Know about health insurance for senior citizens?

Author: Reena More

Retire from work, not life! That is the mantra for senior citizens today. If you are one of those senior citizens who have invested wisely and created a healthy retirement corpus so that you can enjoy your 'golden years', there is one small question we have for you - Do you have health insurance cover?

You might have had a healthy lifestyle all your life, but as you start ageing, you are more vulnerable to medical complications that show up after a certain age. It could lead to a major erosion of your lifetime savings. So, what is the solution?

The solution is senior citizen health insurance!

What Should a Senior Citizen Health Insurance Policy Offer?

These are health insurance plans specifically designed for senior citizens. The following are the features of senior citizen health insurance plans:

  • Age: These policies are meant for citizens in the age group 60 to 75.
  • Medical Exam: No pre-insurance medical tests are required for such policies.
  • Free-look period: The policy can be returned during this period and the premium will be refunded after deduction of certain charges.
  • Yearly checkups: You can avail of this on an annual basis.
  • Cashless hospitalisation: Available if hospitalised over 24 hours and includes medical bills, room rent, doctor’s fees, and so on.
  • Pre and Post Hospitalization: A specified number of days before and after hospitalisation are covered.
  • Waiting period: The policy covers pre-existing diseases after this period is over.
  • Other facilities: Some policies also cover ambulance charges.
Which Factors Should You Check Before Buying a Senior Citizen Mediclaim Policy?

You should compare health insurance policies taking into account the following factors before deciding which one suits you:

  • Policy coverage: Every health insurer offers different coverage against the sum assured you opt for. Therefore, it is important that you compare the health insurance policies for senior citizens against the coverage that it offers and then make an informed decision..
  • Co-payment clause: Co-payment refers to sharing the claim payment between the policy holder and insurer. The policy holder will have to bear a certain predetermined percentage of the claim and the balance will be paid by the insurer. Don't choose a Health insurance policy based on a low premium as it may contain a co-payment clause.
  • Renewal Age: The upper age limit for renewal in case of senior citizen health insurance policies varies from insurer to insurer. While most policies cover individuals between the ages of 60 and 80 years, some companies limit the renewal age to 69 years. Some companies have no upper limit and the policy has to be renewed annually.
  • Pre-existing illnesses: Insurers differ when it comes to coverage of pre-existing illnesses and senior citizen health insurance policies. While some insurers cover pre-existing diseases after a waiting period of 1 to 2 years, there are some insurers which don't cover pre-existing diseases at all. So, before you take the policy, find out if the insurer covers pre-existing illnesses or not.
  • Waiting period: In case of senior citizen health insurance policies, the waiting period should be low, as a claim might need to be made soon after taking the policy. Find out if the current health problems you have do not fall under the diseases mentioned in the waiting period clause.
What Are the Exclusions of Senior Citizen Mediclaim Policies?

There are certain health hazards that are excluded by a senior citizen health insurance policy. They are:

  • Pre-existing ailments
  • Self-inflicted injuries
  • Drug abuse
  • Medical condition(s) detected within 30 days of taking the policy.
  • Patients undergoing non-allopathic treatment like ayurveda, naturopathy or Unani treatment.
  • Injuries caused due to war.
  • Cosmetic treatments to enhance the appearance of a patient and this includes dental treatment. However, plastic surgery to treat accident patients are not excluded.
  • Expenses incurred for diagnostic tests for routine checkups are not covered.
  • Cost incurred for treatment of AIDS.
How Do I Make a Claim Under the Senior Citizen Mediclaim Policy?

The need for quality healthcare is needed for all patients, especially senior citizens. It is important to choose a service provider that provides the required funds during hospitalisation or when there is a medical emergency.

Whether the insurer is providing cashless treatment through a network hospital or reimbursing expenses incurred during hospitalisation, they should be efficient and prompt.

The policy holder should inform the insurer within 24 hours of being hospitalised without fail.

The claim form should be filled at the time of hospitalisation for cashless claims and post-hospitalisation for policies where expenses are reimbursed. Great care should be taken while filling out the form, including the section to be filled out by the attending doctor and all the supporting documents must be attached. One needs to keep original copies of bills and attach copies of the same while making a claim.

Which Tax Benefits Do I Get with a Senior Citizen Mediclaim Policy?

Like any other health insurance policy, a senior citizen health insurance policy premium is eligible for tax benefits under Section 80D of the Income Tax Act, 1961. The amount of rebate available is Rs.30,000/- per individual for health insurance premium.

What Are the Best Health Insurance Policies for Senior Citizens?

In recent times, there have been a lot of options for senior citizen health insurance policies from both, public and private insurers, each with a few distinct features.

These are the health insurance policies available for senior citizens:

  • Star Health Senior Citizen Red Carpet Health Insurance policy: This health insurance policy is for those between 60 and 75 years of age. The sum assured is up to Rs. 10 lacs. Pre-existing illnesses are covered from the second policy year.
  • New India - Senior Citizen Mediclaim policy: You get a cover up to Rs. 1.50 lacs under this health insurance policy. After 18 months of the policy being in force, pre-existing illnesses are covered. This is for senior citizens in the age group 60 to 80 years, renewable up to the age of 90 years.
Enjoy Protection from Health Problems during Retirement

With the host of benefits offered by both private and public health insurance companies, it is truly a golden opportunity for senior citizens. However, they need to choose the insurer carefully. The policy features should be checked for renewability, exclusions, and co-payment clause.