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No Room Rent Capping | No Medical Check-up up to 55yrs | Tax Benefit up to 75k | Buy Health Insurance starting @ ₹244 pm

What is Health Insurance for Senior Citizens?

Health insurance for senior citizens is a type of insurance that takes care of the healthcare needs of older people above 60 years of age. A medical cover acts as a saviour for a senior citizen to receive quality healthcare treatment and services without draining one's savings. Health insurance is a vast umbrella, safeguarding the finances and health of people from all walks of life. Whether old or young, a health emergency can strike anyone randomly. One should be careful to secure good health insurance for any health issues during old age. 

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Top Senior Citizen Health Insurance Plans 

Take a good look at some of the best health insurance plans for senior citizens and pick the one that suits you the most:

Plan Name

Best Features

How to Buy

Aditya Birla Activ Care Plan

  • Staying active gets you benefits in the form of enhancement of sum insured

  • Get access to health experts

  • Get cover for issues such as high BP and diabetes

Care Senior Health Plan

  • Option to choose from various sum insured alternatives

  • You can opt for daily allowance when hospitalised

  • Automatic recharge of sum insured

Bajaj Allianz Silver Health Plan

  • Covers pre-existing diseases until 1 year after policy purchase

  • Entry age is up to 70 years

  • Get free check ups after 4 claim-free years

 

Features of Senior Citizen Health Insurance

Some of the salient features of medical insurance for senior citizens are as follows:

  • Pre-Existing Illnesses Cover

Most senior citizen health insurance plans in India offer coverage for pre-existing illnesses, usually after a waiting period of one year. The insurers also provide critical condition riders to provide additional coverage in times of need.

  • Pre and Post-Hospitalisation Expenses

Several senior citizen health insurance plans will cover the pre and post hospitalisation costs that include medical consultation from specialists, diagnostic tests, ambulance charges, etc. However, get in touch with the insurer as this may differ from one insurer to another.

  • Alternative Treatment Coverage

Depending on your insurance provider, the senior citizen health plan will provide cover for alternative treatments like Ayurveda and Homeopathy.

  • Continuity Bonus

The policy usually offers continuity incentives such as a No Claim Bonus (NCB) for every claim-free year.

  • Fixed Premiums

Most senior citizen health insurance premiums in India come with defined rates. That means the policyholder pays the same value for the chosen coverage, even when renewing the health plan.

Benefits of Health Insurance for Senior Citizens

Here are some of the benefits that you can avail under the best health insurance for senior citizens in India:

  • No Medical Screening

Most insurers do not request the applicants of medical insurance for senior citizens to undergo a medical test before buying the policy.

  • Outpatient Department (OPD) Cover

The policy offers OPD coverage so that it becomes easy to manage the financial needs when treating certain illnesses.

  • Special Rewards

A few health insurance providers also offer family rewards and discounts on senior citizen health insurance schemes, mainly when the policy covers the spouse as well.

  • Free Health Checkups

The policy also provides free health checkups and diagnostic services at dedicated centres after the completion of the specified waiting period.

  • Tax Benefits

The premiums paid towards senior citizen health insurance can be claimed for tax deductions under Section 80D of the Income Tax Act, 1961.

Inclusions and Exclusions Under Senior Citizen Health Insurance

Whilst health insurance plans for senior citizens provide ample coverage to its policyholders; it is imperative to be sure of the inclusions and exclusions that they come with. Remember that the coverage offered is likely to vary from one insurance provider to another.

Inclusions

Exclusions

  • The policy would offer coverage for hospitalisation due to illnesses or injury

  • Hospitalisation includes:

    • Room rent

    • ICU

    • Doctors’ fee

  • Day care treatments such as dialysis, chemotherapy

  •  Modern treatments such as robotic surgeries, balloon sinuplasty

  • Pre and post-hospitalisation up to a specified number of days is covered

  • Organ donor in-patient expenses

  • Most plans also cover AYUSH treatments, Ayurveda, Yoga, Unani, Sidha and Homeopathy

  • Ambulance charges to carry the patient to the hospital

  • There are a number of add-on options that can be included. 

  • The policy does not cover any cosmetic treatments such as plastic surgeries.

  • The plan excludes coverage for sexually transmitted diseases such as HIV/ AIDS.

  • Senior citizen health insurance plans do not cover medical expenses arising out of self-inflicted damage.

  • The policy does not cover illnesses contracted within 30 days of the purchase of the health plan.

  • The insurer will reject the health insurance claims arising from alcohol and drug abuse.

  • Certain treatments such as joint replacement surgeries would be covered after a stipulated waiting period which is usually two years.

  • Injury due to war is exempt from coverage under these policies.

 

Why Do You Need Senior Citizen Health Insurance?

Health insurance is a necessity for most individuals as it enables you to pay for medical emergencies as well as planned treatments. So, let’s understand why one must opt for health insurance for senior citizens:

  • Soaring Healthcare Costs

Healthcare costs have been rising with a sharp increase in medical inflation for many years now. Thus, to prioritise your health without worrying about the financial aspect, a health insurance policy for senior citizens is a must. You can rest assured as the plan enables you to gain access to the best medical facility and provides cashless treatments.

  • Annual Health Checkups

Most senior citizen health insurance schemes offer free annual health checkups to the insured. Due to this, you can opt for regular screenings and ensure your health is well. But it is recommended to understand the terms to avail the free annual health checkups under your plan.

  • Lucrative Add-on Covers

Health insurance plans come with lucrative add-ons such as critical illness cover. As a senior citizen, you can benefit from this add-on as the possibility of getting diagnosed with major ailments tends to rise with old age. However, you must purchase this cover separately from your base cover.

Tax Benefits of Health Insurance for Senior Citizens

A senior citizen health insurance policy not only safeguards you against healthcare costs but also enables you to save on taxes! The dual benefit of such an insurance plan allows you to claim the premium amount under Section 80D of the Income Tax Act, 1961. As a policyholder of over 60 years, you can claim ₹50,000 per financial year towards your health policy. An additional deduction of ₹5,000 can be claimed per financial year towards preventive health check-ups that enable you to detect ailments early on.

However, if you are a senior citizen who is covering the insurance premiums of your children, you can claim an extra deduction of ₹25,000. Under Section 80DDB, you can claim the treatment expenses related to specified medical conditions. The actual healthcare costs incurred or a sum of ₹1 lakh, whichever is less, is allowed.

Points to Remember While Buying Health Insurance for Senior Citizens

Let’s look at a few points that you must keep in mind to avail the best health insurance for senior citizens online:

  • Sum Insured

The first thing that you need to consider when buying a health insurance plan is the sum insured that you opt for. The sum insured is the maximum amount that you would be able to claim in a policy year. While opting a higher sum insured is advised, you also need to keep in mind that a higher sum insured also means a high premium. So, choose a policy that suits your insurance needs as well as your budget.

  •  Premium that you pay

While there are a number of health insurance plans, each claiming to be giving the most reasonable premium prices, it is highly recommended that you compare different senior citizen health insurance plans so that you can get the best deal. 

  • Pre Existing Diseases

After a certain age, one becomes more prone to illnesses. In case you are suffering from an illness, or suffered from one earlier, make sure to mention the same to your insurer before you finalise the plan. There are many health plans that offer coverage for pre-existing illness, with a suitable waiting period. 

  • Co-Payment

Another aspect that you must be careful about is the co-payment clause in your health insurance policy. Co-payment refers to the share of the total medical that you need to pay from your pocket. While there are certain plans that make co-payment mandatory for seniors, there are other options available too, so choose wisely. 

  • Sub-Limits

Check with your insurer for any sub-limits applicable to your plan and go through the policy terms and conditions during the free-look period.

  • Network Hospitals

In the case of health insurance for senior citizens, ideally, it is preferred to select an insurer with a wide range of network hospitals under it. That way, you can seek cashless treatment at the nearest hospital without having to worry about any medical expenses.

  • Waiting Period

Consider the waiting period for certain health conditions, especially the ones you are suffering from. This will help you understand how long you have to wait until your health insurance for senior citizens plan starts covering them.

  • Daycare Treatments

The daycare treatment in health insurance covers numerous procedures and treatments that can be completed within 24 hours. So, make sure you go through the treatments covered under medical insurance for senior citizens to avail extensive coverage.

  • Renewability

It is always recommended to choose senior citizen health insurance schemes offering lifetime renewability so that you don’t have to buy another plan after you reach the maximum age limit.

  • Other Insurance Features

Health insurance offers several features such as domiciliary hospitalisation, daily cash allowance, organ donor cover, etc. So, you must ensure your insurance needs are met by understanding the benefits available under your plan and choosing the best health insurance policy for senior citizens.

Eligibility Criteria for Senior Citizen Health Insurance

The eligibility criteria applicable to health insurance for senior citizens are:

  • The applicant should be between 60 and 80 years of age

  • The applicant should be aware of their pre-existing health conditions. Also, they need a relevant proof regarding the same. Hence, a medical checkup before purchasing the policy is highly recommended

How to File Claims Under Senior Citizen Health Insurance?

In the case of medical contingencies, you must initiate the claim settlement process within 24 hours of hospitalisation. On the other hand, for planned hospitalisation, inform the insurer 48 hours before the hospitalisation.

In either case, here’s how you can file a claim on your senior citizen health insurance plan:

1. Cashless Claim Settlement

  1. Inform the insurance provider regarding the claim at the earliest.

  2. Submit the claim request form at the hospital insurance desk.

  3. The insurer will send an acknowledgement once they receive your intimation.

  4. If necessary, the insurer may raise a query.

  5. Upon resolving the query and further verifications, the insurer will settle the claim directly with the hospital.

2. Reimbursement Claim Settlement

  1. Notify the insurer regarding the claim as soon as possible.

  2. Seek treatment at a preferred hospital and pay for the hospitalisation expenses incurred.

  3. Submit the reimbursement claim form along with the necessary documents to the insurer.

  4. The insurer will raise a query if they need any additional documents.

  5. Make sure that you submit the medical certificate issued by the doctor.

  6. Also, submit the discharge form issued by the hospital.

  7. Upon verification and approval of the claim application, the insurer will credit the settlement amount to your bank account.

Documents Required to Apply for Medical Insurance for Senior Citizen

You need to submit the following documents while buying the best health insurance policy for senior citizens online:

  • Duly filled application form

  • Supporting documents for pre-existing health conditions

  • Proof of age

  • Medical examination test results (if requested by the insurer)

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FAQs on Senior Citizen Health Insurance

✔️Can I buy senior citizen health insurance on Bajaj Markets?

Yes. You can easily purchase individual or family health insurance for senior citizens with age up to 65 years on Bajaj Markets by using our mobile insurance app or through our website!

✔️How can I purchase the best health insurance policy for senior citizens online?

To buy the best health insurance for senior citizens online on Bajaj Markets, follow the below steps:

  • Go to the ‘Health Insurance’ section on Bajaj Markets

  • Select the type of policy as ‘Senior Citizen Health Insurance’.

  • Fill in the necessary details in the application form.

  • Review the policy terms and opt for add-on covers.

  • Pay the premium online.

  • Your senior citizen health insurance policy document will be issued soon.

✔️Which is the cheapest health insurance for senior citizens?

You can find affordable health insurance plans for senior citizens on our platform which is customised to suit your insurance requirements without any trouble!

✔️Can an 80-year-old get health insurance?

Yes. You shall find various insurance companies covering individuals over 80 years of age or super senior citizens. We recommend you to compare all the available health policies based on the coverage and features and then finalise a single plan.

✔️Does the senior citizen health plan cover pre-existing ailments of policyholders?

Yes, senior citizen health insurance covers pre-existing conditions, so we highly recommend you to share your medical history with the insurer. However, a waiting period shall be applicable to the coverage where no claims will be accepted before the set duration is complete.

✔️Do senior citizens require health insurance coverage?

Yes. Health insurance for senior citizens is quite crucial as individuals are bound to experience age-related medical complications as they grow older. To avoid spending your retirement savings on healthcare expenses, you need to have sufficient coverage!

✔️Do I need to undergo medical screening before purchasing health insurance for senior citizens?

Yes. Most health insurance providers shall request you to undergo a medical screening as individuals above 60 years shall have a higher risk. As the probability of experiencing medical complications increases with age, insurers will ask for a pre-policy medical screening prior to buying an insurance plan.

✔️Do all insurance companies provide cashless hospitalisation?

While most health insurance companies these days offer cashless hospitalisation in the hospitals that come under their network, it is recommended that you confirm the same from your health insurance provider.

✔️Do senior citizens get benefits if they transfer their senior citizen health insurance policy?

Yes, even if the policy is transferred or ported, most companies will acknowledge the benefits, however, it largely depends on company policies.

✔️Do health insurance companies provide free annual health check-ups under senior citizens' health insurance?

While such features can vary from company to company, yes, there are many health insurance companies that provide free annual health check-ups under senior citizens' health insurance. 

✔️Should I submit claim documents to the Health insurance company or TPA?

If your health insurance provider has its own claim department then you would have to submit the required documents to them directly. Some health insurance companies outsource this department and authorise a third party to settle the claims on their behalf. In case there is TPA involved, you would have to submit the documents with them. The claim procedure, however, will not be different. 

✔️Are critical illnesses covered under senior citizen health insurance?

Yes, even if you opt for senior citizen health insurance, you can get coverage for critical illness. Some illnesses are covered in the base plan, while for the coverage of some specific illnesses, you may have to buy an add-on/ rider.