Health Insurance For Senior Citizen


Dec 29 2020


The segment of the population that is most susceptible to illnesses and their ensuing costs is that of senior citizens. As retired individuals, facing failing health and financial constraints, health insurance is probably the need of the hour. Obtaining medical insurance for senior citizens was almost impossible in the past insurance companies permitted renewal only if you have been a policyholder with them without a break. However, the Insurance Regulatory and Development Authority of India has instructed companies to set 65 as the highest age for entry into health insurance plans. Subsequently, the senior citizen health insurance policy took its present form.

Health Insurance for Senior Citizens refers to the reimbursement or indemnification of expenses incurred on account of medical conditions, exclusively for the senior citizens. A Mediclaim insurance for senior citizens, on the other hand, offers financial protection from all expenses related to events of hospitalization.

Benefits of Senior Citizen Health Insurance

Health insurance for senior citizens  offers various health insurance benefits to you as a policyholder. Here's a list of the most important ones.

  1. Financial Cover - In uncertain times, health insurance policies ensure that you get protected from unexpected and expensive financial costs and have a safety net to fall back on. While different companies offer varying products, almost all policies cover a wide range of illnesses and their ailments.                                                     
  2. Renewability Age - A medical insurance for senior citizens can not only be taken at the maximum age of 65 years but can also be renewed up to 80 years of age. Some companies allow renewability up to the age of 90 years, provided there has been no break in payment of premium since the policy was first taken.                    
  3. Cashless Hospitalization - Most companies that offer insurance plans to senior citizens allow cashless transactions, i.e., a benefit where the hospital can claim payment for the rendered treatment directly from the insurer.                                  
  4. Tax Benefits U/S 80D - It is important to note that health insurance for either yourself or for family members has an added benefit of reducing taxable income. If you purchase a health plan, you are eligible to get a tax deduction under Section 80D.


What does this Policy cover?

Several features need to be checked before opting for a health insurance policy that best suits you. Read the fine print and make sure you go over all the options available. The most obvious and important factor to consider is the extent of the cover provided. Depending on the vendor, there may be slight variations in product offerings. Still a good outline of what you can expect in a health insurance policy or a Mediclaim Policy for Senior Citizens is enlisted below:

  1. Hospitalization Expenses - These relate to direct expenses incurred on account of hospitalization. Doctor visits, room charges, cost of medication and surgery are entirely covered by an insurance policy, subject to the financial limit of the plan. Certain companies also offer pre- and post-hospitalization cover for a specified period.                                                                                                                         
  2. Daycare Expenses - A few procedures like chemotherapy and dialysis do not require hospitalization. However, most such medical procedures are also enlisted as 'Inclusions' in most Health Insurance Policies for Senior Citizens.                           
  3. Pre-Existing Conditions - While pre-existing medical conditions are not covered from the moment the policy is drawn, most medical insurance companies, usually  after one year, offer a cover to most pre-existing conditions.


Special Features of the Policy

Whether you choose to take up a Health Insurance or a mediclaim for senior citizens, you are eligible for certain benefits:

  1. 'NO CLAIM BENEFIT' - Most insurance companies offer a 'No Claim Benefit' wherein your premium is discounted if you have not made any insurance claims in the previous financial year. Some companies offer reimbursement for a health check-up every 3-4 years of 'No Claim' in addition to the benefit in premium.
  2. TAX GAIN - As a policyholder, under section 80D of the Income Tax Act, you can claim deduction for an annual premium amount not exceeding Rs. 30,000 in a financial year.


Factors to Consider When Comparing Senior Citizen Health Insurance

A few things that you should keep in mind before opting to purchase health insurance for the senior citizens in your family, like your parents, grandparents and your in-laws are:

  1. Coverage: Firstly it is important to understand the kind and amount of cover that is needed. A few things that you must pay more attention to during this phase of the health insurance buying journey are medical history, medical requirements, health concerns, If you have a spouse, your spouse’s health concerns, age and current financial situation. All these factors will influence the amount of cover needed.                                                                                                                        
  2. Lifetime Renewal: You must check if the health insurance for senior citizens plan you choose comes with a lifetime renewal option or not. You will have to decide regarding the renewal option after a certain point. It does make sense to choose a plan with a lifetime renewal option for senior citizens because with age also comes an increased requirement of medical help, medical attention and increased medical care cost. Hence, Lifetime renewal is something that you must give a hard think about.                                                                                                                 
  3. Pre-Existing Conditions: With age also comes ailments. Something that we can’t ignore. Hence it is highly important to keep a check on all pre-existing conditions and hereditary medical conditions. You should look at the entire list of medical diseases and ailments that the health insurance policy for senior citizens covers before buying it. The longer the list, the better.                                                          
  4. Co-Payments: While buying health insurance for senior citizens, you will notice that most plans come with co-pay. This determines the amount of money that you might have to pay from your pocket. Hence, it makes apt sense to choose a plan with the least amount of co-pay to ensure that you do not have to dip into lifetime savings.


Exclusions in Senior Citizen Health Insurance

Being aware of the exclusions that policies entail will not only help you make an informed decision but also prepare you beforehand to deal with such unexpected situations. Most Senior Citizen Insurance Plans do not cover the following situations:

  1. Illnesses contracted within 30 days of signing up for the policy
  2. Dental treatment, except in cases arising out of an accident
  4. Cosmetic Surgery
  5. Vaccination/Inoculation
  6. Illnesses contracted in times of war or nuclear attacks.

Senior Citizens are often the most neglected category in as far as an insurance cover is concerned. Apart from being absolutely necessary, an insurance, be it a health insurance policy or a Mediclaim for senior citizens is quintessential in leading a worry-free and hassle-free life. However, finding the right policy that suits both, your requirements and your budget, may qualify as a challenging task. A little patience and thorough research can help you find that ideal plan that will financially protect you from most untoward medical circumstances. Health insurance benefits are many - the goal is to find the right insurance policy.