Health insurance for senior citizens is a type of coverage that is specially designed to provide financial aid during a medical emergency. As people age, they might become prone to age-related ailments like low immunity, frequent fractures, etc. While one can potentially avoid these issues by taking preventive measures, with health insurance, one can create a financial safety net so that in case of a medical emergency, arranging money would not be a concern and would be taken care of by their insurance company.
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Senior Citizen Health Insurance is a contract between the insurance company and people who are above the age of 60 years. It offers coverage related to medical events such as hospitalisation, room rent, doctor’s fees, ambulance charges, etc. Buying separate health insurance for senior citizens usually avoids the burden of paying expensive premiums on family-floater plans where all the members of a household are insured.
You can add senior citizens to almost all of ACKO Personal Health Plans. Here are a few options that could be suitable to your needs.
This is a great option if you are looking for affordability plus high coverage. You can choose from sum insureds such as Rs. 10 Lakhs, Rs. 25. Lakhs, Rs. 50 Lakhs, and Rs. 1 Cr.
Go for this plan if you are looking for high sum insured to ensure that every medical need of your family is taken care of. You can choose either Rs. 1 Cr or an Unlimited sum insured.
ACKO Platinum Super Top-up offers all the features of our Platinum Plan. Just set a deductible while buying the plan. The coverage will begin for your Super Top-up plan after the deductible.
The government has extended its flagship health insurance scheme, Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY), to include citizens above 70 years of age. In general, senior citizens were excluded from insurance because of the higher risk profile, but in this recent decision, it will be possible for them to enrol in the scheme, irrespective of income status. This will provide the much-needed financial relief to over six crore senior citizens, providing a family health insurance plan with a sum insured of ₹ 5 lakh. The seniors who are already enrolled under other government-sponsored health schemes will now be able to migrate to AB PM-JAY.
Here are the plan details for Senior Citizen Health Insurance at a glance.
| FACTORS | DESCRIPTION FOR SENIOR CITIZEN HEALTH INSURANCE |
| Entry Age | Typically starts at around 60 to 65 years old. |
| Coverage | Includes hospitalisation, surgeries, and some pre-existing conditions. |
| Premiums | May be higher due to age but ensures comprehensive coverage. |
| Renewal | Most plans allow renewals up to a certain age. |
| Co-Payments | Some plans may have co-payments, requiring a contribution. |
| Waiting Period | Initial waiting period for coverage of certain illnesses. |
| Sum Insured | Varies based on the chosen plan and insurer. |
Here are some key features and benefits of this plan.
These plans are typically available for people above a certain age, usually 60 or 65 years old.
These plans provide financial protection against high medical expenses, ensuring that seniors can access quality healthcare without worrying about the cost.
Some plans offer free or discounted regular health check-ups, helping seniors to monitor their health proactively.
These plans cover various medical expenses, including hospitalisation, doctor's fees, medicine costs, and more.
Some plans cover pre-existing diseases after a waiting period, while others may have limited coverage for these conditions.
Many plans don't require senior citizens to undergo medical tests to get coverage.
Some plans may require the policyholder to share a portion of the medical expenses, known as co-payment.
These plans can usually be renewed for a lifetime, ensuring ongoing coverage.
Premiums are often higher due to the increased health risks associated with age.
Insurers may offer a bonus for every claim-free year, reducing future premiums or increasing coverage.
You can often avail cashless treatment at network hospitals, making it convenient.
You can claim a benefit for paying premiums for this plan. This is a provision under Section 80D as per the old regime.
Under the ACKO Platinum Health Plans, you are free to claim from the first date of your health insurance plan. Different types of waiting periods like initial, pre-existing diseases, specific illness, etc. do not apply if you disclose all your medical history upfront.
Usually, there are multiple types of deductions in the claim amount and often the policyholder needs to pay out of pocket. However, under ACKO Standard and Platinum Health Plans you get the full claim amount with absolutely no deductions.
We have added multiple useful add-ons like Doctor On-call, Room Rent Waiver, and Waiver of Non-medical Expenses to ACKO Health Plans. You don’t have to go through the hassle of adding them separately while buying the plan.
Senior citizens should buy health insurance in India because it helps cover their medical expenses. It provides financial protection, so the seniors don't have to worry about the expenses related to frequent doctor visits, hospital stays, or medicines. It's like a safety net for their health and savings.
Here is a list of things to consider while buying this health insurance plan.
You need to have a policy with a wider coverage. For example medical expenses, including hospitalisation, surgeries, and critical illnesses.
Check if the policy covers pre-existing health conditions, as many seniors may have them.
Compare premiums from different insurers to find an affordable option.
Understand if there's a co-payment clause, where you pay a portion of the expenses.
Ensure the policy includes hospitals near your senior's residence for easy access to healthcare.
Look for a policy with a straightforward and hassle-free claims process.
Be aware of waiting periods for specific illnesses, as they can vary.Look for health insurance for senior citizens without waiting period.
Check the maximum renewal age to ensure long-term coverage.
Explore add-ons like maternity coverage or ambulance services, if needed.
Read reviews to gauge the insurer's customer service and claim settlement record.
Top up health insurance for senior citizens helps with additional sum insured in case you run out of coverage of the primary plan. This allows you to get the necessary medical treatment without the financial stress.
To help you choose the best senior citizen health insurance plan tailored to different age groups, check out these detailed guides:
It helps pay for expenses like room rent, doctor's fees, and medicines during hospital stays.
It covers medical expenses a little before and after hospitalisation, like tests or follow-up treatments.
Some plans cover treatments that don't require overnight hospitalisation.
It pays for ambulance services during emergencies.
If a senior citizen can't go to the hospital, it covers treatment at home.
After a waiting period, it may cover existing health issues.
Some plans cover specific severe illnesses when you buy the critical illness add-on.
You don't have to pay upfront; the insurance company settles the bill directly with the hospital.
There might be a waiting period before certain conditions are covered.
Some plans may have limits on particular treatments or room rents.
Some alternative or experimental treatments may not be covered.
Many plans exclude dental and vision care unless required as a result of an accident.
Regular check-ups or preventive care might not be covered.
Expensive or non-generic medicines may not be fully covered.
Costs like transportation or non-medical amenities may not be covered.
Now that we have a solid understanding of senior citizen health insurance, let's delve into the claim settlement process.
In India, senior citizens (individuals aged 60 and above) can avail of certain tax benefits on the premiums paid for health insurance policies under Section 80D of the Income Tax Act (as per the old tax regime). These tax benefits apply to both individual policies and policies that cover senior citizens and their families. Here are the key tax benefits associated with senior citizens' health insurance.
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In this section, we will walk you through the process of buying a senior citizen health insurance policy, ensuring your peace of mind and your loved ones' security.
Before making any decisions, it's essential to research and compare different insurance policies available for senior citizens. Look for policies that offer comprehensive coverage, including hospitalisation, pre-existing conditions, and critical illness coverage. Take into consideration factors like premium costs and coverage limits.
Evaluate your health needs and those of your spouse if applicable. Consider any pre-existing medical conditions, as these can significantly impact your choice of policy. Some policies offer coverage for pre-existing conditions after a waiting period, so be sure to check the terms and conditions.
Based on your age, medical history, and coverage requirements, calculate the premiums for the shortlisted policies. Keep in mind that premiums tend to increase with age, so choose a policy that is sustainable in the long run.
Ensure that the insurance policy you select has tie-ups with hospitals and healthcare providers in your vicinity. This will ensure easy cashless hospitalisation and a hassle-free claims process.
Most senior citizen health insurance policies have a waiting period for specific illnesses. Make sure you understand these waiting periods and choose a policy that aligns with your medical needs.
Once you've selected a policy, fill out the application form accurately and honestly. Any discrepancies in the information provided can lead to claim rejections in the future.
Depending on your age and the policy, you may be required to undergo a medical check-up. This helps the insurance company assess your health status and determine the premium.
Carefully read and review the policy document, paying special attention to the terms and conditions, coverage limits, and exclusions. Seek clarification from the insurance company if you have any doubts.
After reviewing and accepting the policy terms, make the premium payment. Ensure that you pay your premiums on time to keep the policy active.
Once the payment is processed, you will receive the policy documents. Store them in a safe place and make digital copies for easy access.
Senior citizen health insurance policies need regular renewal. Make sure to renew your policy before it expires to maintain continuous coverage.
In case of a medical emergency, notify the insurance company and file a claim promptly. Follow the claim process as per the guidelines mentioned in the policy document.
Maintain detailed records of all medical expenses, hospitalisation, and communication with the insurance company. This will be invaluable during the claims process.
Here are some common myths for Senior Citizen Health Insurance plans.
Contrary to this belief, many insurance providers in India offer health insurance policies tailored specifically for senior citizens. These policies are designed to address the unique healthcare needs of older individuals, providing coverage for a range of medical expenses, including hospitalisation, pre-existing conditions, and critical illnesses.
While it's true that health insurance premiums tend to increase with age, the notion that it is prohibitively expensive for senior citizens is a misconception. By comparing different policies and choosing the one that best suits your needs and budget, you can find affordable health insurance options. Additionally, government schemes like the Pradhan Mantri Vaya Vandana Yojana (PMVVY) offer affordable insurance for seniors.
This myth can deter seniors from seeking health insurance. In reality, many policies cover pre-existing conditions, although there may be a waiting period. It's crucial to carefully review policy terms and conditions to understand how your specific conditions are covered.
Some believe that mediclaim for senior citizens offers limited coverage. However, comprehensive policies provide coverage for various healthcare needs, including hospitalisation, surgery, ambulance services, and even post-hospitalization expenses. Read the policy documents carefully to understand the extent of coverage.
While the insurance claim process can appear daunting, most insurance providers have simplified it. With proper documentation and assistance from the insurer, filing a claim can be a straightforward process. Some insurers even offer cashless hospitalisation, making it even more convenient for seniors.
Many seniors worry that paying health insurance premiums in retirement may strain their finances. However, planning for health insurance as part of your retirement corpus is a wise decision. It ensures that you have financial support when medical emergencies arise, preventing the depletion of your savings.
Senior citizens require specialised healthcare, and the cost of medical treatment can be substantial. To provide them with the best care, it's crucial to choose the right health insurance coverage tailored to their needs. So, here are key tips to choose the right medical insurance for senior citizens.
Look for a plan that offers enough coverage for medical expenses, like hospitalisation and treatments.
Check if the plan covers pre-existing health conditions, as many seniors may have them.
Ensure the insurance company has tie-ups with good hospitals in your area for cashless treatments.
Understand co-payments (your share of expenses) and deductibles (initial costs you pay) and choose what fits your budget.
Opt for a plan with a high renewal age, so you're covered for a longer time.
Compare premiums from different insurers to find an affordable one
Be aware of waiting periods for pre-existing illnesses and try to choose plans with shorter waiting periods.
Look for plans that offer benefits like ambulance cover, domiciliary treatment, and critical illness coverage.
Always read the policy document carefully to understand all the terms and conditions.
Take a look at the following common queries about senior citizen health insurance plans.
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