Buy Senior Citizen Health Insurance – Mediclaim Policy for Seniors

What is a Senior Citizen Health Insurance Policy?

A Senior Citizen Health Insurance Policy is a Health Insurance Plan specifically designed for Senior Citizens aged 60 years and above. Senior Citizen Health Insurance Policy provides coverage for Hospitalisation Expenses, Pre and Post-Hospitalisation Expenses, Daycare Procedures etc. Senior Citizens are at a greater risk of getting hospitalized due to illnesses and injuries and hence Medical Expenses in old age are expected to be substantial. Thus, a Health Insurance Policy is a must for Senior People so that they can afford quality medical care without worrying about high medical expenses.

What does a Senior Citizen Health Insurance Policy Cover?

A Senior Citizen Health Insurance Policy provides the following coverages:

1. Hospitalisation Expenses: A Senior Citizen Health Insurance Policy provides coverage for Hospitalisation Expenses incurred by the Insured which includes expenses such as Room Rent, Nursing Expenses, Surgeon, Anesthetist, Doctor’s Fees, Consultants etc.
2. Pre- and Post-Hospitalisation Expenses: Most Senior Citizen Health Insurance Policies provide coverage for Pre and Post-Hospitalisation Expenses for 30 days and 60 Days respectively. This cover reimburses the costs of diagnostic reports and pharmacy bills which are incurred prior to admission and post discharge from hospital. Such expenses are substantial and hence coverage for Pre and Post Hospitalisation Expenses is very important.
3. Daycare Procedures: Senior Citizens need to undergo many treatments, such as Chemotherapy, Dialysis etc which are Daycare Procedures and which does not require admission in a hospital. Coverage for Daycare Procedures is an essential feature of Senior Citizen Health Insurance Policy.
4. Domiciliary Hospitalisation Cover: Many a times, Senior Citizens do not get admitted to a hospital and avail treatment at home. Domiciliary Hospitalisation Coverage in a Senior Citizen Health Insurance Policy provides coverage for treatment availed at home on the advice of a medical practitioner.
5. Pre-Existing Disease Cover: Most Senior Citizens suffer from some or the other ailment, such as Diabetes, Hypertension. A Senior Citizen Health Insurance Policy provides coverage for Pre-Existing Diseases after a Waiting Period of 3-4 years.

What are the Benefits of a Senior Citizen Health Insurance Plan?

1. Coverage for Hospitalisation Expenses: A Senior Citizen Health Insurance Policy provides coverage for Hospitalisation Expenses, which are expected to be substantial in the later years of life.
2. No Claim Bonus: Many Senior Citizen Health Insurance Policy offer No Claim Bonus or a Cumulative Bonus for every Claim-Free year under the Policy. The Bonus automatically increases the Sum Insured under the Policy without a corresponding increase in premium. The increase in Sum Insured takes care of Medical Inflation as the medical expenses are bound to increase with the passage of time.
3. Tax Benefits: The Premiums paid toward a Senior Citizen Health Insurance Policy are eligible for tax deduction under Section 80D of the Income Tax Act 1961. The Tax Benefits of a Senior Citizen Health Insurance Policy make it more affordable for older people whose income is reducing with retirement.
4. Lifetime Renewability: Senior Citizen Health Insurance Policy offer Lifetime Renewal of Policy as long as Premiums are paid on time. Thus, once you purchase a Senior Citizen Health Insurance Policy, you avail Health Insurance Coverage for lifetime.
5. Simple Claim Process: The Claim Process for a Senior Citizen Health Insurance Policy is verry simple. The Insured can avail Cashless Claim Settlement at Network Hospitals and would not need to bear any expenses out of his own pocket. In case of Reimbursement Claim, the Policyholder has to pay the hospital bill and claim reimbursement from the Insurance Company by submitting the required documents.

What are the restrictions in a Senior Citizen Health Insurance Policy?

A Senior Citizen Health Insurance Policy is likely to have a lot of restrictions compared to a regular Health Insurance Policy considering the higher risk nature of senior citizens. Some of the restrictions are as follows

1. Co-Payment: Some Senior Citizen Health Insurances plan might have a Co-Payment Clause which mandates that the Insured bear a portion of the medical expenses. For example, A Co-Payment Clause of 20% implies that the Insured would have to bear 20% of the hospital expenses.
2. Sub-Limits: Some Senior Citizen Health Insurance Plans have Sub-Limits (i.e. a Cap) on things like Room Rent, Doctor's Fees, Operation Charges etc. For eg. A Sub-Limit of 1% on Room Rent means that the Insurance Policy with a Sum Insured of Rs3 lakhs will pay only Rs3000/day towards Room Rent Expenses. Any Room Rent Expenses over and above Rs3000/day would have to be borne by the Insured.
3. Waiting Period on Pre-Existing Diseases: Pre-Existing Diseases mean diseases that were already existing before the start of the Insurance Policy. Most Senior Citizen Health Insurance Plans would have a Waiting Period before they cover Pre-Existing Diseases. Typically, the Waiting Period ranges between 36 months to 48 months.

Best Senior Citizen Health Insurance Policy in India

The table below lists the best Senior Citizen Health Insurance Plans available in India

Why should I purchase a Senior Citizen Health Insurance Policy?

Unfortunately, large number of people do not have a Health Insurance Policy to cover their medical expenses today. Healthcare expenses are increasing at a rate of more than 10% per annum today. With rising life expectancy, the need for a Health Insurance Policy to cover medical expenses is much greater during the later years as one's income drops because of retirement while medical expenses increase. Healthcare costs during later years might be a big drain on one's finances. However, many Senior Citizens are likely to get rejected from purchasing a regular Health Insurance Policy on account of pre-existing diseases/ailments. In such a case, purchasing a Senior Citizen Health Insurance Policy to protect from rising healthcare costs is a good choice.

How to Choose the Best Senior Citizen Health Insurance Policy?

Policyholders should consider the following factors when purchasing a Mediclaim Policy for Senior Citizens:

1. Co-Payment Clause: Most Senior Citizen Health Insurance Policies have a Co-Payment Clause which states that the Insured has to bear a portion of the medical expenses. For example, A Co-Payment Clause of 20% implies that the Insured has to bear 20% of the hospital expenses. The Insured should choose a Policy which has a low Co-Payment Percentage.
2. Waiting Period for Pre-Existing Diseases: Most Senior Citizens suffer from Pre-Existing Diseases such as Diabetes, Hypertension etc. Health Insurance Policies have a Waiting Period of 3-4 years before they provide coverage for Pre-Existing Diseases. The Insured should choose a Policy which has a low Waiting Period for Pre-Existing Diseases.
3. List of Network Hospitals: Policyholders can avail cashless Claim Settlement at Network Hospitals of Insurance Companies. Policyholders should carefully look at the Network Hospital List and make sure that their preferred hospitals are in the list of network hospitals before finalizing the Policy.
4. Domiciliary Hospitalisation Cover: Sometimes, the Insured may not be able to get admitted to a hospital and needs to avail treatment at home. In such cases, the Health Insurance Policy will reimburse the expenses of the home treatment under the Domiciliary Hospitalisation Cover. Thus, Policyholders should ensure that the Senior Citizen Health Insurance Policy provides Domiciliary Hospitalisation Coverage.
5. Claim Settlement Ratio: Another important point to consider while choosing a Senior Citizen Health Insurance Policy is the Claim Settlement Ratio, which denotes the number of Claims Settled by the Insurance Company as a % of the number of Claims Intimated. The Claim Settlement Ratio denotes the Insurance Company’s Claim Settlement efficiency and the Insured should make sure to select an Insurance Company with a high Claim Settlement Ratio.

What is the Claims Process for a Senior Citizens Health Insurance Policy?

The Claims Process in a Senior Citizens Health Insurance Policy is similar to a regular Health Insurance Policy. The Insured can avail Claims Settlement in 2 ways: Cashless Claim Settlement and Reimbursement Claim Settlement

Cashless Claim Settlement Process under a Senior Citizen Health Insurance Policy

The claims process for availing Cashless Claim Settlement under a Senior Citizen Health Insurance is listed below:

1. Locate the nearest network hospital covered by the Senior Citizen Health Insurance Policy to avail treatment
2. Inform the Insurance Company about the hospitalization before 3-4 days in case of a planned hospitalization and within 4-5 hours in case of an emergency
3. Show the Health Card issued by the TPA at the Insurance Desk at the hospital and fill the Pre-Authorization Claim Form provided by the hospital
4. The Hospital sends the Claim Form to the Insurance Company for approval
5. Avail treatment at the hospital and get discharged. The Insurance Company will settle the bill with the hospital directly.

Reimbursement Claim Settlement Process under a Senior Citizen Health Insurance Policy

The Claims Process for availing Reimbursement Claim Settlement under a Senior Citizen Health Insurance Policy is listed below:

1. Inform the Insurance Company within 24 hours of admission to the hospital and obtain a Claim Intimation Number
2. Make the payment to the hospital for the medical expenses incurred and keep original copies of all the invoices
3. Submit the required documents to the Insurance Company which will verify the claim details, ask for additional documents if required and will approve or reject the claim
4. The approved claim amount gets credited directly to the bank account of the Insured

Get Best Quotes for Senior Citizen Health Insurance Policy with Qian!

A Senior Citizen Health Insurance Policy takes care of medical expenses in the later stages of life when the need for medical care is the greatest. These medical expenses can be substantial precisely at the time when your income is not at its peak. A Senior Citizen Health Insurance Plan will ensure that you can avail of the best treatments without worrying about finances. Confused about which Senior Citizen Health Insurance Policy to select? Approach an Insurance Broker for your Senior Citizen Health Insurance. Get a Free Quote via email at insurance@qian.co.in or call us on 022-35134695. We will get back to you within 24 hours, guaranteed