Senior Citizen Health Insurance

The older we get, the more our physical and mental stress over finances and the ability to afford good healthcare. A senior citizen health insurance planis designed to offer financial aid for medical treatments to individuals over 60 years of age in their hour of need. Senior citizen health insurance plans offer critical illness cover, cashless hospitalisation, pre-existing disease cover, and a higher sum assured.

With increasing age comes the additional risk of contracting diseases and falling sick. Since, the later years of an individual’s life are physically more challenging and financially less sound, having a medical insurance scheme to take care of any urgent medical expenditure is a clever move.

Health insurance schemes for senior citizens/parents offer, various special features like cashless hospitalization, critical illness coverage, specific coverage for diseases like Cancer, Stroke and so on.

Key Features of Senior Citizen Health Insurance:

Some of the most significant features of health insurance plans for senior citizens in India are as stated below-

• Hospitalization cover including medical bills and room charges
• Cashless Hospitalisation
• Day Care expenses which arise out of technological advancements
• Ambulance Charges are covered
• Pre-existing diseases are covered based on the insurance provider
• No medical test required before availing medical insurance. This is based on insurance provider
• Higher sum insured coverage
• Pre-existing disease coverage
• Faster and hassle-free settlement

Best Health Insurance Plans for your Parents:

Following are the most popular senior citizen health insurance plans in India:

Insurance Company	Plan Name	Features
Bajaj Allianz	Silver Health Plan	Cashless facility in all of the network hospitals, under the Silver Health plan. Bajaj Allianz Diagnostic centres can be used for a free health check-up after a period of 4 years which are claim free. Extra 5% discount for the family, and a bonus which is cumulative at a 5% rate for every claim free year. Individuals within the age group of 46 years – 75 years are eligible for this plan, after required medical tests
New India Assurance	Senior Citizen Mediclaim Policy	Eligibility for this policy, the individuals should be between the ages of 60 years – 80 years. This can continue up to 90 years if renewed without a break. Pre and post hospitalization charges are covered up to 30 days for pre hospitalization and 60 days post hospitalization. Hospitalization for illness and injuries will be covered and all treatments conducted will be covered as well. All pre-existing ailments and diseases will be covered after the completions of 18 months with the continuous involvement with the company.
	HOPE – Health of Privileged Elders	The policy will provide the room rates, expenses related to nursing, to the limit of 1% of the sum insured. The policy will include ambulance charges up to Rs. 1000/- or the actual expenses incurred. All doctors, anaesthetist, surgeon, specialists charges are covered under the policy. As well as all the costs related procedures they will need to perform. Example, blood, oxygen tanks, surgical appliances, Dialysis, Chemotherapy, Radiotherapy etc. If the insured individual will need intensive care, then intensive care unit will be covered to a limit of 2% of the sum insured per day.
United India Insurance	Senior Citizens	The policy will cover hospitalization for room and boarding expenses and expenses related to nursing to the limit of 1% of the sum insured or the actual expenses incurred whichever is less. All doctors, anaesthetist, surgeon, specialists charges are covered under the policy. As well as all the costs related procedures they will need to perform. Example, blood, oxygen tanks, surgical appliances, operation theatre charges, x-rays etc. Pre and post hospitalization charges are covered up to 30 days for pre hospitalization and 60 days post hospitalization. For Cataract, Hernia, and Hysterectomy – the coverage will be 25% of the sum insured or the actual expenses incurred whichever is less.
Star Health Insurance	Senior Citizens Red Carpet	Individual eligible for this policy is anyone between the age group of 60 years – 75 years. And they will not require a pre medical test for this policy. Sum assured ranges from Rs.1,00,000 to Rs.10,00,000 lakh. A minimum of 24 hours of hospitalization at the in-patient, including expenses related to the room rent, nursing, boarding, doctors, anaesthetist, surgeon, specialists charges etc. Pre and post hospitalization charges are covered, as well as ambulance costs, as specified.
	Care Freedom	Minimum entry age is 18 years for adults and upper age has no limit. The scheme offers life-long renewability All customers, irrespective of their age are eligible to avail this medical insurance policy without going for a medical check-up. Medical screening is not mandatory to avail this insurance scheme All members of the scheme are eligible to get coverage for annual health check-up Cashless treatment and quick claim settlement are major highlights of the Care Freedom Policy Sum assured gets recharged automatically if the coverage limit is exhausted as a result of any claim made Any pre-existing disease disclosed attracts a waiting period of just 2 years

Myths about Senior Citizen Health Insurance:

There are several myths surrounding health insurance for senior citizens. Even at this age, many people do not purchase health insurance for their parents or in case of a senior citizen, for themselves because of certain misconceptions. Given below are some myths about health insurance that need to be broken and rules that need to be followed while purchasing health insurance for your parents:

• Group insurance is sufficient:This is a very common misconception many people have about health insurance. Many believe that the mediclaim group insurance offered by the company will provide enough cover for their parents. Many employees have been rationalising the cover in order to reduce the steep premium and some of them have taken a step further to exclude parents from the policy. It is very important to not rely on just mediclaim policies to offer health cover to your parents.
• Pre-existing conditions:It is true that most of the health insurance policies do not cover pre-existing ailments, especially when it senior citizens. Because of this very reason, many shy away from opting for a health insurance policy as they are under the impression that a pre-existing ailment might make their parents ineligible for a health insurance policy. But a lot of health insurance policies still offer cover if the ailment is not critical or terminal.
• Insufficient coverage:Many consider health insurance policies to be useless as they do not offer cover for certain existing conditions. While this is true, almost all of the health insurance policies have a waiting period of four years after which existing diseases are covered. But your parents will still be covered for hospitalisation charges in the first four years for other ailments and accidents.
• Higher cost:It is true that health insurance can be slightly more expensive for senior citizens but that should not discourage one from purchasing a health insurance policies. There are many senior citizen health insurance policies in the market that won’t pinch your pocket and offer adequate health cover to your parents.
• Healthy and fit:Though your parents might be in their best shape and have no existing ailments, unforeseen circumstances such as age related ailment or a certain illness can hamper their health any time. It is very important to have health insurance for your parents even if they are fit and healthy.

Key Points to Follow while Buying Health Insurance for Parents:

Listed below are some of the key points that one needs to follow while purchasing senior health insurance policy for their parents.

• Medical history:It is important not to rely on your parent’s knowledge of their medical history when it comes to opting for health insurance. Your parents might not be aware of certain ailments or medical conditions that they might be suffering from. Health insurance providers require you to provide information about existing health ailments that your parents have and are aware of. Hence, it is very important to be thorough with the information you provide regarding the medical history of your parents.
• Choosing the plan:There are several factors that go into choosing the right health insurance policy. It is important to compare between the various health insurance plans available in the market and consider factors such as cover, cost and exclusions before zeroing in on the final right plan.
• Filling the proposal form:Once you’ve chosen the right policy, you’ll need to fill in the proposal form for the policy. It is imperative that you provide correct and relevant information while filling in the form. Providing incorrect information will not only lead to complications but it might also lead to rejection of the application.
• Medical check-up:Once you’ve submitted the proposal form, a doctor on the panel of the insurance company will go through it will conduct an interview to verify the information on the form regarding the medical conditions mentioned on it. Next comes the medical check-up, the doctor will conduct about 11-13 tests depending on the health condition of the individual. Blood routine, lipid profile, sugar, urine routine, liver function test, kidney function test, serum creatinine, PSA (for men), sonography (for women) are some of the tests conducted.

Who Should Buy Health Insurance Plan for Senior Citizens?

Health insurance plans for senior citizens are aimed basically at individuals who are above 60 years of age and are retired with no regular income. This type of health insurance can also be availed by children for their ageing parents.

What to do if the proposal is declined?

In case the insurance company rejects the health insurance proposal for your parents, there are two things you can do:

1. If you have doubts about the medical check-up conducted, you can get another medical check-up done by another doctor and submit the reports to the insurance company. If the insurance company is satisfied with the results the insurer might reconsider your application.
2. In case of rejection, you can always approach another health insurance provider. If you apply for health insurance with the second insurer within thirty days of applying for the first one, you can provide the medical check-up documents obtained from the first insurer to the second insurer.

Advantages of a Senior Citizen Health Insurance Plan:

Following are the benefits of availing a senior citizen health insurance scheme for your parents –

• Tax benefit on medical insurance premium
• Avail treatment and medical facilities across a host of hospitals across the nation
• Enjoy Cashless treatment and daily allowance (depends on insurer)
• Renewal of policy option
• Domiciliary Hospitalization cover
• Enjoy free-look period
• Avail health check-ups annually
• Reload of sum insured

Exclusions – What is not covered under Senior Citizen Medical Insurance?

Here are some of the most frequent clauses that are not covered under the senior citizen health insurance plans –

• Any pre-existing injuries/diseases
• Any diseases contracted within 30 days of availing the policy
• Any non-allopathic treatment
• Expenses related to self-inflicted injuries
• Expenses as a result of drug abuse
• Cost of spectacles/lenses and dental treatment (except arising out of accident)
• Medical expenses incurred for treatment of AIDS
• Certain ailments like joint replacement etc. are covered only after 2 years of availing the policy
• Cosmetic surgery
• Injury due to war, act of foreign army etc.