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Overview of Senior Citizen Mediclaim Policy

For the elderly, healthcare coverage is no longer a luxury, but a necessity. This is especially valid since they are more likely to face health concerns at this stage of their lives. To address this need, senior citizen mediclaim policies provide a safety net. These plans cater to older individuals by covering hospitalisation expenses during medical treatment.

 

The table below gives you a quick insight into the important terms of the senior citizen mediclaim policy:

Particulars 

Details (depending on the company)

Age 

60-80 

Sum insured

₹1 Lakh to ₹15 Lakhs or higher

Premium payable

Depends on the company's terms

Major cover

Hospitalisation expenses

Major exclusions

 

  • Self-harm

  • Cosmetic treatment

  • Drugs and intoxicants

Riders available 

Yes

Lifetime Renewability

Yes

Waiting period 

Yes

Read More: Senior Citizen Health Insurance Plans

Features & Benefits of Mediclaim for Senior Citizens

Mediclaim insurance for senior citizens is meant to provide them with financial aid to deal with medical crises. Check out the features and several benefits of having the best mediclaim policy for seniREAD MOREor citizens: READ LESS

Tax Benefits

Senior citizens with an insurance plan can get tax benefits up to ₹50,000 under Section 80C of the Income Tax Act, 1961.

Hospitalisation Expenses

In case the insured gets hospitalised for an ailment, the expenses for the same are covered by the insurer. These include ambulance charges,  room rent, and surgery charges, among others. Some insurancREAD MOREe providers also offer pre and post-hospitalisation as well. It is recommended to choose a provider depending on your requirements and preferences. READ LESS

Annual Check-Ups

It is crucial for senior citizens to go for regular health check-ups. The best mediclaim policy for senior citizens also offers free annual health checkups as one of its benefits.

No Claim Bonus

If the insured makes no claim in a policy year, then a No Claim Bonus (NCB) is offered. Under this, the insured may either get a discount on premium or renewal fees.

Cashless Treatment

Mediclaim for senior citizens features cashless and reimbursement claim options. Under this, one can get treatment in any of the network hospitals of the health insurance company. Here, they will not bREAD MOREe required to pay for anything from their pockets READ LESS

What is Covered Under Mediclaim Insurance for Senior Citizens?

When you shortlist the best mediclaim for senior citizens, make sure you thoroughly read all the clauses. One of the most important is the coverage. It clarifies to you all the claims you can make if the need occurs:

  • Hospitalisation Expenses

At the time of the policy purchase, a sum assured is guaranteed to the insured. If any medical help arises, the insured can make a claim for hospitalisation expenses up to the sum insured. The following covers are added under it: 

  1. Room charges

  2. ICU charges

  3. Nursing fees

  4. Charges of the anaesthetist, surgeon, practitioner, consultant, etc. 

  5. OT charges

  6. Medicine and drug expenses

  7. Blood, surgical appliances, oxygen, anaesthesia, X-ray

  8. Artificial limbs, stents, implants, pacemakers, dialysis, chemotherapy, and radiotherapy 

  9. Diagnostics

  10. Pre and Post-hospitalisation expenses are covered to a certain extent only (not included by some insurers)

  11. You may also be provided AYUSH treatment cover

  12. Ambulance charges can also be claimed

  13. The insurance company also covers the charges and expenses of the donor

What is Not Covered Under Mediclaim Insurance for Senior Citizens?

The exclusion clause lists what a senior citizen mediclaim policy does not cover for hospitalisation. This includes: 

  • Existing diseases

  • Cosmetic surgery

  • STDs and inherent disease

  • Alcoholism

  • Self-harm 

  • Harm due to illegal activity

Senior Citizen Mediclaim Premium Chart

The premium asked by your insurance provider must be affordable and within your budget. Also, you must get sufficient coverage in return for a premium. Check out the premium charged to the different age groups for the senior citizen mediclaim policy:

Age Group

Premium for Sum Insured (₹10 Lakhs) 

Premium for Sum Insured (₹15 Lakhs) 

60-65

4,043

6,006

66-70

4,463

6,626

71-75

4,935

7,329

76-80

5,408 

8,033

81-85

5,948

8,836

86 and above

6,489

9,639

How To Claim Mediclaim Insurance for Senior Citizens?

Raising a claim is the main component of any insurance policy, including the best mediclaim for senior citizens. The claim process includes: 

  • Cashless Treatment

For cashless treatment, the insured must be admitted to one of the impanelled hospitals as specified by the insurance company. Once the disease is diagnosed, the insured must inform the insurance company or TPA (Third Party Administrator) about the same. 

 

After being hospitalised, the bills will be settled between the insurance company and the hospital. The insured is only charged in case the expenses exceed the sum insured or for inadmissible expenses.

  • Reimbursement Claim

If the insured gets admitted to any other hospital than the network hospital, the following is the process for this claim:

  1. Inform your insurance providers once the disease is diagnosed

  2. Submit all the necessary documents to your insurance provider within the time limit given, after discharge

  3. Your insurance provider will assess all the details and approve the claim


Once approved, all admissible expenses will be disbursed to your bank account.

Health Insurance Plans Available at Bajaj Markets

FAQs- on Mediclaim for Senior Citizens

What are the minimum and maximum age limits for purchasing a senior citizen mediclaim policy?

People between the ages of 60 to 80 years can apply for the senior citizen mediclaim policy. However, the age may vary from company to company.

Are riders available for the senior citizen mediclaim policy?

Yes. Some of the popular riders include:

  • Outpatient treatment

  • Personal accident

  • Critical Illness, etc.

Is there a waiting period for the senior citizen mediclaim policy?

Yes. Most insurance companies mention waiting until an insured can raise a claim.

Can I purchase and renew the policy online?

Yes, you can buy or renew your mediclaim policy online through the official website of your insurance provider.

What if I fail to pay the premium amount?

In case you do not pay the premium even after repeated notification, the policy will be terminated, and you shall also be liable for legal actions.

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