Senior Citizens Health & Medical Insurance Plans Online
Senior Citizens Health Insurance
Old age is both a time to enjoy happy family times and a time for managing health-related problems. Health insurance for senior citizens is an important measure to meet increased healthcare expenditures that are part and parcel of aging. Senior citizen medical insurance plans are designed to meet people’s needs in the age group 60 to 75 years.
Senior citizens’ health insurance plans provide many benefits. From cashless hospitalization and hospital room rent cover to tax benefits and critical illness coverage, senior citizen’s medical insurance is a necessity for many. Senior citizens who are retired or do not have family members or children to take care of them financially can bank on health insurance for their medical needs.
Health insurance companies have introduced numerous types of health insurance for senior citizens in India. These plans are specially designed to meet senior members’ needs and hence are more beneficial compared to general health insurance plans.
Benefits of Senior Citizen Mediclaim Policy
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Medical coverage:
Mediclaim policies for senior citizens offer comprehensive health insurance cover, taking care of various healthcare needs. Most basic health insurance plans provide coverage only up to 65 years, whereas a senior citizens’ Mediclaim policy provides coverage up to the age of 75 years.
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Pre-medical screening:
Some plans require pre-medical screening, which is beneficial as it gives a clear picture of one’s health conditions. Some medical insurance plans for senior citizens don’t require pre-policy medical screening.
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Cashless treatment:
Senior citizens’ health insurance policyholders can avail treatments at quality network hospitals without worrying about bill payments. With the cashless treatment feature, patients avail treatments, and the insurer pays to the hospital on behalf of the policyholder.
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Medical treatment expense cover:
Senior citizen’s health insurance plans offer coverage for all kinds of expenses – pre-hospitalization, post-hospitalization, and inpatient hospitalization expenses.
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No-claim bonus:
Policyholders can avail no-claim bonus for every claim-free year. The percentage of the bonus varies from 10% to 100%, depending on the plan chosen. With every claim-free year, a no-claim bonus helps to increase the sum assured amount.
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Tax benefits:
Health insurance for senior citizens in India, apart from offering financial protection against healthcare expenditure of senior citizens, also provides tax benefits under Section 80D of the Income Tax Act. At times, individuals and families can save up to Rs 1 lakh through tax exemption benefits available on the premiums paid towards the policies, making senior citizens health insurance a crucial factor in financial planning.
Inclusions and Exclusions of Senior Citizen Mediclaim Policy
Inclusions
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Hospital expense cover:
Medical treatment charges are proportionate to the kind of room rented. This means doctors’ fees, nursing charges, and other expenses for a premium room are higher than rooms with lower rent. Senior citizen’s medical policy covers these expenses such as room rent, doctors’ fees, nursing charges, medicines, ICU charges, surgeon and consultant’s fees, among others.
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Other medical expenses:
Certain medical treatments can be complicated and require the use of special equipment. Health insurance for senior citizens covers the cost of these expenses, such as a ventilator, pacemaker, implant, artificial limb, blood test, X-ray, and other procedures that form a part of treatments.
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Day-care treatments:
Typically, health insurance covers treatments that require hospitalization for 24 hours or more. However, some senior citizen’s health insurance plans also cover day-care treatments. These are treatments that require less than 24 hours.
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Pre and post hospitalization:
Pre-hospitalization costs, those that the senior citizen’s policyholder incurs before getting hospitalized, such as diagnoses, blood tests, X-rays, among others, are included in senior citizen medical insurance. Similarly, post-hospitalization expenses, those that are incurred after the policyholder gets discharged from the hospital, such as follow up doctors visit fees, medicines, and tests, are covered by the policy.
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Organ donor expenses:
Medical insurance for senior citizens includes organ donor coverage – these are expenses incurred towards the person donating an organ to the policyholder. The costs covered include surgery for an organ transplant, storage of organs, among others.
Exclusions
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Pre-existing diseases:
Senior citizen’s mediclaim plans usually do not cover pre-existing diseases. Most often, there is a waiting period for coverage of pre-existing illnesses.
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Cosmetic treatments:
cosmetic treatments are excluded from senior citizen’s medical policy unless the treatments are medically recommended as part of other treatments.
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Self-inflicted injuries:
injuries caused due to any self-harm, such as suicide attempts, are excluded from health insurance for senior citizens.
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Dental, hearing, and vision treatments:
dental, hearing and vision-related treatments are typically not included in senior citizen’s health insurance policies unless they require hospitalization. However, this depends on policy clauses and has to be checked with the insurer.
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Permanent exclusions:
injuries and health conditions caused by war, HIV, intentional harm, and congenital diseases are excluded from senior citizen’s health insurance.
Types of Best Health Insurance Plans in India
Things to consider while buying health insurance for senior citizen
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Day-care treatment:
Typically, insurers cover medical expenses only when the policyholder is hospitalized for 24 hours or more. However, if day-care procedures are included in the policy, insurers cover the costs of treatments that do not require hospitalization. Some of these would include chemotherapy, radiation, and surgery. It is advisable to choose a senior citizen’s health insurance plan that covers day-care treatment. It is also essential to check the range of day-care procedures covered in a policy.
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Network hospitals and cashless claim:
Most insurers tie up with reputable hospitals that offer quality treatment. It is crucial to consider the network hospital of the insurance policy and how many hospitals are in the vicinity. This would help senior citizens reach hospitals faster in case of emergencies. Moreover, it is essential to check if the policy provides a cashless claim feature. This would ensure that the policyholder does not have to make any payments; the insurer would directly settle the hospital’s claims.
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Claim settlement ratio and settlement time:
It is vital to assess the insurance company’s credibility and performance, which points to the insurance company’s claim settlement ratio. It shows how fine-tuned their processes are and what could be the waiting time for settling claims.
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No-claim bonus:
Most insurers offer no-claim bonus, which means with every claim-free year, the policyholder receives a bonus or a benefit. Either the sum assured increases or the premium decreases. In some cases, insurers offer both these benefits. Policyholders can avail no-claim bonus from 10% to 100%, depending on the plan chosen.
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Free medical health check-up:
Some mediclaim policies for senior citizens offer free medical health check-up upon completing a pre-specified number of years.
Claim settlement process for senior citizen health insurance
Insurance companies provide a hassle-free claim settlement process for senior citizen health insurance. Claims are settled in two ways: reimbursement or cashless.
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Reimbursement claim settlement:
For reimbursement method, the policyholder must submit a set of documents – claim form filled with hospitalization documents, medical bills, and payment receipts. Once the claim documents are submitted to the insurance company, the insurance company examines the documents and then settles the dues as per the pre-specified timelines.
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Cashless claim settlement:
In the cashless claim settlement process, the policyholder does not have to pay to the hospital. The insurance company directly settles the dues with the hospital. However, a cashless claim facility is offered only at the hospitals that are a part of the insurer network or mentioned in the policy.
Tax benefits of senior citizen health insurance
The premium paid on senior citizen’s health insurance provides a tax deduction of up to Rs 50,000 as per Section 80D of the Income Tax Act, 1961. Individuals and families can save up to Rs 1 lakh tax deductions by including senior citizen’s insurance tax benefits. Those below the age of 60 years can avail up to Rs 25,000 tax benefits. If the parents and children are above the age of 60, then the total tax benefits can be up to Rs 1 lakh.
Why do you need health insurance for senior citizens?
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Rising medical expenses:
The cost of healthcare is always on the rise. Health insurance is crucial for senior citizens, as they are more prone to illnesses. Aging brings with it many health risks and an increasing need for healthcare. Health insurance helps senior citizens, and family members meet rising medical expenses.
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Critical illness cover:
Senior people are more prone to seasonal illnesses due to weak immunity, chronic and critical illnesses, and deteriorating health conditions due to mental disorders that develop due to aging. Health insurance for senior citizens can ensure they receive timely and quality medical attention.
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Peace of mind:
A hectic work life and increasing family needs can cause increased mental stress to families’ breadwinners. Senior parents and grandparents, too, experience increased stress levels with age. Their worries mostly include their children, grandchildren, property and assets, and their depleting retirement savings. In such a situation, when senior family members have health insurance security, some of their worries can be lessened. The fear of financial burden due to health conditions and their children’s concern having to spend from their savings can be reduced significantly.
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Annual health check-ups:
Some health insurance companies offer annual health check-ups in senior citizen’s health insurance. This can ensure that senior citizens are regularly checked and are aware of their health conditions.
Common exclusions of family floater health plan
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Pre-existing diseases:
Family health insurance plans usually do not cover pre-existing conditions. Most often, there is a waiting period for coverage of pre-existing illnesses.
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Cosmetic treatments:
Cosmetic treatments are excluded from most health insurance plans, including family floater plans, unless the treatments are medically recommended as part of other treatments.
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Self-inflicted injuries:
injuries caused due to any self-harm, such as suicide attempts, are excluded from health insurance for family.
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Dental, hearing, and vision treatments:
dental, hearing, and vision-related treatments are typically not included in family floater health insurance policies unless they require hospitalization. However, this depends on policy clauses and has to be checked with the insurer.
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Permanent exclusions:
injuries and health conditions caused by war, HIV, intentional harm, and congenital diseases are excluded from health insurance plans for a family.
How to calculate senior citizen’s health insurance premiums?
The calculation of the health insurance premium is based on many factors. Apart from every insurance company’s clauses and guidelines, factors such as the type of plan, age of the applicant, health condition, and medical history are also factored in determining the premium amount.
These are some of these factors that affect the calculation of premiums.
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The type of health insurance plan:
The kind of health insurance plan – individual, family floater, group health insurance, senior citizen, and critical illness plan – is a vital factor in determining the premium amount. Usually, senior citizens’ health insurance has a higher premium because they are more prone to health ailments and have a higher chance of hospitalization. In family floater plans, insurers consider the age of the oldest member to calculate the premium. Health insurance plans with critical illness inclusion also have a higher premium as the treatment cost for critical illnesses is more.
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The policyholder’s age:
One of the critical factors that affect the premium amount is the policyholder’s age. The higher the age, the higher, is the premium amount. Hence, senior citizen health insurance premium is more.
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Medical history and claims history:
Insurance companies may or may not require a policyholder to go for a pre-policy medical check-up. However, most insurers gather individuals’ medical histories to ascertain the quantum of risk and the probability of claims. Insurers also assess the claims history of the policyholder. More number of claims would point to the fact that the policyholder has higher chances of hospitalization.
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Sum insured:
The higher the sum insured, the higher would be the premium. Senior citizens may require a comprehensive health insurance plan covering a wide range of medical expenses, which requires an adequate sum assured.
Health insurance premium calculators
Although health insurance agents help customers calculate the tentative insurance premium, most insurance companies provide online insurance premium calculators for the ease of customers.
An insurance prospect can calculate the premium amount online and then start looking for a suitable insurance policy, instead of diving into it without any tentative budget. This would help save time and effort and also make the search more meaningful.
Insurance premium calculators allow customers various permutations and combinations and adjustments, with the help of which customers can figure out the most beneficial combinations for them. It will enable them to mix and match.
How to calculate senior citizens health insurance premium with the calculator – key steps
- Search for the choice of health insurance policy in the company’s website
- Most insurance companies have an online premium calculator on their website
- Find the calculator and fill in the details as required
- Select options according to your requirement – type of plan, number of members, age, and sum insured
- Share your contact details
- Click on ‘calculate the premium’ tab
- The insurance company will share the premium amount on your contact details
Usually, such calculators also serve as a sales funnel for the insurance company. Hence if you are interested in buying a policy, you can leave your mobile number and other details there so that the insurance company can get in touch with you to close the sale.
FAQ
Q. What is the senior citizen's health insurance?
A. Senior citizens' health insurance is designed to cover senior citizens' healthcare needs – those above the age of 60. Aging increases health issues. Senior citizens require healthcare more often than younger people. With the rising costs of healthcare, senior citizens' health insurance ensures that older people have financial security towards their healthcare needs.
Q. What are the benefits of buying mediclaim for senior citizens?
A. There are many benefits of buying health insurance for senior citizens – it ensures financial coverage for healthcare needs. It brings peace of mind as one doesn't have to worry about health emergency expenses; it offers tax benefits and covers critical illness benefits.
Q. Are AYUSH treatments covered in senior citizen's health insurance plans?
A. Many health insurance plans provide coverage for AYUSH treatments – Ayurveda, Unani, Sidha, and Homeopathy are covered only if the treatments are done at certified AYUSH centers.
Q. What is the ideal coverage for a senior citizen's health insurance?
A. The ideal coverage for any senior citizen would depend on the individual. Every individual has different healthcare needs. Moreover, everyone has a different medical history. The amount of coverage would depend on these factors. Apart from that, many insurance companies have an upper limit for the sum insured for senior citizen's health insurance. In such cases, you may not be able to exceed the limit. However, as a thumb rule, coverage of Rs 5 lakh to Rs 20 lakh is usually recommended considering the range and extent of senior citizens' healthcare needs.
Q. How do I buy health insurance for senior citizens?
A. You can buy health insurance for senior citizens from many options of insurance companies and plans. Get in touch with an insurance company or an agent that can recommend the best plans. Compare the plans to assess different parameters such as the age of entry, maximum renewal age, maximum sum insured offered, additional features, etc. The fastest and most convenient way to buy a health insurance plan is online. You can also visit insurance aggregators to compare and contrast the features of various health policies offered to make an informed decision.
Q. Does senior citizen medical insurance require a pre-policy medical test?
A. Most health insurers make a pre-policy medical test for senior citizens mandatory as senior citizens are at a higher risk of health issues.
Q. What are the key factors to consider when buying senior citizen health insurance plans?
A. The most important factors to consider when buying health insurance for senior citizens are the entry and exit age specified in the plan, the maximum age for renewal of the policy, the inclusions and exclusions, co-payment feature, waiting period, pre-policy health check-up, and critical illness coverage.
Q. What is the ideal coverage for a senior citizen's health insurance?
A. The ideal coverage for any senior citizen would depend on the individual. Every individual has different healthcare needs. Moreover, everyone has a different medical history. The amount of coverage would depend on these factors. Apart from that, many insurance companies have an upper limit for the sum insured for senior citizen's health insurance. In such cases, you may not be able to exceed the limit. However, as a thumb rule, coverage of Rs 10 lakh to Rs 25 lakh is usually recommended considering the range and extent of senior citizens' healthcare needs.
Q. What are the inclusions in medical insurance for senior citizens?
A. Most senior citizen's health insurance plans include pre and post hospitalization coverage, medical bills and hospital room rent, cashless hospitalization, ambulance cost coverage, pre-existing diseases, free health check-up, and alternate AYUSH treatments.
Q. Can senior citizens be included in family floater plans?
A. Typically, health insurance plans have a cap on senior members' age to be included in a family floater plan. The reason being, older people, have more healthcare needs compared to younger people. Another reason is that health insurers would consider the age of the oldest member to calculate the premium. Senior members in a family floater plan would mean higher premiums and higher sum insured because their medical needs are higher.
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Hiren Desai
I was very confused to buy Health cover for my parents, when IIFL approached me they offered me multiple brands with multiple features - staff even guided best plan for my parents and made me undertsood tax benefit also.
Hiren Desai
29, Businessman
Hira Nath
It’s been 20 years of togetherness but we never knew the importance of a family health insurance all thanks to IIFL to enhance our knowledge and getting us a family floater on our anniversary date.
Hira Nath
35, Private Job
Hiren Desai
I was very confused to buy Health cover for my parents, when IIFL approached me they offered me multiple brands with multiple features - staff even guided best plan for my parents and made me understood tax benefit also.
HHiren Desai
35, Private Job
Hira Nath
It’s been 20 years of togetherness but we never knew the importance of a family health insurance all thanks to IIFL to enhance our knowledge and getting us a family floater on our anniversary date.