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What is Senior Citizen Health Insurance?

Senior Citizen Health Insurance Plans are made for people in the old age when health problems occur frequently in daily life. It is very necessary to buy a health insurance that suits their requirements at an old age. These policies are for people primarily between 65 to 80 years in age. Most policies have capping on different benefits like room-rent etc. as companies look to reduce the risk factor. You should give more preference to the plan with a lesser waiting period, higher room rent etc. It’s difficult to get the ideal and perfect product with all the benefits and no limits. However, if a policy is properly searched and compared before buying, then it proved to be very effective during any medical emergency. Some of the insurers have also started to offer plans exclusively designed for senior citizens.

Frequently Asked Questions

    Factors To Consider While Buying

    Coverage level: Every health insurance plan in the market differs in the context of the coverage. While the basic features of the coverage are the same, the terms and conditions may be different. Additionally, health insurance plans also have unique coverage options like the restoration of the Sum Assured, fewer sub-limits, coverage for Ayurvedic or Unani treatments, etc. So, before you opt for any plan, its scope of coverage should be the main focus. You need to weigh what are your needs and then determine whether a particular policy suits your requirements.

    Sub-Limits: We often tend to overlook this as these factors may sound trivial at the time of buying but they become equally important at the time of medical emergency. For instance, the limit on specific surgeries, ambulance charges, room rent, etc. are there in most health plans. 

    Waiting Period: Health insurance plans have an initial gap period during which certain advantages cannot be availed by the policyholder. Different insurance companies have a different waiting period in their various plans. For example, ailments like fissure, piles, hip-bone replacement, etc. have a 2 year waiting period before it is covered. Pre-existing ailments, like diabetes, hypertension, etc., are covered after a certain period of time. In these cases, you should look for the plan with the lowest waiting period or you can look out for a Critical Illness Plan for Diabetes etc.

    Network of Hospitals: A network hospital is considered to be one of the best options for senior citizens as it has a cashless facility. This means that the policyholder just need to show the medical card provided by the insurer and the insurer will bear all the valid medical expenses until the Sum Insured is exhausted. 

    Co-Payment: The concept of co-pay is introduced in order to divide the risk between insurer and policyholder. Your contribution is generally 10-20 percent which varies from insurer to insurer. Senior citizens generally have a pre-existing illness and insurance companies generally do not cover them with regular family floater plans as the Sum Insured may prove to be inadequate for them. Lesser premium with a co-payment clause is a better alternative for the senior citizens.

    What is covered in Parents Health Insurance

    1. Cashless facility: The insurance company issues an identity card to the Insured and on showing this card on the networked hospital, he/ she can avail cashless facility meaning insurance holder need not pay anything to the hospital. The Insurer would have a tie up on almost all the hospitals already to facilitate cashless facility.

    2. Hospitalization cash benefits: Every day hospitalization expenses are covered to reduce the financial burden of the insurance holder. This would be great help to the insured as this amount would compensate the loss of earnings and other costs.

    3. Pre and post hospitalization costs: Usually pre and post hospitalization expenses are covered up to 60 to 90 days and some insurance company even approve up to 140 days.

    4. Ambulance charges: Even ambulance charges are covered by some insurance company and the insurance holder need not worry about those charges.

    5. Health checks up: In case there is no Claim for certain number of years, some company even provides free health check up to the insured.

    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, the act of foreign army etc.

    Practical example that you can relate to:

      Yash is a software engineer with a regular income of Rs. 60,000 per month. His parents are aged above 60 and are healthy except for certain mild ailments. However, Yash has two kids who are studying in school. Yash’s wife is a homemaker and they have no other sources of income. In this case, a health insurance is quite important for each of his parents. Considering Yash’s position it would be best for him to take a health insurance plan for his parents so as to avoid any sudden medical expense that might arise. In case of any medical emergency, Yash no longer needs to bother about expenses as each parent is covered by an individual health plan which is customised according to the needs.

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