Mediclaim Policy For Senior Citizens

Contents Summary

Introduction

Mediclaim Policy for Senior Citizens or Senior Citizen Health Insurance is a type of insurance plan that covers medical expenses incurred by people above 60 years of age. The plan offers preventive health check-up facilities, cashless hospitalization at network hospitals for the elder persons. The plan also covers pre-existing diseases, hospitalization expenses, critical illness, pre and post-hospitalization expenses, and Coronavirus treatment.

General characteristics of Mediclaim Policy For Senior Citizens

1. Entry age is 60 years(minimum) and no maximum age limit.
2. Cashless claims are available at network hospitals.
3. Availability of preventive health check-ups.
4. Lifetime renewability.
5. You can get tax benefits under Section 80D of the Income Tax Act, 1961.

Benefits of Mediclaim Policy For Senior Citizens

Mediclaim policy for senior citizens offer an array of benefits like,

Medical coverage for elder persons

Under the senior citizen health insurance plans, persons above the age of 60 years get health coverage whereas, regular family health insurance plans provide coverage to people upto 65 years of age.

Pre medical screening

Unlike most health plans, elderly people do not require to undergo any medical screening before buying the policy.

Hospitalization expenses

Senior citizens can get wide coverage in these schemes. These plans cover medical expenses including pre and post-hospitalization, in-patient hospitalization, etc.

Cashless treatment

The plans also offer cashless treatment to elderly persons at network hospitals of the insurance company. The facility is provided as the person gets admitted for a minimum of 24 hours.

Renewability

Most of the health plans for senior citizens come with lifetime renewability.

Tax benefits

Senior citizens’ health plans come with Tax exemption benefits on the premiums paid every financial year. It is under Section 80D of the Income Tax Act, 1961.

Bonus

Senior citizens can avail no-claim bonus for every claim-free year, which can get a discount on renewal premiums. These discounts range from 20%-100% in some plans.

Some Health Insurance Plans for Senior Citizens

Aditya Birla Activ Care Plan

  • Entry age – 55-80 years.
  • Sum Insured – Rs. 3-10 Lakhs(standard), Rs. 5-25 Lakhs(premier).
  • Pre-existing disease coverage – from the 3rd year.
  • Pre policy medical check-up – Required.

Bajaj Allianz Silver Health Plan

  • Entry age – 46-70 years.
  • Sum Insured – Rs. 50,000-5 Lakhs.
  • Pre-existing disease coverage – from the 2nd year.
  • Pre policy medical check-up – Required.

Bharti AXA Smart Health Insurance Plan

  • Entry age – 18-65 years.
  • Sum Insured – Rs. 50,000-5 Lakhs(basic), Rs. 1-5 Lakhs(premium),
  • Pre existing disease coverage – from the 5th year.
  • Pre policy medical check-up – Required for people aging 45 years or above.

Care Senior Health Plan

  • Entry age – 61 years and above.
  • Sum Insured – Rs. 3-10 Lakhs.
  • Pre-existing disease coverage – from the 5th year.
  • Pre policy medical check-up – Not Required.

Cholamandalam Individual Healthline Insurance Plan

  • Entry age – 18-65 years.
  • Sum Insured – Rs. 3-5 Lakhs(standard), Rs. 3.5-5.5 Lakhs(superior), Rs. 4.5-10 Lakhs(advanced).
  • Pre-existing disease coverage – from the 5th year.
  • Pre policy medical check-up – Required for people aging 55 years or above.

Digit Health Care Plus Plan

  • Entry age – 18 years and above.
  • Sum Insured – upto Rs. 3 Crores.
  • Pre-existing disease coverage – from the 1st/2nd/3rd/4rth/5th year depending on the plan coverage.
  • Pre policy medical check-up – Dependent.

Edelweiss Health Insurance Plan

  • Entry age – 18 years and above.
  • Sum Insured – Rs. 1-5 Lakhs(silver), Rs. 5-20 Lakhs(Gold), Rs. 15 Lakhs-1 Crore(platinum).
  • Pre-existing disease coverage – from the 3rd/4rth/5th year depending on the plan coverage.
  • Pre policy medical check-up – Required for people aged 50 years or above.

Future Generali Health Suraksha Plan

  • Entry age – 18-70 years.
  • Sum Insured – Rs. 1-5 Lakhs(gold), Rs. 6-10 Lakhs(platinum).
  • Pre-existing disease coverage – from the 5th year.
  • Pre policy medical check-up – Required for people aged 50 years or above.

IFFCO Tokio Individual Medishield Plan

  • Entry age – 18-65 years.
  • Sum Insured – Rs. 50,000-50 Lakhs.
  • Pre-existing disease coverage – from the 4rth year.
  • Pre policy medical check-up – Required for people aged 60 years and above.

Kotak Mahindra Health Care Plan

  • Entry age – 18-65 years.
  • Sum Insured – Rs. 2-4 Lakhs(excel), Rs. 5-25 Lakhs(premium).
  • Pre-existing disease coverage – from the 5th year.
  • Pre policy medical check-up – NA.

Liberty Health Connect Plan

  • Entry age – 18-65 years.
  • Sum Insured – Rs. 3-7.5 Lakhs(e-connect), Rs. 2-10 Lakhs(basic), Rs. 3-15 Lakhs(elite), Rs. 2-15 Lakhs(supreme).
  • Pre-existing disease coverage – from the 3rd/4rth/5th year depending on the plan coverage.
  • Pre policy medical check-up – Required for people ageing 55 years and above.

Manipal Cigna Pro Health Insurance Plan

  • Entry age – 18 years and above.
  • Sum Insured – Rs. 2.5-50 Lakhs(protect), Rs. 4.5-50 Lakhs(plus), Rs. 5.5-50 Lakhs(accumulate), Rs. 15-50 Lakhs(preferred), Rs. 1 Crore(premier).
  • Pre-existing disease coverage – from the 3rd/4rth/5th year depending on the plan coverage.
  • Pre policy medical check-up – NA.

Max Bupa Heartbeat Plan

  • Entry age – 18 years and above.
  • Sum Insured – Rs. 5-50 Lakhs(gold), Rs. 15 Lakhs-1 Crore(platinum).
  • Pre-existing disease coverage – from the 3rd/5th year depending on the plan coverage.
  • Pre policy medical check-up – Dependent.

National Senior Citizen Mediclaim Policy

  • Entry age – 18 years and above.
  • Sum Insured – Rs. 1-10 Lakhs.
  • Pre-existing disease coverage – from the 3rd year.
  • Pre policy medical check-up – NA.

New India Senior Citizen Mediclaim Policy

  • Entry age – 60-80 years.
  • Sum Insured – Rs. 1-1.5 Lakhs.
  • Pre-existing disease coverage – from the 1 and half year.
  • Pre policy medical check-up – Required.

Oriental HOPE Insurance Plan

  • Entry age – 60 years and above.
  • Sum Insured – Rs. 1-5 Lakhs.
  • Pre-existing disease coverage – from the 3rd year.
  • Pre policy medical check-up – Required.

Raheja Qube Health Insurance Plan

  • Entry age – 18-65 years.
  • Sum Insured – Rs. 1-50 Lakhs(basic), Rs. 3-50 Lakhs(comprehensive), Rs. 1-50 Lakhs(super saver).
  • Pre-existing disease coverage – from the 5th year.
  • Pre policy medical check-up – Dependent.

Reliance Health Gain Plan

  • Entry age – 18-65 years.
  • Sum Insured – Rs. 3-18 Lakhs.
  • Pre-existing disease coverage – from the 4rth year.
  • Pre policy medical check-up – Required for people aging 45 years and above with a sum insured of Rs 12 Lakhs onwards.

Royal Sundaram Lifeline Health Insurance Plan

  • Entry age – 18 years and above.
  • Sum Insured – Rs. 2-4 Lakhs(classic), Rs. 5-50 Lakhs(supreme), Rs. 25 Lakhs-1.5 Crore(elite).
  • Pre-existing disease coverage – from the 3rd/4rth/5th year depending on the plan coverage.
  • Pre policy medical check-up – NA.

SBI Arogya Premier Plan

Entry age – 18-65 years.
Sum Insured – Rs. 10-30 Lakhs.
Pre-existing disease coverage – from the 5th year.
Pre policy medical check-up – Required for people aging 55 years and above.

Star Senior Citizen Red Carpet Insurance Plan

  • Entry age – 60-75 years.
  • Sum Insured – Rs. 1-25 Lakhs.
  • Pre-existing disease coverage – from the 2nd year.
  • Pre policy medical check-up – Not Required.

TATA AIG Medicare Plan

  • Entry age – 18 years and above.
  • Sum Insured – Rs. 3-20 Lakhs.
  • Pre-existing disease coverage – from the 4rth year.
  • Pre policy medical check-up – Required for people aging 45 years and above.

United India Senior Citizen Health Insurance Plan

  • Entry age – 61-80 years.
  • Sum Insured – Rs. 1-3 Lakhs.
  • Pre-existing disease coverage – from the 5th year.
  • Pre policy medical check-up – Required.

Universal Sompo Senior Citizen Health Insurance Plan

  • Entry age – 60-70 years.
  • Sum Insured – Rs. 1-5 Lakhs.
  • Pre-existing disease coverage – from the 3rd year.
  • Pre policy medical check-up – Dependent.

Need of Senior Citizen Health Insurance Plans

Senior citizens need the coverage of health insurance as they get weak due to increasing age. They tend to get less immune to diseases and lose the strength to handle daily tasks or stress unlike they were able to do it previously.

Hospital admission of parents or any close elder person is very stressful emotionally but, also financially due to the rising medical expenses. Health plans specifically designed to deal with these conditions can provide financial support at times of emergency.

Healthcare expenses

Due to the inflation rates, medical expenses are skyrocketing rapidly. Hospitalization, treatment, medicines of them are enough to dig deep into your savings. Health plans for senior citizens can play a major role to save you from this situation as these schemes are imperative for elder people to receive the best health care services.

Critical illness coverage

Some health issues are very common to appear with increasing age like Heart problems, Kidney problems, Cancer, etc. With senior citizen health insurance plans, you will get coverage for these difficulties as a basic or add-on feature.

Annual health check-up

Elder persons can obtain free health check-ups yearly under senior citizen health plans. This feature saves medical expenses as elder persons require regular screening. Although, some plans have this feature is available every 2 or 3 claim-free years.

Senior Citizen Health Insurance plans coverages

Hospitalization expenses

These plans do cover expenses of hospitalization including room charges, doctor fees, nursing fees, medicines and drugs costs, OT charges, ICU charges, surgical appliance charges, etc. Also, artificial limbs, orthopedic implants, prosthetic devices, diagnostic test costs are covered for an elder person.

Pre and post-hospitalization expenses

Medical costs before getting admitted and after discharge are covered in senior citizen health insurance plans.

Daycare treatment

Particular daycare treatments like chemotherapy, dialysis which require less than 24 hours of hospitalization are covered in these policies for senior citizens.

Pre-existing disease

Any pre-existing disease of the insured senior citizen is covered under these schemes after a specific waiting period.

Domiciliary hospitalization expenses

In case the doctor suggests carrying out the treatment at home, the insurance company will also bear the expenses for domiciliary hospitalization.

Organ donor expenses

Most of the mediclaim policies cover organ donor expenses during organ transplants.

AYUSH treatment

AYUSH treatment expenses are covered in some senior citizen mediclaim policies if, the treatment has been taken in government recognized hospital or institute.

Add-ons

These policies cover the treatment cost of Covid-19 and ambulance charges in case of emergencies upto a specified limit.

(Note: these are the coverages generally offered in most policies but, can vary plan to plan.)

What Senior Citizen Health Insurance Plans do not cover?

  • Expenses rising up for self-inflicted injury or suicide.
  • Expenses rising up for drug or alcohol abuse and related treatments.
  • Medical issues diagnosed within 30 days of purchasing the policy except, accidental injuries.
  • Non Allopathic treatment costs.
  • Treatment costs due to act of foreign army or civil war.
  • Costs of cosmetic surgery.
  • The costs related to dental treatment, lenses, spectacles are not covered unless caused by accident.
  • Treatment costs of AIDS.

(Note: the list of exclusions varies from plan to plan by specific insurers.)

Claim settlement procedure

Policyholders need to file claims as they get hospitalized or to avail emergency medical treatment. A claim can be raised in two processes, either avail cashless treatment at network hospitals or claim reimbursement of the expenses incurred in non-network hospitals.

Cashless claim process

To avail of the cashless treatment facility, the policyholder needs to follow the steps mentioned below.

1. Insured need to get hospitalized at any of the Network Hospitals of the insurer listing.

2. Then a pre-authorization form needs to fill up and submit to the hospital authority.

3. The hospital will send the pre-authorization form to the insurer’s company for verification.

4. After verification, either the request will get accepted or rejected. If accepted, obtain the treatment and get released. The insurance company will settle the claim directly with the hospital. But if the request gets rejected, the reasons will be also notified along with.

Reimbursement claim process

To opt reimbursement claim, the insured must follow the steps mentioned below.

1. The insurance company needs to be informed as soon as the insured person gets hospitalized.

2. Submit the claim form duly signed and along with all original documents during discharge. These documents include all bills of medicines, pathological reports, doctor’s prescriptions, certificates of hospital admission and discharge.

3. The claim will be settled by the insurance company’s claim team after reviewing and the amount will get reimbursed.

Tax benefits of Senior Citizen Health Insurance

Senior Citizen Health Insurance Plans not only provide financial assistance to elderly persons at times of medical emergencies but, also allow them to avail tax exemption under Section 80D of Income Tax Act, 1961. A person will be eligible for an income tax rebate of upto Rs. 50,000 if, you hold a health insurance plan for your parents. Also a rebate of Rs. 5,000 can be availed towards preventive health check-ups every financial year. A rebate of Rs. 1 Lakh can also be availed if, the senior citizen takes a critical illness treatment.

If a person is earning and paying the premiums of senior citizen health insurance on behalf of their son/daughter, the person will be eligible to avail of an extra income tax rebate of Rs. 25,000. Which means a total of Rs. 75,000 of tax deduction can get under Section 80D.

Considerations before choosing and buying Mediclaim Policy for Senior Citizen

A Senior Citizen Health Insurance Plan provides coverage to elderly people with medical needs, but how to choose the correct plan to suit your particular requirements? Here are some factors you should consider while selecting and buying the right health insurance.

Daycare treatment

Under a regular health insurance policy, the insured elder person must be hospitalized for at least 24 hours to raise a claim. But, due to the advancement of medical technologies, a lot of treatments can be done through daycare procedures. So, it is better to choose a senior citizen health plan which offers good daycare procedures like dialysis, chemotherapy, etc.

Cashless facility

Every insurance company has a wide network of hospitals, so it is important to check the hospital listing before you select a plan. The network should be in your locality or the area you might relocate to shortly.

Efficacy of claims

Another important factor to check is the claim settlement ratio and claim settlement time taken by the insurer company. If the claim settlement time is less and the claims settlement ratio is high then, it is an indication of better chances of faster claim settlement.

No claim bonus

Most of the insurance companies provide no claim bonus or discount if, no claims are raised by the policyholder in the previous year. It has two benefits, either the policy premium decreases or the sum insured amount gets increased.

Free health check-up

Some good Senior Citizen Health Insurance plans offer preventive health check-ups annually for free. This offer can be availed after completion of certain policy years or after every 2/3 claim-free years depending on the insurance plan.

Co-payment

Some Senior Citizen Health Insurance plans come with a co-payment clause. In this, a part of the claim amount has to be paid by the policyholder and the rest is paid by the insurance company. So, you must opt for a plan with low to zero co-payment.

Pre existing disease waiting period

Elder persons are more likely to have a pre-existing disease which could end up all of the savings. Most of the plans do have coverage for this but, after a waiting period. So, always select a health plan that has a minimum waiting period for the pre-existing disease.

Domiciliary hospitalization

In some situations doctors do advise providing treatment at home or the elder person may not be able to move and get admitted to the hospital. In such scenarios, health plans with domiciliary hospitalization that cover all the treatment expenses prove to be helpful. It can be availed by some best policies only after being advised by a qualified doctor.

Renewability

It is very important to check the renewability of policy. If a policy gets ceased for renewal especially after the age of 60 years, then it is not a good health plan for senior citizens. Always select the insurance plan specifically for senior citizens which has lifetime renewability for hassle-free medical coverage in the future.

Special Advise

We all wish that you stay healthy and active throughout your life but, no one has seen the future. So, at times of medical emergencies, emotional stress is enough to weaken you along with physical issues. Elder persons are more vulnerable to pre-existing diseases also. So, don’t let the financial stress act along with all of these difficulties. Buy a health plan and hope for the best.

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