Silver Health for Senior

Cashless facility

Avail access to cashless facility at over 18,400 + hospitals* in India.

Hospital Cash Tax

Avail income tax benefit under Section 80D of the Income Tax Act.*

*On opting for Senior Health Plan for your parents, you can avail Rs 25,000 per annum as a deduction against your taxes (provided you are not over 60 years). If you pay a premium for your parents who are senior citizens (age 60 or above), the maximum health insurance benefit for tax purposes is capped at Rs 50,000. As a taxpayer, you may, therefore, maximise tax benefit under Section 80D up to a total of Rs 75,000, if you are below 60 years of age and your parents are senior citizens.  If you are above the age of 60 years and are paying a medical insurance premium for your parents, the maximum tax benefit under Section 80D is, then, Rs 1 lakh.

Hassle-free claim settlement

Our in-house claim settlement team ensures a quick, smooth and easy claim settlement process. Also, we offer cashless claim settlement at more than 18,400 + network hospitals* across India. This comes in handy in case of hospitalisation or treatment wherein we take care of paying the bills directly to the network hospital and you can focus on recovering and getting back on your feet.

Family discount

Avail a family discount of 5% for each member of your family covered under this policy.

Customised plans

This policy offers innovative packages customised especially to fulfil your requirements.

Why is Senior Citizen Health Insurance - Silver Health Plan Important?

As people age, medical costs often increase. Senior citizen health insurance schemes serve as a crucial financial security, providing access to high-quality healthcare without the burden of financial concerns. This type of insurance empowers older people to focus on their health and well-being without worrying about the expenses associated with medical treatments and procedures. It offers safety, knowing they can afford necessary healthcare services and treatments, supporting their overall quality of life during their golden years.

What is Covered under the Senior Citizen Mediclaim Policy?

Senior citizen mediclaim policies offer a range of coverage options, but some major benefits offered by the best health insurance policy for senior citizens include:

Hospitalisation Expenses:

Covers room charges, surgeon fees, medications, and other costs incurred during hospitalisation.

Daycare Procedures:

Covers treatment costs for procedures requiring less than 24-hour hospitalisation.

Pre & Post-Hospitalization:

Covers expenses related to doctor consultations, medications, and diagnostic tests before and after hospitalisation.

It's important to note that specific coverage details may vary depending on the chosen policy. Always carefully review the policy wording to understand what's included in your plan.

Why Choose Bajaj Allianz Silver Health Plan for Senior Citizens?

Peace of Mind for Golden Years:

Focus on enjoying your retirement without worrying about unexpected medical bills. The Silver Health Plan helps manage hospitalisation costs, protecting your savings.

Comprehensive Coverage:

This plan goes beyond just hospitalisation expenses. It covers pre and post-hospitalisation care, and ambulance charges, and offers free health check-ups.

Rewarding Healthy Habits:

The Silver Health Plan incentivises a healthy lifestyle by offering a cumulative bonus for claim-free years, effectively increasing your coverage over time.

Wider Entry Age Limit:

Enrol in a health insurance plan even at a later stage in life. The Bajaj Allianz Silver Health Plan has a higher entry age compared to some standard plans.

Tax Benefits:

Get tax deductions under Section 80D of the Income Tax Act for the premiums you pay towards your health insurance policy.

*Claims are subject to terms and conditions set forth under the health insurance policy.

**Tax benefits are subject to change in prevalent tax laws.

Important points to note before buying Extra Care Plus policy

Inclusions

- Pre and post hospitalisation expenses Covers hospitalisation expenses and an amount equivalent to 3% of admissible pre and post hospitalisation expenses.

- Ambulance charges Covers ambulance charges in an emergency, subject to a limit of Rs 1,000.

- Pre-existing illness cover Covers pre-existing illnesses 1 year after your policy issuance.

Exclusions

- Any disease contracted during the first 30 days of commencement of the policy.

- Diseases such as a hernia, piles, cataract, benign prostatic hypertrophy, and hysterectomy will not be covered until a waiting period of 1 year.

- Non-allopathic medicines.

- All expenses arising from AIDS and related disorders.

- Cosmetic, aesthetic or related treatment.

- Any disease or ailment arising due to the use of intoxicating drugs and alcohol.

- Joint replacement surgery (other than due to accidents) will have a waiting period of four years.

- Treatment of any mental illness or psychiatric illness.

Policy Information Silver Health Claim Process

Claim by Direct Click (CDC)

Bajaj Allianz general insurance has introduced an app based claim submission process known as “Health Claim by Direct Click” (CDC) This facility allows you to register and submit claim documents through the app itself for claims up to Rs 20,000.

What you need to do:

Register your policy and card number in the Insurance Wallet App.

Register your policy and health card number in the app.

Register the claim.

Fill the claim form and arrange for the hospital-related documents.

Upload the documents using the app menu.

Submit the claims for further processing.

Get confirmation within a few hours.

Cashless claim process (Only applicable for treatment at a network hospital):

Cashless facility at network hospitals is available 24x7, throughout the year, without any interruption in service. But hospitals that provide cashless settlement are liable to change their policy without notice. Therefore, you must check the hospital list before getting admitted. The updated list is available on our website and with our call centre. Bajaj Allianz Health Card along with a government ID proof is mandatory at the time of availing cashless facility.

When you are opting for cashless claims, follow the steps given below:

- Get the pre authorisation request form filled and signed by the treating doctor/hospital and signed by you or a member of your family, at the hospital’s insurance desk.

- Network hospital will fax the request to the Health Administration Team (HAT).

- HAT doctors will examine the pre authorisation request form & decide on cashless availability, as per the policy guidelines.

- Authorisation letter (AL)/denial letter/additional requirement letter is issued within 3 hrs depending on the plan and its benefits.

- At the time of discharge, the hospital will share the final bill and discharge details with HAT and based on their assessment, final settlement will be processed.

Important points to note

- In case of planned hospitalisation, register/reserve your admission as per the network hospital’s procedure for admission in advance.

- Admission at network hospital is subject to availability of a bed.

- Cashless facility is always subject to your policy terms and conditions.

- The policy does not cover the following :

- Telephone

- Food and beverages for relatives

-  Toiletries

- In-room rent nursing charges are included. However, if a higher room is used then the incremental charges will be borne by you.

- In case the treatment is not covered as per the policy terms and conditions, your claim- cashless or reimbursement, will be denied.

- In case of inadequate medical information, pre authorisation for cashless claim can be denied.

- The denial of cashless facility does not mean denial of treatment and does not in any way prevent you from seeking necessary medical attention or hospitalisation.

Reimbursement of pre/post hospitalisation expenses

Relevant medical expenses incurred before admission and after discharge from the hospital will be reimbursed as per the policy. Prescriptions and bills/receipts of such services should be submitted to Bajaj Allianz General Insurance along with the duly signed claim form.

Reimbursement Claim Process

- Inform the BAGIC HAT team about the hospitalization.

- To register your claim online click here

- To register your claim offline, please call us on our toll-free number: 1800-209-5858.

- After discharge, you or a member of your family must submit the following documents to HAT within 30 days:

- Duly filled and signed claim form with mobile number and email ID.

- Original hospital bill and payment receipt.

- Investigation report.

- Discharge card.

- Prescriptions.

- Bills of medicines and surgical items.

- Details of pre-hospitalization expenses (if any).

- In-patient papers, if required.

- All documents to be sent to the HAT for further processing and based on the assessment, the final settlement will be done within 10 working days.

- Post hospitalisation claim documents must be sent within 90 days from the date of discharge.

Documents required for reimbursement claim

- Original pre-numbered hospital payment receipt duly sealed and signed.

- Original prescriptions and pharmacy bills.

- Original consultation papers (if any).

- Original investigation and diagnostic reports along with original bills and payment receipt for the investigation done within and outside the hospital.

- If you or a member of your family availed a cashless claim but did not utilise it, a letter from the hospital stating so.

- A letter from the treating doctor mentioning incident details (in case of an accident).

- Hospital registration certificate and hospital infrastructure on the letterhead.

- A cancelled cheque bearing IFSC code and name of the insured.

- Indoor case paper copy attested from the hospital from the date of admission to the date of discharge with detailed medical history and doctor’s notes with temperature, pulse and respiration charts.

- X-ray (in case of a fracture).

- Obstetric history from the treating doctor (in maternity cases).

- FIR copy (in case of an accident).

- A requirement for some special cases.

- In case of a cataract operation-lens sticker with a bill copy.

- In case of a surgery-implant sticker with a bill copy.

- In case of a heart-related treatment-stent sticker with a bill copy.

All original documents need to be submitted to the following address:

Health Administration Team

Bajaj Allianz House, Airport Road, Yerawada, Pune-411006.

Mention your Policy Number, Health Card Number and Mobile Number clearly on the face of the envelope.

Note: Keep a photocopy of the documents and courier reference number for your records.

Inform the Bajaj Allianz General Insurance HAT about the hospitalisation. a) To register your claim online click here