The possibility of contracting illnesses increases with age. If not prepared, senior citizens have to bear the inflating medical costs. Such financial pressure can get overwhelming and also affect their retirement savings. A solution to preserve your savings while getting the best medical care is investing in senior citizen health insurance plans. Such a policy is specifically designed for people aged above 60 years. If you or your parents exceed this age range, you should consider buying a senior citizen medical insurance policy to manage the unprecedented medical expenses in your old age.
The best senior citizen health insurance policy is one that offers maximum coverage against all significant medical conditions that typically impact senior citizens’ health. It should also come with a decent sum insured amount to cover the various medical costs arising from a medical diagnosis. For instance, the policy should cover the cost of hospitalisation, surgeon’s fees, ambulance charges, pre and post-hospitalisation expenses, medical tests and screenings, and annual health check-ups, among other things. You should also be able to customise your policy with additional riders.
Features & Benefits of The Best Senior Health Citizen Insurance Plans
When looking for the best policy for senior citizens, check for these salient features:
As senior citizens, you may have specific health concerns for which you may require coverage. Insurers may typically not offer this type of coverage with standard health plans. However, a Senior citizen health insurance plan can help bridge this gap. Such a plan focuses on areas such as domiciliary care, critical illness coverage, day-care charges, and more. Some plans also cover alternative treatments and procedures to help you seek non-allopathic treatments under the AYUSH (Ayurveda, Yoga and Naturopathy, Unani, Siddha, and Homeopathy) vertical.
Free Health Check-up
Early detection is essential to stop ailments from turning into severe threats. For this, regular check-ups are necessary. The insurance company typically assesses your medical history to understand your health condition and determine the premium. Hence, insurers conduct an annual medical check-up during the policy renewal period. They consider your changing health conditions to determine the appropriate premium amount for the following policy year.
General health insurance plans come with an age limit, which means you cannot renew the policy after a certain age. One of the beneficial features of the best senior citizen health insurance policy is that it eliminates this age limit constraint. Insurers today include the lifelong renewability clause in senior citizen plans that prevents the hassle of re-qualifying for new medical insurance after growing old. With this benefit, you can enjoy your chosen health coverage under a senior citizen health policy for life.
Insurers enable you to personalise or customise the senior health insurance plan based on your needs. While they may devise the base plan to include or exclude certain aspects of coverage, they provision of additional riders enables customisation. You can thus personalise your plan by choosing various riders to meet your specific healthcare needs. However, the addition of riders to your policy attracts a higher premium. You must thus perform a cost-benefit analysis to make the right selection.
No Claims Bonus
If you successfully complete the policy period without raising claims, the insurance company rewards you with a no claim bonus. Insurers offer the no claims bonus either as a discount on the premium amount or enhance your policy’s sum insured. In either case, the bonus is offered progressively over a period of 5 years, wherein you can get up to 50% discount (10% for each claim-free year), or a 50% enhanced sum insured.
Tax Saving Benefits
The best senior citizen health insurance plan comes with tax benefits on crucial investments like insurance. The Government of India offers annual tax deductions of up to ₹50,000 on senior citizen health insurance policies under section 80D of the Income Tax Act, 1961. Such a benefit also includes a tax rebate of ₹5000 on preventive health check-ups. However, these benefits may be claimed only by individuals purchasing the senior citizen policies. Thus, individuals under 60 years purchasing health insurance for their parents may claim annual tax deductions of ₹75,000 (₹25,000 for self, spouse, and children, and ₹50,000 for parents). Additionally, senior citizens purchasing insurance for their parents can claim up to ₹100,000 in tax deduction benefits.
Best Medical Insurance for Senior Citizens – Inclusions and Exclusions
The best health insurance plans come with a standard coverage structure with inclusions and exclusions as follows:
- In-patient hospitalisation costs like medicines, room rent, ICU charges, doctor fees, etc.
- Pre-and post-hospitalisation expenses
- Cost of domiciliary care
- Modern procedures
- AYUSH treatment
- Day-care procedures
- Organ donor expenses
- Ambulance charges
- Self-imposed injuries
- Adventure sport-related accidents
- HIV/AIDS treatment
- Dental treatments unless due to accidental injury
- Expenses for treating alcohol or drug addiction
- Injuries resulting from war, terrorist activities, strife, etc.
- Recreational cosmetic surgeries
How to Determine the Ideal Coverage for Senior Citizen Health Plans?
Consider these factors while choosing the best senior citizen health insurance plans.
- Health Concerns
Your current health condition is a significant factor that influences the kind of coverage you would need. For instance, if you have pre-existing illnesses, the best medical insurance for senior citizens is the one which covers you against these ailments. It helps to consult your doctor to evaluate your health profile and detect the possible health concerns before purchasing your insurance plan.
- Medical History
Insurance companies look into your medical history to decide the premium amount. They also use it as an important factor to finalise the coverage, and sum insured. You should do the same. Understand your medical history to detect the definite health concerns that need medical protection. Based on this information, you can evaluate the offered coverage and compare the insurers’ offers.
- Desired Premium
Your budget should also form a guiding factor while determining the ideal coverage. If you want a lower premium, go for the minimum coverage that meets your essential needs. But if you can afford to pay a higher premium amount, check out add-ons that meet your specific coverage requirements. To get a better idea, you can conduct a cost-benefit analysis before selecting the coverage.
- Geographical Location
The area of your residence determines your coverage needs to a great extent. If you reside in a metro city, the exposure to pollution, imbalanced climatic conditions, processed foods, etc., is high. As a result, you are exposed to higher health risks. This is not the case in rural areas with limited environmental distress. Thus, this factor is worth consideration to determine the ideal coverage.
Best Senior Citizen Health Insurance Policies Available in India
The best health policy for senior citizens is one that provides maximum coverage while being affordable. Here are some policies worth considering.
- Health Suraksha Platinum Smart Plan by HDFC Ergo
A policy with a high sum insured lets you combat the inflating medical costs and seek the best treatment. HDFC Ergo’s Health Suraksha Platinum Smart Plan is designed to focus on this aspect. With a significantly high sum insured of ₹75 lakhs, this policy helps you bear the hefty medical costs. You can also choose premium hospital rooms with no upper cap on the daily rent. If you don’t want high coverage but extensive perks at a lower premium, you can also check out HDFC Ergo’s Health Suraksha Silver Plan and Health Suraksha Gold Plan.
- Care Senior by Care
Loaded with various value-added benefits, Care Senior by Care gives you complete protection in your golden years. It includes features like automatic recharge on the sum insured, OPD cover, a discount of 15% on the premium payable, no pre-policy medical check-up, etc. You can also meet your specific needs with special add-on covers to reduce the waiting period and enhance your sum insured with the no claims bonus. Moreover, you can adjust the sum insured based on your preference.
- ReAssure by NIBH
Niva Bupa Health insurance offers holistic solutions for managing medical expenses with their ReAssure policy. Besides being the best policy for senior citizens, it safeguards your entire family. You can rely on it to reassure your family’s safety at every step. Some notable highlights of ReAssure health insurance plan are its 30-minutes cashless claim processing, 30% discount on renewal premiums based on the step count in Niva Bupa Health App, chance to double the sum insured within two claim-free years, etc. These features, combined with a wide network of hospitals, ensure a smooth claim settlement experience.
- Activ Health Platinum Enhanced by Aditya Birla Health insurance
The Activ Health Platinum Enhanced Insurance Plan is a one-of-a-kind health insurance plan. It offers coverage that goes beyond the standard norms. You can cover chronic illnesses and modern treatments under this policy. You can also get mental illnesses, dental procedures, and obesity treatment cover under the premium plan. Additionally, Aditya Birla Health insurance packs in benefits like 100% return on premium through rewards, reloaded sum insured, access to an expert health coach, second e-opinion on critical illnesses, etc. Such advanced features make it the best senior citizen health insurance plan. You can also choose the relatively affordable Activ Health Platinum Essential Health insurance Plan by Aditya Birla Health Insurance.
Tips for Picking the Best Senior Citizen Health Insurance Policies
Follow the below tips while choosing the best senior citizen policy among the many choices available in India
- Identify Coverage Needs
Before looking for the best policy, you must identify your coverage needs. Once you have determined your requirements, you can customise the policy accordingly. Consider factors like your pre-existing health conditions, need for transportation assistance during medical emergencies, type of care required, etc. Match these aspects with the features included in the senior citizen health insurance policies and choose a plan that best fits your requirements.
- Compare Providers
Most insurance companies offer personalised insurance plans with value-added benefits to attract attention. They also include exclusive discounts on premiums. You can check the benefits an insurer offers by entering your details on their website and getting a quote. Also, ensure you consider their reputation and years of service to assess their credibility. Comparing various insurers for their benefits and coverage enables you to finalise the right one.
- Examine Claim Settlement ratios
The claim settlement ratio shows you how soon and how many claims an insurer settled during a given year. The ratio is expressed as a percentage and you can see the settles claims, the pending ones, and the claims rejection ratio. Choosing an insurer with a high claim settlement ratio is critical as it can impact your own chances of getting filed claims settled. You can find information about various medical insurance providers’ claim settlement ratios on the IRDAI website.
- Check Network Hospitals
While choosing the best health insurance providers, it is essential to check their network hospitals. It helps to select an insurer with a wide network of hospitals that can fulfil your various medical needs in old age. You must also ensure you select an insurer with a good hospital in or around your neighbourhood so that you can seek urgent hospitalisation during medical emergencies. The ideal insurer is one that has tied up with various reputed hospitals offering specialised treatments.
- Understand co-payment
Most senior citizen health plans come with a co-payment clause. Under this clause, you are required to pay for a portion of the treatment cost, while your insurer bears the rest, up to the sum insured limit. Insurers fix the co-payment amount as a percentage of the claim amount. Some insurers may forego this requirement and charge a higher premium. You must assess the co-payment requirement while buying your policy or use it as a parameter to compare plans depending on whether or not to choose a plan with the co-payment clause.
- Look into critical illness benefits
A crucial aspect of old age is handling expenses arising from critical illnesses. Conditions like cancer, heart problems, stroke, kidney failure, etc., become increasingly common during old age. The medical cost of treating them is extremely high since most conditions warrant long-term care. Hence, the best medical insurance for senior citizens should include critical illness benefits. Additionally, you must check the waiting period on the policy before claiming coverage for critical ailments.
Purchasing the Best Medical Insurance For Senior Citizens – The Steps
Most insurance companies have made it convenient to buy senior citizen policies online. You can visit their official website and follow these steps.
- Locate the ‘Senior Citizen Health Policy’ on your chosen insurer’s website.
- Enter your personal details like your age, name, location, contact information, etc.
- You will get a tentative insurance quote stating the sum insured and possible premium amount.
- If you are satisfied with the quote, you can go to the next section and fill in the essential details in the declaration form.
- Now upload the digital copies of the required documents for verification.
- Pay the applicable premium via NetBanking or Mobile Banking.
- Once your payment is processed, the insurer verifies your details.
- If everything is correct, you will receive the policy documents in your email within a few hours. You can take a printout of the same for future reference.
Alternatively, you may approach your insurance agent or broker to purchase your senior citizen plan.
Do senior citizen health insurance policy benefits continue after porting?
Yes, you continue to enjoy benefits like cumulative bonus and completed waiting period even after porting your senior citizen policy to a new insurance company. However, you must ensure you port to a plan with similar coverage as the previous one.
What is the entry and exit age in medical insurance for senior citizens?
The entry age in most senior citizen health insurance plans is 60-65 years. For the exit age, there is no limit, as you can enjoy lifetime renewability benefits. However, the exact age criteria may differ from one insurer to another. Hence, it is best to check their policy terms.
Are medical insurance plans for senior citizens costly?
Yes, compared to other categories, senior citizen health plans are relatively expensive due to the high risk of contracting illnesses in old age. The greater the risk for insurers, the higher premium they charge. Despite the high cost, you can save through discounts and seasonal offers. Therefore, researching and comparing policies is important while buying health insurance.
What documents are required while buying senior citizen medical insurance policy online?
Insurers generally ask for basic documents like your age, identity and residence proof. They may also ask for your medical records and income proof documents. You need to provide soft copies of these documents while purchasing your policy online.
How to file a senior citizen medical insurance claim?
Following are the steps
1. Inform your insurer/agent about your intention to file a claim
2. Tell them about the hospital where you intend to seek treatment and inform them whether you wish to file a cashless or reimbursement claim.
If you choose the cashless claim method, the insurer contacts the network hospital to settle your claim. If you opt for a reimbursement claim after seeking treatment at your preferred hospital, you must submit the original bills, copies of suggested treatment course, etc., after being discharged from the hospital.
Is a medical check-up required before buying the senior citizen health policy?
Yes, almost all insurance providers insist that their senior citizen policy buyers under a medical check-up. The check-up enables insurers to assess your medical condition and determine the premium amount. Insurers typically ask you to undergo the check-up at one of their network hospitals.