Bajaj Allianz Health Insurance For Senior Citizens

Introduction

Bajaj Allianz Silver Health Plan for Senior Citizens is a health insurance policy designed especially for senior citizens. Private healthcare is getting unaffordable day by day, which leads squarely to exorbitant medical bills. Also, healthcare costs increase with age.

Sometimes, all it takes is just one medical emergency to wash out all of your life’s savings. Nowadays, affordable health insurance plans are not only available for the young. Bajaj Allianz Silver Health plan is an exclusive health insurance policy for senior citizens that protects them from emergency healthcare expenses. This Health Plan is a comprehensive medical insurance policy for senior citizens that provides financial security for critical illnesses, hospitalization, medical check-ups, and more.

Invest in a health insurance policy for senior citizens and save your parents and yourself from financial difficulties due to unforeseen situations. The plan also offers cover to you and your spouse when you need expensive medical care.

Features of Bajaj Allianz Health Insurance For Senior Citizens

1. Pre-existing illness cover – This policy covers pre-existing illnesses until 1 year after the policy is issued.

2. Co-payment waiver – You can avail co-payment waiver, which is a voluntary amount(%) that you can opt to pay from the overall medical while the rest of it is taken care of by the insurer.

3. Cumulative Bonus – Avail 10% cumulative bonus up to your limit of indemnity for every claim-free year, the maximum limit is up to 50%.

4. Pre and post-hospitalization coverage – Covers pre and post-hospitalization expenses for up to 60 and 90 days respectively.

5. Higher entry age – This policy covers members up to 70 years of age.

6. Ambulance coverage – This policy covers a limit of Rs. 1,000 as ambulance charges in an emergency.

7. Free health check-up – Avail free health check-ups at designated medical centers after completion of 4 continuous claim-free years.

8. 15 days of free look period. It is not valid at the time of policy renewal.

Basics details of Bajaj Allianz Health Insurance For Senior Citizens

I. Eligibility age – 46-70 years.
II. Policy term – 1 year.
III. Renewability – Lifetime indemnity limit for continuous policy renewal.
IV. Insured sum amount – Minimum and Maximum sum insured amount ranges from Rs. 50,000 – Rs. 5 Lakhs.
V. Discount – A family discount of 5% applies to the policy.
VI. Co-payments – The policyholder is expected to bear 20% of the admissible claim in case of medical treatment at a non-impaneled hospital. Waiver of co-payment can be availed in case of payment of extra premium.

Some additional benefits of the Bajaj Allianz Silver Health Plan

1. Tax savings

You can avail of income tax benefits under Section 80D of the Income Tax Act, 1961. On opting for Senior Health Plan for your parents, you can avail of Rs. 25,000 per annum as a deduction against your taxes(provided not over 60 years). If you pay a premium for your parents aged 60 years or above, the maximum health insurance benefit for tax purposes is capped at Rs. 50,000.

As a taxpayer, you can get the tax benefit up to a total of Rs. 75,000(if you are below 60 years and your parents are senior citizens aged 60 years or above). If you are aged above 60 years and paying a medical insurance premium for your parents, then you can get a maximum tax benefit of upto Rs. 1 lakh.

2. Claim

The in-house claim settlement team makes the claim settlement process very quick, smooth, and easy. Bajaj Allianz also offers cashless claim settlements at more than 6,500 network hospitals across India.

3. Avail a family discount of 5% for each member of your family covered under this policy.

4. This policy offers attractive and customized packages to fulfill your requirements.

5. Avail access to the cashless facility at over 6,500 hospitals in India for cashless facility.

Inclusions and exclusions of Bajaj Allianz Health Insurance For Senior Citizens

The policy does cover

  • Expenses amounting equivalent to 3% of admissible pre and post hospitalisation expenses.
  • Ambulance charges upto a limit of Rs. 1,000 in emergency.
  • Pre-existing illnesses get cover after 1 year of policy inception.
  • After 4 years of policy period, free health check ups in designated diagnostic centers are provided including ECG, Glucose test, physician consultation, lab tests, cholesterol, X-ray etc.

The policy doesn’t cover

  • Any disease contracted during the first 30 days of commencement of the policy.
  • Diseases such as a hernia, piles, cataract, benign prostatic hypertrophy, and hysterectomy will uncovered until a waiting period of 1 year.
  • Non-allopathic medicines.
  • All expenses arising from AIDS and related disorders.
  • Cosmetic, aesthetic or related treatment.
  • Any disease or ailment arising due to the use of intoxicating drugs and alcohol.
  • Joint replacement surgery(other than due to accidents) will not cover until a waiting period of 4 years.
  • Treatment of any mental illness or psychiatric illness.

Easy and fast claim process of Bajaj Allianz Health Insurance For Senior Citizens

Claim by Direct Click (CDC)

Bajaj Allianz General Insurance has an app-based claim submission process known as “Health Claim by Direct Click” (CDC). This facility allows you to register and submit claim documents through the app itself for claims up to Rs. 20,000.

Procedure

  • Register your policy and card number in the Insurance Wallet App.
  • Register your policy and health card number in the app.
  • After that Register the claim.
  • Fill the claim form and arrange for the hospital-related documents.
  • Upload the documents using the app menu.
  • Submit the claims for further processing.
  • Get confirmation within a few hours.

Cashless claim

The Cashless facility at network hospitals is available 24×7 throughout the year, without any hassle in service. But, keep in mind that hospitals providing cashless settlements are liable to change their policy without notice. So, keep the network hospitals checked and get admission in the enlisted ones.

The updated list is available on the official website of Bajaj Allianz general insurance. Also, the issued Health Card along with a government ID proof is mandatory for availing of the cashless facility.

Procedure

  • Get the pre authorisation request form filled and signed by the treating doctor/hospital and also signed by you or a member of your family, at the hospital’s insurance desk.
  • Network hospital will fax the request to the Bajaj Allianz ‘Health Administration Team(HAT)’.
  • HAT doctors will check the pre authorisation request form and decide on the availability of cashless facility, as per the policy guidelines.
  • Authorisation letter(AL) or denial letter or additional requirement letter will be issued within 3 hrs depending on the plan and its benefits.
  • At the time of discharge, the hospital will share the final bill and discharge details with HAT. Based on their assessment, final settlement will be processed.

Important factors to know about cashless facilities

  • Admission at network hospital is subject to bed availability.
  • Cashless facility is always subject to policy terms and conditions.
  • The policy does not cover – telephone charges, foods for relatives, toiletries.
  • Its include Room rent nursing charges. But, if room charges are high then the incremental charges will not be carried by insurer.
  • In case, the treatment is not covered as per the policy terms and conditions, then your claim cashless or reimbursement will be rejected.
  • In case of inadequate medical information, pre authorisation for cashless claim can get denied.
  • The denial of cashless facility does not mean denial of treatment and does not prevent you from seeking necessary medical attention or hospitalisation.

Reimbursement claim procedure.

  • Inform the Bajaj Allianz General Insurance HAT(Health Administration Team) about the hospitalization.
    a. To register your claim online, visit the official website and go to the silver health plan option.
    b. To register your claim offline, call on toll-free number 1800-209-5858.
  • After discharge, you or a member of your family must submit the following documents to HAT within 30 days,
    a. Duly filled and signed claim form with mobile number and email ID.
    b. Original hospital bill and payment receipt.
    c. Investigation report.
    d. Discharge card.
    e. Prescriptions.
    f. Bills of medicines and surgical items.
    g. Details of pre-hospitalization expenses(if any).
    h. In patient papers, if required.
  • All documents to be sent to the HAT for further processing and based on the assessment, the final settlement will be done within 10 working days.
  • Post hospitalisation claim documents must be sent within 90 days from the date of discharge.

Pre and post-hospitalization reimbursement

Relevant medical expenses incurred before admission and after discharge from the hospital will be reimbursed as per the policy. Prescriptions and bills/receipts of such services should be submitted to Bajaj Allianz General Insurance along with the duly signed claim form.

Bajaj Allianz Silver Health Plan also covers some diseases after completion of 1 year

  • Endometriosis.
  • Cataracts.
  • surgery for Duodenal or Gastric Ulcers.
  • Hemorrhoids.
  • Benign prostatic hypertrophy.
  • Uterine bleeding.
  • Hydrocele.
  • Hernia.
  • Treatment for stones in the biliary system or urinary tract.
  • Prolapse of intra-abdominal organs.
  • Ear surgery.
  • Hysterectomy.
  • Anal fissures.
  • Prolapsed intervertebral discs.
  • Fistulae.
  • Fibromyoma.
  • Skin surgery.
  • Internal tumor or cyst.
  • Joint surgeries.

Contact of Bajaj Allianz Health Insurance For Senior Citizens

Bajaj Allianz General Insurance Company.
Address – Bajaj Allianz House, Airport Road, Yerawada, Pune – 411006.
Call – 1800-209-0144, 1800-209-5858.
E-mail – [email protected] / [email protected] (for senior citizen).

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