Health Insurance for Senior Citizens

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.

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...
Health insurance for senior citizens is a type of coverage that is specially...

ACKO Health Insurance Plans starting at Rs.20/day*

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What is Senior Citizen Health Insurance?

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.

Senior Citizen Health Insurance Plans at ACKO

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.

ACKO Standard Health Insurance Plan

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. 

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ACKO Platinum Health Plan

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.

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ACKO Platinum Super Top-up Health Plan

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.

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Details on How Senior Citizen Health Plans Work

Here are the plan details for Senior Citizen Health Insurance at a glance.

FACTORSDESCRIPTION FOR SENIOR CITIZEN HEALTH INSURANCE
  
Entry AgeTypically starts at around 60 to 65 years old.
CoverageIncludes hospitalisation, surgeries, and some pre-existing conditions.
PremiumsMay be higher due to age but ensures comprehensive coverage.
RenewalMost plans allow renewals up to a certain age.
Co-PaymentsSome plans may have co-payments, requiring a contribution.
Waiting PeriodInitial waiting period for coverage of certain illnesses.
Sum InsuredVaries based on the chosen plan and insurer.

Key Features of Senior Citizen Health Insurance Plans

Here are some key features and benefits of this plan.

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Age Eligibility

These plans are typically available for people above a certain age, usually 60 or 65 years old.

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Financial Security

These plans provide financial protection against high medical expenses, ensuring that seniors can access quality healthcare without worrying about the cost.

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Health Check-ups

Some plans offer free or discounted regular health check-ups, helping seniors to monitor their health proactively.

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Wide Coverage

These plans cover various medical expenses, including hospitalisation, doctor's fees, medicine costs, and more.

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Pre-existing Conditions

Some plans cover pre-existing diseases after a waiting period, while others may have limited coverage for these conditions.

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No Medical Tests

Many plans don't require senior citizens to undergo medical tests to get coverage.

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Co-payment

Some plans may require the policyholder to share a portion of the medical expenses, known as co-payment.

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Renewal

These plans can usually be renewed for a lifetime, ensuring ongoing coverage.

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Premium

Premiums are often higher due to the increased health risks associated with age.

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No Claim Bonus

Insurers may offer a bonus for every claim-free year, reducing future premiums or increasing coverage.

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Cashless Hospitalisation

You can often avail cashless treatment at network hospitals, making it convenient.

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Tax Benefits

You can claim a benefit for paying premiums for this plan. This is a provision under Section 80D as per the old regime.

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Benefits of Senior Citizen Health Insurance Plans at ACKO

No Waiting Period (under ACKO Platinum Plans)

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.

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100% Claim amount

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.

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Multiple built-in Add-ons

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.

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Why should senior citizens buy a health insurance policy?

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.

Top Things to Consider When Buying a Medical Policy for Senior Citizens

Here is a list of things to consider while buying this health insurance plan.

Coverage

You need to have a policy with a wider coverage. For example medical expenses, including hospitalisation, surgeries, and critical illnesses.

Pre-Existing Conditions

Check if the policy covers pre-existing health conditions, as many seniors may have them.

Premium Cost

Compare premiums from different insurers to find an affordable option.

Co-Payment

Understand if there's a co-payment clause, where you pay a portion of the expenses.

Network Hospitals

Ensure the policy includes hospitals near your senior's residence for easy access to healthcare.

Claim Process

Look for a policy with a straightforward and hassle-free claims process.

Waiting Period

Be aware of waiting periods for specific illnesses, as they can vary.Look for health insurance for senior citizens without waiting period.

 

Renewal Age

Check the maximum renewal age to ensure long-term coverage.

Additional Benefits

Explore add-ons like maternity coverage or ambulance services, if needed.

Customer Reviews

Read reviews to gauge the insurer's customer service and claim settlement record.

Top up coverage

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.

What are the inclusions and exclusions of Health Insurance Plans for Senior Citizens?

Hospitalisation Costs

It helps pay for expenses like room rent, doctor's fees, and medicines during hospital stays.

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Pre and Post Hospitalisation

It covers medical expenses a little before and after hospitalisation, like tests or follow-up treatments.

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Day Care Procedures

Some plans cover treatments that don't require overnight hospitalisation.

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Ambulance Charges

It pays for ambulance services during emergencies.

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Domiciliary Care

If a senior citizen can't go to the hospital, it covers treatment at home.

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Pre-Existing Conditions

After a waiting period, it may cover existing health issues.

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Critical Illness

Some plans cover specific severe illnesses when you buy the critical illness add-on.

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Cashless Hospitalisation

You don't have to pay upfront; the insurance company settles the bill directly with the hospital.

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Waiting Period

There might be a waiting period before certain conditions are covered.

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Specific Treatment Limits

Some plans may have limits on particular treatments or room rents.

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Alternative Therapies

Some alternative or experimental treatments may not be covered.

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Dental and Vision

Many plans exclude dental and vision care unless required as a result of an accident.

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Routine Check-ups

Regular check-ups or preventive care might not be covered.

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Certain Medications 

Expensive or non-generic medicines may not be fully covered.

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Non-Medical Expenses

Costs like transportation or non-medical amenities may not be covered.

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Claim Settlement Process for Senior Citizen Health Insurance

Now that we have a solid understanding of senior citizen health insurance, let's delve into the claim settlement process.

Notification of Claim: The process begins with the insured or their family notifying the insurance company about the hospitalisation or medical treatment. This notification should be made as soon as possible to avoid any delays in claim processing.

 

Approval or Rejection: Based on the verification, the insurance company either approves or rejects the claim. If approved, the insurance company will settle the hospital bill directly with them. You may just have to bear nominal charges.

 

A cashless claim allows stress free hospitalisation and recovery. You don’t need to arrange for a large sum of money to avail the necessary treatment.

Notification of Claim:The process starts with the insured or their family informing the insurance company about hospitalisation or medical treatment. This notification should be made as early as possible to avoid any claim processing delays.

 

Document Submission: Upon notification, the insurance company will provide a list of documents required for claim processing. These typically include:

  • Medical bills and receipts
  • Discharge summary
  • Policy documents
  • KYC documents
  • Any other documents as specified by the insurer
  • Claim Verification

 

Once the documents are submitted, the insurance company conducts a thorough verification process. This involves assessing the authenticity of the documents and ensuring they meet the policy's terms and conditions.

 

Approval or Rejection: Based on the verification, the insurance company either approves or rejects the claim. If approved, the insured or their family will receive the claim amount as per the policy's coverage.

 

Settlement Timeframe: The Insurance Regulatory and Development Authority of India (IRDAI) mandates that insurance companies settle health insurance claims within 30 days of receiving all necessary documents. In case of delays, the insurer is liable to pay interest on the claim amount.

What are the Tax Benefits of Senior Citizens Health Insurance?

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.

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

Up to ₹50,000 per year.

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.

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.
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How to buy a senior citizen health insurance policy?

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.

Research and Compare Policies

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.

Assess Your Health Needs

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.

Calculate Premiums

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.

Check Network Hospitals

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.

Understand the Waiting Period

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.

Fill Out the Application Form

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.

Medical Check-up

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.

Review the Policy Document

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.

Make the Payment

After reviewing and accepting the policy terms, make the premium payment. Ensure that you pay your premiums on time to keep the policy active.

Receive Policy Documents

Once the payment is processed, you will receive the policy documents. Store them in a safe place and make digital copies for easy access.

Renew Your Policy

Senior citizen health insurance policies need regular renewal. Make sure to renew your policy before it expires to maintain continuous coverage.

File Claims Promptly

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.

Keep Records

Maintain detailed records of all medical expenses, hospitalisation, and communication with the insurance company. This will be invaluable during the claims process.

Myths about Health Insurance for Senior Citizens In India

Here are some common myths for Senior Citizen Health Insurance plans.

"Senior Citizens Can't Get Health Insurance"

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.

"The Best Medical Insurance for Senior Citizens is Exorbitantly Expensive"

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.

"Existing Health Conditions Aren't Covered"

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.

"Health Insurance for Seniors Has Limited Coverage"

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.

"The Claim Process is Complicated"

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.

"Health Insurance Premiums Can't Be Afforded in Retirement"

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.

Tips to choose the right health insurance coverage for senior citizens

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 t medical insurance for senior citizens.

Coverage Amount

Look for a plan that offers enough coverage for medical expenses, like hospitalisation and treatments.

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Pre-existing Conditions

Check if the plan covers pre-existing health conditions, as many seniors may have them.

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Network Hospitals

Ensure the insurance company has tie-ups with good hospitals in your area for cashless treatments.

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Copay and Deductibles

Understand co-payments (your share of expenses) and deductibles (initial costs you pay) and choose what fits your budget.

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Renewal Age

Opt for a plan with a high renewal age, so you're covered for a longer time.

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Premiums

Compare premiums from different insurers to find an affordable one

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Waiting Periods

Be aware of waiting periods for pre-existing illnesses and try to choose plans with shorter waiting periods.

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Additional Benefits

Look for plans that offer benefits like ambulance cover, domiciliary treatment, and critical illness coverage.

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Read the Fine Print

Always read the policy document carefully to understand all the terms and conditions.

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Frequently Asked Questions (FAQs)

Take a look at the following common queries about senior citizen health insurance plans.

To buy a senior citizen mediclaim policy in India, you typically need the following documents:

  • The proof of age (like Aadhaar card, PAN card, or passport) is the evidence of age.
  • The evidence of identity (for example, Aadhaar card, PAN card, or voter ID)
  • Evidence of address (like utility bills, Aadhaar card, or ration card)
  • The medical reports (if necessary by the insurance company)
  • Passport-size photographs

The amount of health insurance needed by senior citizens can be different, but the general advice is to have a coverage of at least ₹5 lakhs to ₹10 lakhs. This is the way to guarantee sufficient medical insurance for major diseases and hospitalisation costs.

The best type of health insurance for senior citizens above 60 years often includes:

  • Comprehensive coverage with a higher sum insured
  • Minimal co-payment and sub-limits
  • Coverage for pre-existing diseases after a waiting period
  • Benefits like free health check-ups, cashless hospitalisation, and no-claim bonus
  • Policies specifically designed for senior citizens, as they cater to the unique healthcare needs of older adults.

Yes, at 65 years old, you are eligible for best health insurance for senior citizens in India. This type of insurance is specially designed to provide healthcare coverage for individuals in your age group. It can help you get financial support for medical expenses, making it easier to manage your health and well-being. So, you can definitely consider getting Senior Citizen Health Insurance to ensure you have peace of mind when it comes to your health.

When seeking senior citizen medical insurance in India, prioritise coverage for pre-existing conditions, opt for a sufficient sum insured, ensure affordability, confirm nearby network hospitals, understand co-payment terms, note treatment waiting periods, secure policy renewability with age, streamline the claims process, consider critical illness coverage, be aware of exclusions, watch for waiting periods when changing policies, and explore any extra riders for added benefits. Thoroughly review and compare policies to make an informed decision for your well-being and peace of mind.

Yes, usually you need a medical screening when buying best health insurance for senior citizens in india. It's like a health check to decide the right insurance and cost based on your health.

This depends upon the terms and conditions of the insurance company. Please get in touch with your insurer to know more.

You should submit the documents to either the TPA (Third Party Administrator) or the insurance company depending upon the claim type. Usually, you must submit the documents to the insurer in case of an online claim, and to the TPA if you are opting for an offline claim.

Yes, if you have opted for a Critical Illness Add-on while buying the plan then these are covered as per the terms and conditions of the insurance company

Usually, the higher the risk, the higher is the cost of a health insurance policy. So, the cost of your health insurance plans for senior citizens depends on your current and historical medical status as well along with your age. 

This depends upon the terms and conditions of your health insurance plan. Do check the plan details and policy wordings to confirm if annual health check-ups are covered.

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Written by Roocha Kanande

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Reviewed by Rupinderjit Singh Author info Icon

I find the world of policies and premiums absolutely fascinating! Join me as I unravel insurance with a dash of creativity and a fresh perspective.