre-existing medical condition is more for them.

Medical check-up:Some insurers require medical check-ups to be done before they issue health insurance policies.

A few other variables to consider are :

 Maximum age for renewal

  • Entry and exit age
  • Exclusions
  • Critical illness cover
  • Domiciliary hospitalization

 

Advantages of Senior Citizen Health Insurance Plans

A Senior Citizen Insurance Plan offers benefits to a policyholder. A few are:

  1. Financial Cover : Health Insurance policies ensure that one is protected from unexpected and high medical expenditure. They cover a wide variety of illnesses and their related treatments.
  2. Renewability :These policies can not only be taken at the maximum age of 65 but can be renewed too up to the age of 80. Few companies allow policies to be renewed up to the age of 90 years, provided there has been no break in payment of premium since the policy was first taken.
  3. Cashless Hospitalisation : Most companies that offer insurance plans to senior citizens allow cashless transactions where the hospital can claim payment for the treatment given directly from the insurer.
  4. Tax Gain : Under section 80D of the Income Tax Act, one can claim deduction for an annual premium amount not exceeding Rs. 30,000 in a financial year.
  5. No Claim Benefit ‘: Most insurance companies offer a ‘No Claim Benefit’ which offers the benefit of discount in premium if there were no insurance claims in the preceding  financial year. Some companies also offer reimbursement for a Health check-up every 3-4 years of ‘No Claim’ in addition to the benefit in premium.

Expenses Covered under Senior Citizen Policies

  1. Hospitalisation Expenses like Doctor visits, room charges, cost of medication and surgery etcsubject to the financial limit of the plan, in some cases pre- and post-hospitalization cover for a specified time period.
  2. Day Care Expenses covering procedures like chemotherapy and dialysis which do not require hospitalization, enlisted as ‘Inclusions’ in most Health Insurance Policies for Senior Citizens.
  3. Pre Existing Illnesses covered by most medical insurance companies, usually after a period of one year from day of taking policy.

  

Exclusions under Senior Citizen Health Insurance Plan

Most Senior Citizen Insurance Plans do not cover the following situations:

  • Illnesses contracted within 30 days of signing up for the policy
  • Dental treatment, except in cases arising out of accident
  • HIV/ AIDS
  • Cosmetic Surgery
  • Vaccination/Inoculation
  • Illnesses contracted in times of war or nuclear attacks.

Some insurers that offer Senior Citizen Health Insurance

A few Good Health Insurance Plans for Senior Citizens in India are briefly discussed below. This should help one to choose from and buy a plan that fulfills one’s insurance needs.

1). Star Health Senior Citizen Red Carpet Plan: If one is looking for an unique plan for aging parents, Star Health’s Red Carpet Policy is an ideal choice.

Features :

  • Covers medical costs due to any disease, sickness, injury or accidents.
  • Covers pre-existing conditions from the second policy year.
  • Minimum waiting period of 12 months,
  • No pre-policy medical check up
  • Cash less treatment in more than 6000 network hospitals.
  • The premiums are very much pocket-friendly considering the benefits on offer

Exclusions :

Expenses on Hospitalization are payable if the patient is hospitalised for a minimum period of 24 hours. However this time limit will not apply for Day Care treatments /procedures, taken in the Hospital /Nursing Home and the Insured is discharged on the same day

2) National Insurance VaristhaMediclaim:VaristhaMediclaim is one of the best health plans available for senior citizens in terms of coverage as well as premium.

 

Features:

  • Covers Hospitalization , Pre and post-hospitalization expenses, Organ’s donor expenses, Ambulance charges etc
  • Optional critical illness cover
  • Diabetes and hypertension, even pre-existing diseases are covered right from the inception of the policy (at a 10% additional premium)
  • Sum insured increased by 5% for each claim free year
  • Reimbursement of cost of health check up once in every 3 years
  • Affordable premium

Exclusions :

  • Expenses incurred on cosmetic surgery, dental expenses, visual aid, hearing aid, vaccination, HIV/AIDS, diagnostic tests not directly relevant to any disease, vitamins and tonics, pregnancy related expenses and naturopathy are not covered
  • Pre acceptance medical checkup for fresh entrants.
  • Insured has to make 10% co-payment in all claims. Plus, if it’s a case of pre-existing disease, an additional 10% co-pay has to be borne by the insured

 3). Oriental Insurance HOPE (Health of Privileged Elder):HOPE from Oriental Insurance is popular for its product features and high claim settlement and high incurred claim ratios. HOPE covers specified diseases at an optimum premium.

Features:

  • Covers Hospitalization expenses including room, boarding and nursing expenses, ICU expenses, surgeon fees, medical practitioner fees, specialist’s fee etc.
  • Discount in premium for opting voluntary co-payment
  • Discount in premium for every claim free year
  • Benefit of continuity extended if already insured with any mediclaim policy of the company
  • Ayurvedic/ Homeopathic/ Unani treatment covered

Exclusions :

  • Compulsory co-payment of 20% on admissible claim amount
  • Loading for new entrants
  • Covers specified diseases only
  • Pre and post hospitalization expenses are not covered
  • Pre-acceptance medical screening is required and expenses of which has to be borne by the insured

4). Bajaj Allianz Silver Health :Silver Health is a customer oriented insurance plan, offering good health insurance to senior citizens.

Features:

  • In-patient hospitalization expenses
  • Pre and post hospitalization expenses covered
  • Emergency ambulance charges covered subject to a limit of Rs 1000/claim
  • In-house health claim administration team
  • Fast claim settlement
  • Innovative packages to match individual need

 

Exclusions :

Non-allopathic medicines, AIDS and related disorders, cosmetic, aesthetic or related treatment, use of Intoxicating drugs and alcohol, treatment of any mental illness or psychiatric illness

5). New India Senior Citizens Mediclaim Policy: This offers a standard coverage at the lowest premium among all the health insurance plans available for senior citizens in the market.

 

Features:

  • Hospitalization expenses incurred for the treatment of illness/injury
  • Pre and post hospitalization expenses up to 30 and 60 days respectively
  • Discount on premium for voluntary excess
  • Family discount
  • Reimbursement of cost of health check up once in every 4 claim-free years
  • The lowest premium among all the health plans

  Exclusions:

Expenses incurred on dental treatment, debility, AIDS, cosmetic surgery, vaccination and inoculation, pregnancy and child birth, war, nuclear weapon, etc.

Tablelisting the good health insurance plans for senior citizens with relevant details (www.policybazar.com)

S.No. Insurer Product Name Entry- Exit Age Cap Maximum Renewal Age Sum Assured Limit Premium Unique Selling Proposition
1 Star Health Senior Citizen Red Carpet 60-75 Lifelong 1,00,000 to 5,00,000 4450 to 18,000 (excluding service tax) One of the first health insurance plans introduced for senior citizens with a wide coverage and unique value added benefits.
2 National Insurance VaristhaMediclaim 60–80 90 1,00,000 (plain cover) or 2,00,000 (with critical illness cover added) For mediclaim= Rs 4,180 to 6890. For critical illness= 2007- 2288. One of the most affordable health insurance plans with valuable features.
3 Oriental Insurance HOPE – Health of Privileged Elder For people aged 60 years and above Lifelong 1,00,000 to 5,00,000 4,500 to 29,000 What make this plan click are the numerous discounts it offers. Plus, there’s no upper cap on the entry age.
4 Bajaj Allianz Silver Health 46-70 75 50,000 to 5,00,000 1,995 to 29,039 A comprehensive health insurance plan offering great flexibility in sum assured.
5 New India Assurance Co. Ltd. Senior Citizen Mediclaim Policy 60–80 90 1,00,000 or 1,50,000 3,850 to 7,650 The lowest premium among all the health plans for senior citizens.

Conclusion

Finding the right policy that suits the requirements and budget of a personmay be a bit difficult thing to do. However, some patience and thorough research can help one choose the ideal plan that will financially protect from unwanted medical expenses.One can also consult a financial planner, with sufficient experience and expertise in health insurance, to help choose the right plan for senior citizens .

Debalina Roy Chowdhury

Dilzer Consultants

 

Sources:

https://www.cignattkinsurance.in/health-and-wellness/glance-need-overall-health-insurance-senior-citizens

https://www.policybazaar.com/health-insurance/senior-citizen-health-insurance/articles/best-health-insurance-plans-for-senior-citizens/

https://www.bankbazaar.com/insurance/senior-citizen-health-insurance.html

https://www.advisorkhoj.com/articles/Health-Insurance/How-to-choose-the-best-Health-Insurance-policy-for-senior-citizens