Health insurance for senior citizens

Health insurance for senior citizens

Senior citizens require care and comfort to fully enjoy their golden years but diseases, unexpected accidents, and more can prevent them from doing that. By purchasing health insurance for senior citizens, they can relax and have peace of mind as their health-related expenses are taken care of by the insurance provider.

What is health insurance for senior citizens?

Health insurance for senior citizens is a health insurance plan that is built for people who are 60 years old or more. It comes with a sum insured that covers a range of expenses such as emergency hospitalization, treatment for certain illnesses, and pre-existing diseases. The insurance plans generally come with a waiting period and a lifetime renewability option. Everyone should get a health insurance plan to make themselves prepared for unexpected and sudden occurring health issues that may crop up later in life.

These policies usually come with a co-payment option where the policyholder pays a portion of the expenses. Such types of plans generally come with a lower premium. The plans for senior citizens can be purchased on an individual basis where only the policyholder enjoys the benefits offered by the health insurance provider. However, certain health insurance for senior citizens in India also covers the family members such as their spouse and parents.

What are the benefits of a senior citizen health insurance policy?

Purchasing the best health insurance for senior citizens comes with many advantages like from savings to better treatment. Some of the major ones are:

Covers a wide range of ailments

The best health insurance for senior citizens provides ample coverage for a range of infections, illnesses, and diseases. As senior citizens are more susceptible to health problems, a health insurance plan ensures they can rest assured of getting treated for their health concerns sooner rather than later.

Improves the chance of treatment

A senior citizen purchasing the plan may have a pre-existing condition that can lead to the development of a critical illness later in life. With the help of insurance plans for senior citizens or even critical illness insurance for senior citizens, the chances of getting prompt treatment in case of an emergency have increased manifold.

Early detection of health problems

Even though the body may feel and look fine, the policyholder may have internal issues. By purchasing the best health policy for senior citizens, the individual can get regular health check-ups where diseases and problems are diagnosed timely so the treatment can start as early as possible. Paying for regular health check-ups is quite expensive so a plan helps save money.

Better savings

An insurance policy for senior citizens saves money in the long run as medical expenses can be over the roof if paid out of pocket. Sometimes even savings will not suffice as treatment costs are high, especially for senior citizens. Having a good plan in place helps to save money especially when diagnosed with a critical illness.

Protects from medical inflation

Medical inflation is a cause of concern for Indians which has increased medical expenses more than ever before. By buying health insurance for senior citizens above 60 years, the policyholder is protected from medical inflation and can better cover all types of expenses required for complete treatment.

Tax benefits

Purchasing health insurance for the elderly is also beneficial as it has numerous tax benefits. The premiums paid by the senior citizens can be used for income tax deductions of up to Rs. 50,000 per annum as specified in the Income Tax Act, 1961’s Section 80D. Senior citizens can get a rebate of Rs. 5,000 for preventive health check-ups and a rebate of Rs. 1 lakh when they are getting treated for a critical illness.

Provides a no-claim bonus

Some health insurance for senior citizens plans to provide a no-claim bonus to senior citizens. In this when the policyholder does not avail of a claim, he is provided with a discount when he renews the health insurance policy. This gives an incentive for senior citizens to maintain good health. The no-claim bonus is 20% or above in most cases.

What is covered in a health insurance plan for people above 60?

Generally, a health policy for senior citizens has the following inclusions.

Hospitalization expenses

Hospitalization expenses can range from being hospitalized due to a pre-existing condition or due to accidents. The plans for senior citizens usually cover expenses such as ICU charges, room rent, consultation charges, medicine bills, and so on.

Pre- and post-hospitalization expenses

The best health insurance for senior citizens in India provides cover for pre and post-hospitalization expenses. Even though they may not seem like much, these expenses can easily add up and cause a dent in the savings which is why a cover is mandatory to manage expenses with ease.

Daycare procedures

The policies for the elderly cover daycare procedures which may be required in certain cases. Daycare procedures require a person to stay in the hospital for a maximum of 24 hours and do not come under hospitalization.

Cover for AYUSH treatment

The best health insurance policy for senior citizens provides cover for AYUSH (ayurveda, yoga and naturopathy, unani, siddha or homoeopathy) treatment. These enable senior citizens to try out alternative treatment methods which were not covered earlier.

Pre-existing illnesses

Most health insurance policies made for senior citizens come with pre-existing illness coverage because by the time many people reach 60 years of age, they may have developed an illness already. The cover is usually provided after a waiting period of some months.

What is not covered in a health insurance plan for senior citizens?

Typically, a health insurance policy for senior citizens has the following exclusions.

Preventive care

Usually, preventive care such as immunisation is not covered under a health insurance policy made specifically for the elderly. However, if the vaccination is required as part of the treatment included in the policy, then it is covered.

Experimental treatments

Experimental treatments such as those which have not been approved by the appropriate boards are not covered under the health insurance policy.

Cosmetic/plastic surgery

Cosmetic surgery or plastic surgery undertaken by the senior citizen unless it was mandatory due to injuries from an accident or scars from the treatment of a disease is often not covered by health insurance plans.

Certain hospitalizations

When hospitalization for enteral feedings and supplements is required without the certification of a medical practitioner, then it is not covered by the health insurance policy.

Rehabilitation procedure

Sometimes even the best health insurance plan for senior citizens does not include rehabilitation procedure-related expenses such as those required for long-term nursing care or rest cure purposes. It is best to confirm the same with the insurance provider.

Certain types of medical practitioners

If the policyholder lives in the same house as the medical practitioner or is related to him, the health insurance policy most probably will not cover the expenses incurred.

Extra requirements during hospitalization

Sometimes the policyholder may require extra comfort during his stay at the hospital. This can be certain types of food, extra hygiene, TV, and so on. If the hospital charges extra for all these, the insurance provider will not cover them in the policy.

What is the eligibility criteria to buy Mediclaim for senior citizens?

The Mediclaim policy for senior citizens can be purchased by anyone who is 60 years old or more in India and is an Indian citizen. The insurance policy covers expenses when the treatment is received in India only. This is the basic requirement for a senior citizen to avail of an insurance policy but the eligibility criteria differ from one insurance provider to another. Some insurers require pre-medical screening before they sell their policy while others do not.

What should you consider while buying a Mediclaim policy for senior citizens?

When purchasing health insurance for parents above 60, the following factors must be considered to ensure it is the right fit.

Age limit

The health insurance policy may come with a maximum age limit so determining the current age of the policyholder is of immense value to understand which plans are available. In many cases, there is no age limit for buying a health insurance policy but in others, the cap may be up to 75 years or above. It is best to ascertain the age limit in advance to save time.

Inclusions and exclusions

When selecting health insurance for senior citizens in India, the inclusions and exclusions must be considered because it shows the extent of the policy coverage. For policyholders with a pre-existing disease, health insurance for senior citizens with pre existing disease must be chosen to ensure they get the coverage they need to manage treatment costs.

Sum insured

As people get older, they are at a higher risk of having diseases especially if they already have conditions that increase the chances of health issues at a later stage. Understanding the sum insured enables the policyholder to know whether it is sufficient to cover all the costs of hospitalization, medicines, and so on. A higher sum insured is better to cover all expenses incurred.

Waiting period

Just like health insurance, a senior citizen Mediclaim policy also comes with a waiting period even though it is less than a standard health insurance plan. The waiting period can be a month to a year but a claim can only be made after the completion of the waiting period. It is also applicable to cover pre-existing diseases, and so on.

Lifetime renewability

Experts advise older policyholders to purchase insurance plans that come with lifetime renewability features as they are convenient and hassle-free. The policyholder simply must renew the policy to enjoy the benefits provided. Plans without this feature are also available to senior citizens but these are more expensive as purchasing a brand-new policy is also a hassle.

Enhancement of the sum insured

When purchasing medical insurance for senior citizens, it is important to know whether the enhancement of the sum insured is provided. It is when the policyholder has the freedom to opt for a higher sum insured at the time of plan renewal or he can increase the sum insured with the cumulative bonus or both.

Who should buy a health insurance plan for senior citizens?

A senior citizen should ideally purchase medical insurance for senior citizens as soon as he turns 60 years old. Even people with pre-existing conditions can purchase health insurance provided the illnesses are included in the insurance policy. By staying healthy and fit in the later years, the policyholder can enjoy benefits such as a no-claim bonus. Health insurance for senior citizens is necessary to get treatment without worrying about hefty treatment costs.

Claim settlement process for senior citizen health insurance

The claim settlement process of health insurance for senior citizens depends on the type of claim; reimbursement claim or cashless claim.

The process for the reimbursement claim includes informing the health insurance provider before getting treatment, paying the medical bills and expenses associated with the medical event and then collecting all the documents required. Lastly, it involves raising a claim with the insurance provider so that he can reimburse the amount to the policyholder as specified in the health insurance policy document.

The process of claim settlement for cashless health insurance for senior citizens plan is slightly different. It involves informing the insurance provider before getting treatment at a hospital and then submitting all the documents such as the authorisation form, health card, and so on. If required and specified in the policy, the applicable deductibles must be paid. Lastly, the insurer directly pays the hospital for the expenses incurred in the treatment of the senior citizen.

Key takeaways

Health insurance for senior citizens is a necessity to enjoy benefits such as coverage for hospitalization, alternative treatments, daycare procedures, and many other expenses that can put a serious dent in their savings. Senior citizens require more medical care and attention which is why purchasing a plan safeguards them from suffering from financial problems when they should be enjoying their retirement years.


Can a 70-year-old get health insurance?

Yes, it is possible. The senior citizen age in India is 60 years and so anyone who is 60 or older can get Mediclaim for senior citizens or a health insurance policy.

What is the maximum entry age for senior citizen health insurance?

The upper age limit to purchase senior citizen insurance policy can vary from insurer to insurer. Some insurers do not have an upper age limit but other insurers have a limit of up to 80 years. It all depends on the insurance provider.

Do senior citizens get any tax benefit on the health insurance policy?

Yes, the health insurance premium for senior citizens can be used to get tax benefits as mentioned in Section 80D of the Income Tax Act, 1961. The policyholder can avail of tax exemption of up to Rs. 50,000 in a financial year.

What is the difference between senior citizen health insurance and standard health insurance?

Health insurance for senior citizens is built based on the needs of the senior citizens and applies only to senior citizens. Anyone over 18 years can purchase standard health insurance which can include additional riders for better coverage. Both are important for financial support.

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