Senior Citizen Health Insurance

• Day Care Treatments: Many modern treatments like dialysis, chemotherapy, and radiotherapy can be done without 24-hour hospitalisation. Choose a senior citizen health plan that covers such day care procedures for faster claims and better benefits.
• Coverage Amount: Look for a plan that offers enough coverage for medical expenses, like hospitalisation and treatments.
• Pre-existing Conditions: Check if the plan covers pre-existing health conditions, as many seniors may have them.
• Network Hospitals: Ensure the insurance company has tie-ups with good hospitals in your area for cashless treatments.
• Copay and Deductibles: Understand co-payments (your share of expenses) and deductibles (initial costs you pay) and choose what fits your budget.
• Room Rent Limit: Look for policies with a higher or no cap on room rent to avoid out-of-pocket expenses during hospital stays.
• Renewal Age: Opt for a plan with a high renewal age, so you're covered for a longer time.
• Premiums: Compare premiums from different insurers to find an affordable one
• Waiting Periods: Be aware of waiting periods for pre-existing illnesses and try to choose plans with shorter waiting periods.
• Additional Benefits: Look for plans that offer benefits like ambulance cover, domiciliary treatment, and critical illness coverage.

Deduction on Premium Payments

Senior citizens can claim a deduction on the premium paid for health insurance policies for themselves and their family members, including spouse, dependent children, and parents (whether dependent or not). The maximum deduction allowed is as follows

For senior citizens (aged 60 and above)

Up to ₹50,000 per year.

Additional Deduction for Parents

If a senior citizen pays the premium for health insurance policies for their parents (who may or may not be senior citizens), they can claim an additional deduction. The maximum deduction allowed for the premium paid for parents is as follows:

• For parents below 60 years of age: Up to ₹25,000 per year.
• For parents aged 60 and above (senior citizens): Up to ₹50,000 per year.

Total Deduction

The total deduction available under Section 80D for health insurance premiums (for self, family, and parents) for senior citizens can go up to ₹1 lakh per year if both the senior citizen and their parents are also senior citizens.

It's important to note that these deductions are subject to certain conditions and limitations:

• The premium must be paid using a mode other than cash to claim the deduction. The deduction is available only for premiums paid for health insurance policies and not for life insurance policies.
• The total deduction limit for senior citizens' health insurance is inclusive of the premiums paid for both individual and family health insurance policies.
• To avail of these tax benefits, senior citizens need to maintain proper records of premium payments and provide relevant documents when filing their income tax returns.

• Sum Insured: The sum insured is the highest amount that an insurance company will pay for claims during the policy period. If your medical expenses are more than this amount, you will have to pay for the extra charges yourself. Common sum insured options are Rs. 5 lakh, Rs. 10 Lakh, Rs. 25 lakh, etc.
• Inclusions: Inclusions refer to the set of medical services, treatments, and conditions that are included in a health insurance policy. Common inclusions include:
  • Hospitalisation expenses
  • Daycare treatments
  • Pre and post-hospitalization bills
  • Ambulance costs
• Exclusions: Exclusions are the specific conditions or treatments which are not covered by the health insurance policy. Common exclusions include:
  • Pre-existing diseases (usually for 2-3 years)
  • Cosmetic surgeries and Dental treatments (unless due to accidental injury)
  • Self-inflicted injuries
  • Substance abuse-related treatments
  • Experimental treatments
• Critical Illness Coverage: The critical illness coverage is a supplement to the health insurance policy which can be added as an extra benefit or rider. It is a one-time cash payment given to the recipient if he/she is diagnosed with a specified serious illness, for instance, cancer, heart attack, stroke, or kidney failure. This coverage is for the treatment of critical illnesses and thus, it helps in the management of the high costs that are related to the treatment. Also, it provides financial support during the recovery period.
• Pre-Existing Diseases: The pre-existing diseases are the medical conditions or illnesses that the policyholder had before buying the health insurance policy. Insurers usually have a waiting period during which they do not cover the treatments of these conditions. The waiting period can be from 2 to 3 years, after which the conditions may be covered depending on the policy terms.
• Cashless Health Insurance policy for senior citizens: Cashless mediclaim policy for senior citizens enables them to get the treatment at network hospitals without having to pay the money upfront. The insurance company directly pays the bill to the hospital. This reduces the pressure of having to arrange money in case of medical emergencies. To use the cashless services, the insured has to be admitted to one of the insurer's network hospitals and follow the claim process specified by the insurer.

• Visit your State Government's Social Welfare Department website
• Look for the section on Senior Citizen ID Cards, Elderly Welfare, or Old Age Benefits
• Register/login with your basic details
• Fill out the online application form
• Upload scanned documents (age proof, address proof, photo)
• Submit and note your application reference number