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Government Health Insurance for Senior Citizens
Apr 15, 2021

Government Health Insurance Scheme for Senior Citizens

With increasing healthcare costs, having health insurance becomes a must, especially if you have elderly parents. As you grow older, the onset of various illnesses begins, which is why you need to purchase a suitable senior citizen health insurance scheme. So, let’s understand the importance of health insurance plans for senior citizens and look at some suitable policies.

Importance of Having a Senior Citizen Health Insurance Scheme

There are several reasons as to why owning a health plan for older people is so crucial. So, allow us to take you through some important pointers.

Health Plans Secure Your Savings

Many medical procedures can take a toll on your finances, causing you to dip into your savings. As a senior citizen, the last thing you would want is for an illness to affect your retirement fund. With a senior citizen health insurance scheme, all of your medical expenses are secured by the insurer. Thus, you can be carefree while seeking treatment and recover to be healthy instead of worrying about your finances.

Insurance Protects the Higher Tendency of Falling Ill

Turning 60 years of age comes with its own set of pros and cons. One of the major cons can be a higher tendency to fall ill or experience age-related medical issues. Multiple visits to the doctor can easily burn a hole in your pocket, and therefore, having health insurance for senior citizens becomes vital. Your medical needs are taken care of, and nothing can stop you from enjoying your retirement days!

Offers Peace of Mind

Increase in expenses, especially when you are retired, can be worrisome. Having a backup in case of an unfortunate situation that may or may not occur always provides you with a peace of mind. Thus, with health insurance, you can rest assured regarding any emergencies as you are already secured.

Benefits of Mediclaim for Senior Citizens

Having the best medicare plan for seniors can offer a multitude of benefits, ensuring their well-being and financial security. Let's get into the advantages:

Financial Security:

One of the primary benefits of a mediclaim policy for senior citizens is the financial security it provides. As medical expenses can be substantial, especially for elderly individuals requiring frequent healthcare services, a mediclaim policy covers these expenses, preventing any financial strain on the individual or their family.

 Comprehensive Coverage:

Mediclaim policies designed for senior citizens often come with comprehensive coverage options. These may include shorter waiting periods, high sum insured amounts, covering various medical expenses such as hospitalisation, accident-related treatments, daycare procedures, and ambulance services.

Pre-existing Conditions:

Unlike many other insurance options, mediclaim policies for senior citizens typically cover pre-existing conditions with shorter waiting periods . This ensures that individuals with existing health ailments can still benefit from the insurance coverage without facing extensive exclusions.

Tax Benefits:

one can avail Tac benefits by investing in a mediclaim insurance policy for Parents. The premiums paid towards the policy are eligible for tax deductions, offering additional financial relief.

Cashless Treatment:

Many mediclaim policies offer cashless treatment facilities, allowing senior citizens to access medical services without worrying about upfront payments. Additionally, some policies provide hospital daily cash allowances, further easing the financial burden during hospitalisation.

 Nationwide Coverage:

Mediclaim policies often provide coverage across the country, enabling senior citizens to seek medical assistance at various healthcare facilities without geographical restrictions.

Preventive Care:

Some mediclaim policies include provisions for preventive healthcare, such as annual health check-ups. These check-ups help in early detection of health issues, ensuring timely intervention and better health outcomes for senior citizens.

Easy Renewals:

Renewing a mediclaim policy for senior citizens is usually hassle-free. It ensures that individuals continue to enjoy uninterrupted coverage without the need for extensive paperwork or medical examinations.

What is Covered Under Senior Citizen Mediclaim Policy?

A Senior Citizen Mediclaim Policy offers comprehensive coverage tailored to the specific healthcare needs of elderly individuals. Here's an overview of what is covered under the Bajaj Allianz silver health plan policy:

Hospitalisation Expenses:

The medical insurance for senior citizens policy covers hospitalisation expenses incurred due to illness or injury. This includes room rent, nursing charges, doctor's fees, surgical expenses, and other medical costs during hospitalisation.

Pre and Post Hospitalisation Expenses:

In addition to hospitalisation costs, the policy also covers pre and post-hospitalisation expenses. These expenses, typically up to 3% of the admissible hospitalisation expenses, include diagnostic tests, consultations, and medications incurred before and after hospitalisation.

Ambulance Charges:

Senior Citizen Mediclaim Policies often cover ambulance charges in case of emergency transportation to the hospital. The coverage for ambulance services is subject to a specified limit, such as Rs 1000 per claim.

Coverage for Pre-existing Illnesses:

While pre-existing illnesses are covered under the policy, there may be certain restrictions. However, the company's liability for such illnesses is typically restricted to 50% of the sum insured in a policy year.

H3 - Daycare Procedures:

The senior citizen health insurance scheme covers a wide range of daycare procedures, which are medical treatments or surgeries that do not require 24-hour hospitalisation. These procedures are often performed in a day care centre or hospital and are covered subject to the terms and conditions of the policy. Typically, a list of specific daycare procedures, such as 130 procedures, is covered under the policy.

Why Should I Buy a Health Insurance Plan for Senior Citizens?

To guarantee thorough coverage and peace of mind, understanding the complex topic of senior citizen medical insurance needs careful consideration of numerous issues. Here are the top reasons why you need a health insurance plan for senior citizens:

Coverage for Age-Related Ailments:

These policies cover conditions like cancer, heart issues, and kidney failure, along with pre-existing diseases such as hypertension and diabetes.

Savings Protection from Long-Term Medical Costs:

Health insurance provides financial relief for lifestyle-related diseases, preventing depletion of savings during emergencies.

Preparedness for Rising Healthcare Expenses:

With healthcare costs increasing, insurance covers medical treatments and tests, ensuring financial stability during emergencies.

Comprehensive Benefits:

Policies cover hospitalisation, pre-and post-hospitalization care, daycare, and more, often including free health check-ups.

No Compromise on Healthcare:

Policies offer extensive coverage, including online consultations and protection against critical illnesses, with the sum reinstatement facility for continuous financial security.

Essential Things to Remember Before Buying The Best medical insurance for senior citizens

Here are the essential things to remember before buying the best health insurance plans for senior citizens:

Age Requirement:

Ensure the policy aligns with the age of the insured and offers flexibility in enrollment and renewal, considering the maximum age restrictions.

Insured Amount:

Assess the sum insured or healthcare benefits to guarantee adequate coverage for potential medical expenses, considering the increasing health risks associated with ageing.

Coverage:

Opt for a policy that covers a wide range of ailments, including pre-existing conditions, with minimal exclusions to ensure comprehensive protection.

Existing Health Conditions:

Verify coverage for pre-existing health conditions and understand the waiting period before filing a claim related to such conditions.

Network of Hospitals:

Choose a policy with an extensive network of hospitals for convenient access to quality healthcare services, especially in emergencies.

Premium:

Compare premiums among insurers, considering factors like age, health status, and coverage benefits, to find an affordable yet comprehensive policy.

Co-Payment Provision:

Understand the co-payment clause, if any, and evaluate its impact on out-of-pocket expenses for medical treatments.

Claim Settlement Ratio:

Research the insurer's claim settlement ratio and their claims processing efficiency to ensure a smooth experience in case of filing a claim.

IRDAI Rules & Regulations for Government Health Insurance for Senior Citizens

Below are some of the rules and regulations set by the IRDAI (Insurance Regulatory and Development Authority) for senior citizen health insurance scheme:
  1. According to the IRDAI, the individual should be at or more than 65 years of age to buy senior citizen health insurance scheme by Government of India
  2. If a senior citizen’s insurance application is accepted, then the insurer should reimburse 50% of the pre-insurance medical check-up cost
  3. It is mandatory for insurance providers to offer a reason for rejecting a senior citizen’s insurance application in writing
  4. For a government health insurance for senior citizens, the individual should be allowed to change their Third-Party Administrator (TPA) wherever possible
  5. No insurance company can reject the renewal request of a senior citizen health plan unless there is a case of fraud, misinterpretation, etc.

Government Health Insurance for Senior Citizen Schemes

Pradhan Mantri Jan Arogya Yojana or PMJAY (was known as Ayushman Bharat Scheme) Pradhan Mantri Jan Arogya Yojana is an insurance scheme funded by the Indian Government which also cover the insurance needs of women and children. Some key features of this plan are:
  1. Cover of INR 5 lakhs annually for each family living under below poverty line
  2. Secondary and tertiary healthcare is included
  3. Covers all pre-existing diseases in health insurance
  4. Follow-up treatment provision is included in the policy
  5. Access to paperless and cashless health insurance facilities
  6. Healthcare benefits available all across India
  7. Daycare expenses are included
If you are looking for a more comprehensive cover that is customisable and offers flexibility & other additional benefits then explore our Senior Citizen Health Insurance policy.

Health Insurance for Senior Citizens by Bajaj Allianz

The Health Insurance Plan for Senior Citizens offered by Bajaj Allianz safeguards all types of medical needs. Any financial worries regarding healthcare are now taken care of by the insurer. Here are some key features:
  1. Covers pre-existing illnesses with shorter waiting periods
  2. Offers cumulative bonus
  3. Provides free health check-up
  4. The policy includes pre and post hospitalisation cover
  5. Offers ambulance cover and waiver of co-payment
Eligibility criteria for buying this policy & additional requirements under health insurance for senior citizens:  
Entry Age 46 to 80 years
Renewal Age Lifetime Renewal
Sum Insured INR 50,000 to INR 5 lakhs
Pre-medical Tests Mandatory
 

FAQs

1. Which insurance company is best for senior citizens?

The type of insurance company depends on your personal choices and situations. However, some of the best insurance companies for senior citizens include Bajaj Allianz.

2. Do senior health insurance plans cover problems that already exist?

Yes, senior health insurance plans typically cover pre-existing conditions either immediately or after a waiting period.

3. Which health insurance is best for senior citizens in India?

Top health insurance options for senior citizens in India include Bajaj Allianz’s silver health plan.

4. Who is eligible for Mediclaim for senior citizens?

Individuals aged 60 and above are eligible for mediclaim for senior citizens.

 5. What are the available health insurance plans for senior citizens?

The Silver Health Plan from Bajaj Allianz is one of the best health insurance plans available to elderly persons in India.

6. What should seniors know before purchasing a mediclaim policy?

Seniors should consider factors like age eligibility, coverage for pre-existing conditions, network hospitals, premiums, co-payment clauses, claim settlement ratio, and critical illness coverage.

7. Are critical illnesses covered under health plans for senior citizens?

Health plans for senior citizens typically provide coverage for critical illnesses. These policies offer financial protection in case of severe, life-threatening conditions such as cancer, heart attack, stroke, and organ failure.

8. What are the considerations when choosing the best Medicare plan for seniors?

Considerations when choosing the best Medicare plan for seniors include age eligibility, coverage for pre-existing conditions, network hospitals, premiums, co-payment clauses, claim settlement ratio, and critical illness coverage.   *Standard T&C apply. Disclaimer: All savings are provided by the insurer as per the IRDAI approved insurance plan. ** Tax benefits are subject to change in prevalent tax laws. Insurance is the subject matter of solicitation. For more details on benefits, exclusions, limitations, terms, and conditions, please read the sales brochure/policy wording carefully before concluding a sale.

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