A guide to buying health insurance plan for senior citizens in India

With the changing lifestyles and increasing medical costs, having a health insurance policy is a must. More so for senior citizens as they are prone to illnesses and have limited or no income source.

Today there is an array of health insurance plans that assure you high benefits at low premium rates. But the real challenge lies in opting for a right health policy that will cater to the needs of your parents.

So how do you choose the right Health Insurance for senior citizen above 60 years? Quite a daunting question, right?  We would say no, if you read the below guide that helps you understand all about health insurance for senior citizens in India.

What is a senior citizen health insurance plan?

You never know when a sudden medical emergency for your parents can result in a financial crisis. Hence, at times like these, having a senior citizen health insurance plan is beneficial.

A senior citizen health insurance plan offers financial coverage to individuals aged between 65 years to 80 years.

Why to buy senior citizen health insurance for the elderly?

Here are a few reasons on why you should consider buying a health insurance plan for your parents:

Skyrocketing medical expenses

Parents might have limited income

They might be dependent on their heirs

Senior citizens are more prone to illness

Types of health insurance plans that provide coverage for senior citizens:

When you are a child, you are your parent’s responsibility. But as you grow younger, your parents become your responsibility. Hence, taking care of them when they grow older is a necessity.

So here are health insurance plans that provide coverage to senior citizens.

Individual plans:

This type of plan provides cover only for one person who can avail hospitalization benefits.

Group plans:

Many employers today offer health insurance plans that cover family members of the employees. But, a few plans don’t provide parental coverage and cover only the spouse and kids of the employee.

Family Floater plan:

This type of health insurance plan provides cover for the entire family of the policyholder. It lets you claim the entire amount for the medical expenses of one member and covers the cost of individual family members up to the sum insured. If you are thinking to cover your parents under this plan, then it would cost you a higher premium. This is because the premium for the family floater plan is calculated on the basis of your parent’s age.

Senior citizen plan:

IRDA has mandated all the insurance companies to give insurance to people up to the age of 65. Under this plan, the waiting period for pre-existing diseases is low as compared to other plans.

Factors to keep in mind while buying health insurance for senior citizens:

Waiting period:

Health insurance policies come with a waiting period, on the fulfilment of which a policyholder can make claims. Generally, a health insurance policy has a waiting period of over 30-90 days. Certain policies also have a waiting period for specific illnesses.

For eg.x: Bajaj Allianz Silver Health policy has a waiting period of 30 days, before which policyholder cannot make claims. Also, the same policy covers diseases like hernia, piles, cataract and others after a waiting period of 1 year.

So always check for the waiting period as senior citizens fall prey to illnesses soon and then you might end up paying from your own pocket.

Pre-existing diseases:

This is a critical factor that can affect your policy. If your parents have any existing diseases, then you will have to wait for a few years before you claim. Health Insurance policies have a cap limit for covering these diseases after a year or two or even more. The illness and resultant hospitalization, days after buying the policy won’t allow you to make any claim.

Sum Insured/ Cover:

Considering the growing age of your parents and rising medical costs, it’s always a better idea to opt for a cover with the highest sum insured. But, higher the sum insured, higher the premium, which is also subjected to an increase on the renewal of the policy.

Entry age:

A few insurance companies limit the entry age up beyond which your parents are not eligible for a senior citizen health insurance policy. The Bajaj Allianz-Silver Health Plan for Senior citizens has an entry age of 46-70 years. While the Apollo Munich and Tata AIG provide health insurance without any entry age restrictions

Alternative treatments:

Always check if the plan provides coverage for treatments like Ayurveda and homeopathy. This is because your parents would not always opt for cumbersome hospitalization process and high doses of medicines.

Sub-limit:

A few insurance policy specific a sub-limit for various diseases. For instance, a policyholder can only claim 50,000 for treatment of an eye operation even if he has a sum insured of Rs. 5lakh.

It’s always better to opt for a health policy without any sub-limit as you never know when your parents would need medical treatment.

Co-payment:

Co-payment requires the policyholder to pay a certain percentage of the medical expenses incurred. This means that if you have a claim settlement of 2 lakh then you will have to pay 10-30% co-pay as mentioned in your policy. And the rest of the amount will be borne by the insured. Policies without this factor usually have a higher premium.

Deductible:

This factor requires you to pay a fixed amount at the time of claim settlement. For example: If you have a claim amount of 30,000 and have a deductible limit of 5,000 then the company will only pay you 25, 000. Ideally, one should opt for a plan that has the least deductible clause.

Renewal age:

All health insurance policies have an age limit only until which you can renew the policy. Generally, health insurance policies for senior citizens in India can be renewed till 90 years. Also, a few companies have set the renewal age limit only till 80. So it’s always wise to check on the renewal age to have to understand till what age your parents are insured.

Network of hospitals:

Insurance companies offer you a list of hospitals that are covered/fall under their network. If you visit a hospital covered by the company, then you can opt for a cashless treatment. But, if you visit a hospital that is not covered under the company’s network, then you will have to pay the bills first, which will be reimbursed later.

A senior citizen health insurance policy should cover a broad network of hospitals in your vicinity as you never know when a medical emergency would strike in and your parents would need immediate hospitalization.

Exclusions of senior citizen health insurance plan:

A health insurance plan for senior citizen does not cover the following

  • Self-inflicted injuries
  • Treatment of AIDS
  • Cosmetic surgery
  • Dental treatments
  • Any non-allopathic treatment
  • Any pre-existing injuries/diseases
  • Expenses as a result of drug abuse
  • Cost of spectacles/lenses and dental treatment (except arising out of accident)
  • Injury due to war, the act of foreign army etc.

Best health insurance plans for senior citizens:

Insurer Age Renweal age Pre-existing Medical check up
National Insurance-Varishtha mediclaim for senior citizen 60-80 years Till 90 All pre-existing diseases are covered after policy has been in force for 48 months Not required if the policyholder was covered with a health insurance plan since last 3 years.
Star Health-Senior Citizen Red Carpet 60-75 Lifelong Coverage provided from 2nd year No medical tests required
New India Assurance Co.Ltd 60-80 Till 90 Coverage provided after 18 months

Medical health check required for new entrants