Medical cover has become a quintessential requirement these days. Especially when it comes to elderly people, the chances of getting sick and contracting medical ailments are higher. So, it is advised that people in the older age group must have a health insurance plan. One such plan is the senior citizen mediclaim policy. Being a type of health insurance, a Mediclaim policy for senior citizens primarily covers the hospitalisation expenses incurred for the treatment of various illnesses.
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 lakh or higher |
Premium payable |
Depends on the company's terms |
Major cover |
Hospitalisation expenses |
Major exclusions |
|
Riders available |
Yes |
Lifetime Renewability |
Yes |
Waiting period |
Yes |
Read More: Senior Citizen Health Insurance Plans
Mediclaim insurance for senior citizens is meant to provide the much-needed financial assistance to deal with any medical crisis. Check out the features and several benefits of having the best mediclaim policy for senior citizens:
The Section 80D of Income tax allows all the senior citizens with an insurance plan to avail of tax benefits up to ₹50,000
In case the insured gets hospitalised for an ailment, the expenses for the same are covered. Right from the ambulance charges to the room rent and surgery charges, etc. are all covered. Some insurance providers also otter Pre and post hospitalisation as well. So, depending on your requirements and preferences, you must choose a provider
It is vital that senior citizens go for regular health check-up and so, the best mediclaim policy for senior citizens also offer free annual health checkups
If the insured makes no claim in a policy year, NCB, that is, No Claim Bonus is offered. Under this, the insured may either get a discount on premium or renewal fees.
Mediclaim for senior citizens provides cashless and reimbursement options. Under cashless, one can get treatment in one of the network hospitals of the health insurance company without having to pay directly from pocket.
Take a look at some of the best Senior Citizen Health Insurance plans that you can opt for:
Name of Plan |
Hospitalisation Cover |
Starting Rate of Premium |
Star Health Senior Citizen Red Carpet |
₹ 25 lakh |
₹ 4450/year |
Niva Bupa Health Companion |
₹ 12.5 lakh |
₹ 5085/year |
Bajaj Allianz Individual Health Guard- Gold |
₹ 50 lakh |
₹ 2836/month |
Reliance Health Infinity |
₹ 1 crore |
₹ 2119/month |
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:
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. Following covers are added under it-
Room charges
ICU charges
Nursing fees
Charges of the anaesthetist, surgeon, practitioner, consultant, etc.
OT charges
Medicine and drug expenses
Blood, surgical appliances, oxygen, anaesthesia, X-Ray, artificial limbs, stents, implants, pacemaker, dialysis, chemotherapy, and radiotherapy
Diagnostics
Pre and Post-hospitalisation expenses are covered to a certain extent only. However, some providers may not include these expenses
You may also be provided AYUSH treatment cover
Ambulance charges can also be claimed
The insurance company also covers the charges and expenses of the donor.
The exclusion clause specifies all the causes of hospitalisation that remain out of the reach of a senior citizen mediclaim policy:
Existing diseases
Cosmetic surgery
STDs and inherent disease
Alcoholism
Self-harm
Harm due to illegal activity
The premium asked by your insurance provider must be affordable and within your budget. Also, you must enjoy sufficient coverage in return for a premium. Check out the premium charged to the different age groups for senior citizen mediclaim policy:
Age Group |
Premium for Sum Insured (₹10 lakh) |
Premium for Sum Insured (₹15 lakh) |
60-65 |
4043 |
6006 |
66-70 |
4463 |
6626 |
71-75 |
4935 |
7329 |
76-80 |
5408 |
8033 |
81-85 |
5948 |
8836 |
86 and above |
6489 |
9639 |
Raising a claim is the end motto of any insurance policy including the best mediclaim for senior citizens, The right claim process includes-
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.
If the insured gets admitted to any other hospital than the network hospital, the following are the process for reimbursement claim:
Step: Inform your insurance providers once the disease is diagnosed.
Step 2: Collect all the necessary documents and submit to your insurance provider within the time limit given (after discharge from the hospital).
Step 3: Your insurance provider will assess all the details and approve the claim. Once approved, admissible expenses will be disbursed to your bank account.
The following table will help you get a fair idea of the maximum coverage that you can claim with respect to different illnesses:
Name of the Surgery/ Illness |
Maximum Charges |
Cataract |
₹10,000 |
Prostate |
₹18,000 |
Hysterectomy |
₹22,000 |
Cholecystectomy |
₹18,000 |
Hernia-Inguinal |
₹16,000 |
Fissurectomy |
₹9,000 |
Kidney stone/ Lithotripsy |
₹13,000 |
Arthroscopy |
₹10,000 |
Mastectomy(Radical) |
₹36,000 |
Tympanoplasty |
₹13,000 |
Septoplasty |
₹9,000 |
PID-Discectomy |
₹31,000 |
Senior citizen mediclaim policy has been one of the most popular insurance plans. This is primarily because of the specific coverages provided for affordable premium amounts. Also, senior citizens' needs differ from those of younger people. Hence, they also need special care. So, if you have older parents in the house, check out and buy for them the best mediclaim for senior citizens now!
People between the age of 60 to 80 years can apply for the senior citizens mediclaim policy. However, the age may vary from company to company.
Yes. Some of the popular ones include
Outpatient treatment
Personal accident
Critical Illness, etc.
Yes. Most insurance companies mention waiting until an insured can raise a claim.
Yes, you can buy or renew your mediclaim policy online through the official website of your insurance provider
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.