All sections of society face unique challenges when it comes to aging, a natural process. The term senior citizen refers to individuals who are older than 60 years of age. In India, two out of three senior citizens suffer from some chronic illness, according to the first Longitudinal Aging Study in India (LASI). Chronic hypertension, diabetes, cardiovascular disease, bone, and joint disease, and others are observed to be common among the elderly. The biggest 'unknowns' of retirement are health care needs. It is difficult to set retirement savings goals when you are experiencing chronic diseases since the medical cost is rising. If you receive standard treatments for these chronic diseases, you may drain your savings. To meet their unique health needs, senior citizens need health insurance. Therefore, you should immediately acquire a right and effective health plan that will satisfy all your health care requirements.
Why is Senior Citizen Health Insurance Necessary?
1. Planning without stress - Although it is inevitable that you will fall as you age, you can still plan to be financially secure when such a medical emergency occurs. The process of purchasing a health insurance plan is hassle-free and wouldn't take up much of your time. Thus, you can plan for your future medical emergencies stress-free by buying health insurance.
2. Prevents debt crises - A medical emergency after 60 can become a financial emergency when you do not have a regular source of income. If you are retired, you may not have a regular source of income, so any medical emergency may become a financial emergency. Debt crises can result from financial emergencies. Such situations can be avoided with health insurance.
3. Increases Resistance to Diseases and Illnesses - Older people are more likely to get sick and be hospitalized as a result of illnesses and diseases. The importance of having a health insurance policy for seniors cannot be overstated.
4. Costs of medical care are rising - Medical costs have increased as a result of technological advancements. A health insurance policy can help you in the event of an emergency medical situation, given the skyrocketing costs in the medical field.
5. Income after retirement is limited or unstable - Retirement causes income to become limited or unstable as there is no fixed income source. Having a good health insurance plan is important for senior citizens or retired citizens after 60, in order to avoid financial hardships.
Features of Senior Citizen Health Insurance
Health insurance plans for senior citizens include the following features:
- During their golden years, senior citizens need adequate health insurance coverage, which is why senior citizen health insurance plans offer higher sum insured options.
- Senior citizens have many health insurance options available on the market that are renewable for a lifetime. As long as the insured individual pays the required premiums on time, the policy can be renewed as many times as the insured wishes.
- There is a wide range of coverage benefits available in senior citizen health insurance plans. There are many types of health insurance, including emergency ambulance coverage and specific illness coverage.
- There is a waiting period before pre-existing disease coverage is provided. There may be a difference between insurance companies in the waiting period.
- In case of hospitalization, a senior citizen's health insurance policy allows them to receive cashless or reimbursement treatment according to their preferences.
- Under some senior citizen health insurance plans, senior citizens and their spouses are covered under one policy. Insured individuals are kept at ease by this.
- Health insurance policies for senior citizens usually include a co-payment option. Paying lesser health insurance premiums is possible if you choose co-payments.
Benefits of Senior Citizen Health Insurance
- Screening for pre-health conditions - Pre-medical screenings are not mandatory under most health insurance policies.
- Expenses related to domiciliary care - Domiciliary treatment expenses are covered by most senior citizen health insurance plans. Treatments that would otherwise need to be hospitalized are administered at home.
- Choosing a second opinion - It is common for people to seek a second opinion when they are ill. Senior citizens generally have access to a one-second opinion each year as part of their health insurance policy.
- Bonus for no claims - Insurers receive a No Claim Bonus if they do not make a claim during a given year. You can get a No Claim Bonus of 20%-100% in most senior citizen health insurance plans.
- Hospitalization coverage - In addition to providing coverage for expenses associated with in-patient hospitalization, senior citizen health insurance plans also cover expenses associated with pre-hospitalization and post-hospitalization. Plans may differ in this regard.
- Benefits of taxation - Section 80D of the Income Tax Act, 1961 provides tax benefits for premiums paid for senior citizen health insurance policies.
Best Senior Citizen Health Insurance Plan
1. HDFC Ergo Health Insurance
- Senior Optima - An excellent medical insurance plan specifically designed for seniors, Optima Senior is offered by HDFC ERGO General Insurance. Health care for you and your spouse is provided hassle-free throughout their lives. There is a maximum cover of Rs. 5 lakhs offered by this plan. It eliminates the need to pay additional loadings in case of illness. This plan is available to individuals over 61 years of age. In addition, if you cover yourself and your spouse, you will get discounts and other benefits. A wide variety of benefits are covered by this plan. There is no max entry age, no claim-based loading or underwriting, e-opinion, portability benefits, and no claim-based discount. Besides this, you can get organ donor coverage, emergency ambulance coverage, and in-patient hospitalization coverage.
- Health Suraksha - A health insurance plan like my: Health Suraksha Policy by HDFC Ergo is one you cannot ignore. With this plan, you can choose a sum insured ranging from Rs. 3 lakhs to Rs. 75 lakhs. There are three options: Silver Smart, Gold Smart, and Platinum Smart. The name of the plan implies that it can be purchased at any age and it can be renewed for as long as the policyholder lives. In addition to comprehensive benefits, the policy offers the option to pay a yearly premium in 3, 6, or 12 equal installments. A long-term medical insurance policy of up to three years is also offered under this plan at an affordable premium rate. To provide its policyholders with proper and comprehensive coverage, the plan offers features such as in-patient hospitalization, pre- and post-hospitalization, domiciliary hospitalization, and daycare treatment. As well as these benefits, the plan also provides some beneficial elements such as exclusive features such as air ambulance coverage, recovery benefits, infertility coverage, wellness features such as fitness discounts during renewal, and health incentives for maintaining health. Additionally, Flexi benefits include the option of capping room rent and co-paying to receive discounts on premiums. Additionally, there are some discount options such as a family discount, long-term policy discount, and loyalty discount.
2. Tata Aig Health Insurance
- Medi Senior - Retirement should be a time of health and peace for senior citizens. The Medi Senior Citizen Health Insurance Plan is designed with dignity and self-reliance in mind. As long as the hospital definition is met, it covers treatment in all hospitals in India. This medical insurance policy covers the insured as well as his or her spouse if he or she is at least 61 years old. This plan is available to people of any age. It is possible to purchase the policy for a sum insured of Rs. 2 lakhs, Rs. 3 lakhs, or Rs. 5 lakhs. A number of benefits are provided to policyholders by it. There are many benefits, including domiciliary treatment coverage, organ donation coverage, daycare coverage, discounts, and a free look period.
3. Niva Bupa Health Insurance
- Health Companion - Providing both individual and family floater coverage for several healthcare expenses, the Health Companion Policy is a comprehensive medical insurance policy offered by Niva Bupa Health Insurance. You can choose from different sum insured options starting from Rs. 2 lakhs to Rs. 1 crore, depending on your budget and requirements. There are different variants of the policy, namely variants 1, 2, 3, and Family First, which differ in terms of coverage benefits and sum insured options. It is available for 1 year or 2 years. A discount is offered on the premium paid for the second year if you buy it for two years. This policy is also available in top-up form with deductible options between 1 lakh and 10 lakhs. In addition to organ donation expenses, inpatient hospitalization expenses, pre-hospitalization and post-hospitalization expenses, daycare expenses, health check-up expenses, domiciliary hospitalization expenses, and modern treatments, the Health Companion Policy covers several benefits. Furthermore, the policy offers two optional benefits: hospital cash coverage and Safeguard (rider) that you can include in your policy for additional coverage above the benefits of the base policy. Refill benefits, No Claim Bonuses, lifetime renewability benefits, and Section 80D tax benefits are also included in the policy benefits. There are a lot of benefits included with the policy which may be useful in the event of a health emergency, which is why many people prefer it.
4. Care Health Insurance
- Care Senior Plan - Medical insurance for seniors is affordable with Care Senior Plan by Care Health Insurance (Religare). Individual and floater plans are available. Plans that offer sums assured of Indian rupees 3 lakhs, 5 lakhs, 7 lakhs, and 10 lakhs are available under the plan. There are no-claim bonus options and super no-claim bonus options available with this plan, which can increase the sum assured by 150%. There is an option to cover no-claim bonuses in super. A medical checkup is not required prior to purchasing this policy. This plan offers optional coverage of OPD care up to Rs. 5000 per policy year, which covers doctor consultations, diagnostic tests, and pharmacy expenses. In addition to opting out of SMART SELECT, an individual can also choose to pay a 15% premium increase.
- Care Advantage Plan - You and your family have been adequately protected with Care Advantage's comprehensive health insurance policy up to Rs. 1 crore. If you are hospitalized for more than 24 consecutive hours, your policy will cover your hospitalization expenses. The policy can be purchased on an individual or floater basis by people who are at least 18 years old. Depending on your budget and other requirements, you can buy a policy for 1 year, 2 years, or 3 years. The good news is that this policy does not have a maximum entry age restriction. You can benefit from a number of coverage benefits provided by the policy, including hospitalization expenses, pre-hospitalization expenses, post-hospitalization expenses, and organ donation expenses. Furthermore, the insurance plan offers automatic restoration of the sum insured, No Claim Bonuses for each claim-free year, with a maximum of 50% of the sum insured, as well as tax benefits under Section 80D of the Income Tax Act, 1961, as described above.
Eligibility Criteria For Mediclaim Policy For Senior Citizens
Specifically designed for people over 60 years of age, senior citizen health insurance plans provide medical coverage. These plans provide elderly people in their old age the most protection, whether they purchase them individually or as a family floater. Premiums paid for these plans can also be tax deductible. Things to Keep in Mind When Buying Senior Citizen Health Insurance Policy for Your Parents Consider the following 5 things when choosing a health cover for people over 60 if you are a senior citizen or buying one for a parent who is:
- Check out the different plans and compare their features - Choosing the right health insurance policy for an individual is important since it should cover a range of specific medical needs, including chemotherapy, organ donation, dialysis, etc. Ensure the policy includes features such as a sub-limit on the rent, consultation charges, and copays. You may have to pay a higher amount out of pocket if the sub-limit or co-pay is low.
- Make sure the sum assured is high - It is important to consider the rising cost of medical care as well as the uncertainty of the future when choosing the sum assured, the total amount for which you or your parents will be insured.
- Keep a record of the waiting period - In light of the age of the senior citizen population, a shorter waiting period for pre-existing diseases would be more beneficial. If the life insured needs insurance coverage at the most critical time, select a plan with a shorter waiting period.
- Parental policies should be separate - As premiums for family floater plans are determined by the eldest member of the family, parents who are senior citizens should not be included. Additionally, the renewal age depends on the eldest member's age. There is a possibility that a parent could use the sum assured in one claim, even though the entire family shares it.
- Co-payment - There are many health insurance policies for senior citizens that include a co-payment option, which means the policyholder is responsible for some of the medical expenses. In most cases, a copayment of 20 percent of the claim amount is required. Copayments may be reduced for renewals with some insurers, however.
Misconceptions About Senior Citizen Health Insurance
Health insurance for senior citizens is surrounded by several myths. There are some misconceptions that prevent people from purchasing health insurance even at this age for their parents or for themselves if they are seniors. In order to purchase health insurance for your parents, you must break some myths and follow some rules
- It is sufficient to have group insurance - Health insurance is very commonly misunderstood by many people. Many parents believe their parents will be covered by the company's medical group insurance. Several employees have rationalized the policy to reduce the steep premiums, and some have taken the step of excluding parents from it. The importance of not relying solely on Mediclaim policies for your parent's health insurance cannot be overstated.
- Conditions that preexist - There is no coverage for pre-existing ailments in the majority of health insurance policies, particularly for senior citizens. The same reason is why many people shy away from purchasing a health insurance policy as they assume their parents will be ineligible due to a pre-existing condition. Even if the condition isn't critical or terminal, many health insurance policies still cover it.
- Coverage is insufficient - Due to the absence of coverage for certain existing conditions, many people consider medical insurance policies to be useless. It is true that most health insurance plans cover existing diseases after a four-year waiting period. In the first four years, your parents will still be covered for hospitalization costs.
- Costs are higher - The cost of health insurance can be slightly higher for senior citizens, but this shouldn't discourage them from purchasing one. Health insurance policies for senior citizens can cover your parents adequately and won't pinch your pocket.
- A healthy and fit lifestyle - In spite of their good health and no existing ailments, your parents might be prone to certain illnesses or age-related ailments at any time. Whether your parents are healthy or not, it is critical for them to have health insurance.
Inclusions of Senior Citizen’s Health Insurance
Insurers define the coverages for senior citizen plans in their policies. Health insurance claims can be filed under these conditions. The following is a list of the general coverage that is covered by senior citizens' health insurance. Depending on the insurer, these can differ.
- The hospitalization process - Provides coverage for illness and injury treatment. In addition to doctor visits, room rent, operation theatre fees, etc., hospitalization expenses include expenses related to doctor's visits.
- Charges for the ICU - There is a significant difference between ICU charges and normal room rent expenses. Insurance policies for senior citizens cover these expenses.
- Charges for ambulances - According to the terms and conditions of the health plan, transport charges will apply to the insured to the nearest medical facility.
- Hospitalization and post-hospitalization - Up to 30 days of coverage for expenses related to pre-hospitalization and 60 days of coverage for expenses related to post-hospitalization.
- Treatment in daycare - Treatments that don't require hospitalization for longer than 24 hours are categorized as daycare procedures. Cataract surgery, for example, is covered.
- Coverage for domiciliary care - Treatments that can be obtained at home are covered.
- Getting a second opinion - A consultation fee from another medical professional is also included.
- Checkups for preventive health - To detect any future ailments, full-body health checks are required.
Exclusions of Senior Citizen’s Health Insurance
Health insurance plans for senior citizens include the following exclusions. Detailed exclusions can be found in the policy document.
- Self-harm or suicide attempts are intentional injuries.
- Adventure sports can result in the need for medical treatment.
- As a result of war, injuries occur.
- A venereal disease or an STD (sexually transmitted disease).
- Surgery for cosmetic purposes is not recommended unless it is necessary due to an accident.
- In most cases, dental treatment is not necessary unless an accident has caused it.
- Obesity-related medical treatment.
- Gender replacement surgery or treatment.
- There is no coverage for unproven medical treatments.
- Expenses associated with maternity leave.
