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Health Insurance

Health Insurance For Senior Citizens

Avni Mittal

Written by Avni Mittal

Insurance Writer

Gaurav Bhat

Reviewed by Gaurav Bhat

IRDAI-Certified Expert at Ditto

SP0738578124

Certified
Health Insurance For Senior Citizens

Senior citizen health insurance is simply a hospitalization cover built for higher age and higher medical risk. That is why the fine print matters more than the sum insured, especially the clauses that decide how much the insurer pays versus how much you pay.

In this guide, we will explain how to get health insurance for senior citizens, which plans are worth considering, and how they compare through a product-wise breakdown. We will also cover premium benchmarks, what to do if an insurer rejects the proposal or adds conditions, and the key things to check before you buy.

How Can Senior Citizens Get Health Insurance in India?

1) Buy a Comprehensive Plan

If the senior medically qualifies, this is usually the best place to start. Many comprehensive plans today allow entry at older ages, but approval still depends on health and underwriting.

Why this is better: 

    • Comes with fewer built-in restrictions, so out-of-pocket expenses are usually low
    • Offers strong coverage growth features like bonuses and restorations, which matter more as medical costs rise with age
    • Works better as a long-term policy, you can renew year after year without changing your policy frequently

2) Buy a Senior Citizen Specific Plan

These are plans marketed specifically for seniors. They can make sense when comprehensive plans are hard to get medically, or feel unaffordable.

Why it’s not recommended as a first choice:

    • Often comes with built-in limits like co-pay, room rent caps, and sub-limits, which can reduce payouts even with a high sum insured
    • Offers fewer coverage-growth features compared to comprehensive plans, so your usable coverage can feel inadequate over time

For example, Star Health has a senior citizen-focused plan called Red Carpet, and it comes with a mandatory 30% co-pay.

Did You Know?

Many insurers now offer senior-citizen-specific support like dedicated helplines and priority email queues. For example, HDFC ERGO lists a separate 24x7 number for senior citizens and persons with disabilities (022 6158 2026). Niva Bupa also offers priority assistance via seniorcitizensupport@nivabupa.com.

Best Health Insurance Plans for Senior Citizens (2026)

At Ditto, we shortlist the best plans for senior citizens using a simple framework:

    • Policy Terms: Room rent rules, co-pay, consumables coverage, and waiting periods
    • Insurer Metrics: Hospital network strength and claims service track record 
    • Premium Value: Whether the price is fair for what the plan actually offers

Based on the same framework, here are our top senior citizen health insurance picks.

PolicyMaximum Entry AgeComplaints per 10,000 Claims (Avg FY 2022-25)
HDFC ERGO Optima SecureNo Limit9.28
Care SupremeNo Limit42
Aditya Birla Activ One MAXNo Limit18.67
Niva Bupa ReAssure 2.0 Platinum +99 years (Similar to no limit)42.85
SBI Super Health Platinum InfiniteNo Limit20.51

Note: Sometimes, multiple plans from the same insurer rank in our top 10. To keep the list balanced, we feature only one plan per insurer, even if more qualify.

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Product-Wise Analysis of the Best Senior Citizen Health Plans (2026)

Let’s see how the top plans actually stack up for senior citizens. We’ll go one by one and call out what each policy does well for older ages, where the fine print can hurt (co-pay, room rent limits, sub-limits, and pre-existing disease rules), and how the plan design plays out during real claims.

The goal is simple. By the end, you should not just have a shortlist, you should know which plan fits your parents’ age and health profile, and what to double-check before you buy.

1) HDFC ERGO Optima Secure

HDFC ERGO has a 96.71% claim settlement ratio (Avg FY 2022-25) and a network of 13,000+ hospitals.

Key Features

    • Clean Policy Structure: no co-payment, no room rent limits, and no disease-wise sub-limits
    • Secure Benefit: gives you 2x coverage from day 1, so a ₹10 lakh base cover becomes ₹20 lakh from the very first day
    • Plus Benefit: increases your base cover by 50% after year 1 and 100% after year 2, irrespective of claims.
    • Restore Benefit: restores 100% of the base sum insured for subsequent claims in the same year; by default, it triggers once per policy year, but it can be made unlimited by paying extra
    • Protect Benefit: covers listed non-medical expenses and consumables by default that many insurers typically don’t cover
    • Limitless (add-on): Offers unlimited coverage for 1 or 2 claims in the entire policy lifetime
    • ABCD Chronic Care (add-on): reduces waiting period for asthma, high blood pressure, cholesterol, and type 2 diabetes from 3 years to 30 days

Key Drawbacks

Premiums are on the higher side, and underwriting can be stricter, so some profiles may see loading charges that can make it even more expensive.

Final Verdict

If the senior citizen qualifies medically and the premium is not a dealbreaker, Optima Secure is one of the best comprehensive plans to buy.

2) Care Supreme

Care Health has a 93.12% claim settlement ratio (Avg FY 2022-25) and a network of 11,400+ hospitals.

Key Features

    • Clean Policy Structure: no co-payment, no room rent limits, and no disease-wise sub-limits
    • Unlimited Automatic Recharge: restores your sum insured unlimited times in the same policy year, even for the same illness
    • Cumulative Bonus (inbuilt): increases cover by 50% each year up to 100% of the base sum insured, and it does not reduce even if you claim.
    • Cumulative Bonus Super (add-on): adds an extra 100% bonus each year, up to 500% of the base sum insured, on top of the inbuilt bonus, irrespective of claims
    • Cumulative Bonus Booster (add-on): gives an additional 100% bonus every year with no upper cap, so the cover can keep growing with continuous renewals.
    • Instant Cover (add-on): cuts the waiting period from 3 years to 30 days for conditions like asthma, diabetes, and hypertension
    • Modification of PED Waiting Period (add-on): reduces the pre-existing disease waiting period from 3 years to 1 or 2 years
    • Unlimited Care (add-on): offers unlimited coverage for a single hospitalization, once  in the entire policy lifetime

Key Drawbacks

Some important benefits, like consumables and health check-ups, are optional and need to be paid for separately, and the insurer’s complaint volume is higher than some peers.

Final Verdict

If you want a fairly priced plan for senior citizens with strong inbuilt restoration and easy add-ons to tighten waiting periods, Care Supreme is a good option.

3) Aditya Birla Activ One MAX

Aditya Birla has a 95.81% claim settlement ratio (Avg FY 2022-25) and a network of 12,000+ hospitals.

Key Features

    • Super Reload: if you make multiple claims in the same year, the plan refills your cover unlimited times 
    • Super Credit: your cover grows at every renewal, irrespective of claims, by 100% of base sum insured per year, up to 500%, maximum up to ₹3 crore
    • Claim Protect: covers non-payable items by default, which is a common reason people end up paying extra out of pocket during claims
    • Chronic Care (add-on): reduces pre-existing disease waiting period from 3 years to 0 days for listed chronic conditions like diabetes, asthma, high blood pressure
    • PED Waiting Period Reduction (add-on): lets you reduce the pre-existing disease waiting period from 3 years to 2 years or 1 year
    • Health Returns: depending on your health, fitness levels, steps taken everyday you can get back up to 100% of the renewal premium

Key Drawbacks

Aditya Birla is relatively newer in the market, so senior citizens may prefer a more established insurer. Also, if you add waiting period reduction or chronic- care add-ons, you need to keep paying for them every year till the policy is active.

Final Verdict

With strong inbuilt features at a relatively low price and more lenient underwriting, it can be a good fit for senior citizens who want comprehensive cover without paying a high premium.

4) Niva Bupa ReAssure 2.0 Platinum +

Niva Bupa has a 91.61% claim settlement ratio (Avg FY 2022-25) and a network of 10,000+ hospitals.

Key Features

    • Clean Policy Structure: no co-payment, no room rent limits, and no disease-wise sub-limits
    • ReAssure Forever: once the first claim is paid, it triggers an “unlimited” refill for life, where each future claim can go up to your sum insured.
    • Booster+: unused base sum insured can carry forward and accumulate up to 5x
    • Lock the Clock:  your premium is locked as per your entry-age until a claim is paid, premiums can still increase due to insurer-wide pricing increases or due to medical inflation
    • Disease Management Rider (add-on): offers immediate cover for inpatient hospitalization or day-care treatment for complications arising out of diabetes or hypertension
    • Safeguard / Safeguard+ (add-on): covers non-payable items, which helps reduce the usual out-of-pocket add-ons in hospital bills.

Key Drawbacks

It can feel a bit “feature-heavy” to compare, and despite a strong claim settlement ratio, the complaint volume is higher than peers, so service consistency can vary.

Final Verdict

If you want a more innovative, feature-led policy and are okay with some service inconsistency, Niva Bupa can be a decent option.

5) SBI Super Health Platinum Infinite

SBI General has a 96.13% claim settlement ratio (Avg FY 2022-25) and a network of 16,600+ hospitals.

Key Features

    • Clean Policy Structure: no co-payment, no room rent limits, and no disease-wise sub-limits
    • Reinsure Benefit: unlimited restoration of sum insured in the same policy year, triggered from the first paid claim, up to 200% of base sum insured
    • Health Multiplier Benefit: for listed serious illnesses, the plan increases the coverage up to 3x
    • Claims Shield: covers consumables like gloves, masks, cotton, and bandages, which help reduce out-of-pocket costs during hospitalization.
    • Short PED Waiting Period: Pre-existing diseases are covered after 2 years only
    • OPD Benefits: Up to ₹10,000 out-patient department benefits like check-ups and pharmacy bills

Key Drawbacks

Even though the benefits are strong, servicing can feel more process-heavy, which can lead to slower grievance resolution. It is also expensive, since this premium variant starts at a ₹50 lakh sum insured.

Final Verdict

If you want a high-coverage plan with aggressive restoration and a strong critical illness multiplier, and you are okay with a more process-driven service experience, this is a solid option to shortlist.

Premium Comparison of Health Insurance Plans for Senior Citizens

ProfilesHDFC ERGO Optima SecureCare SupremeAditya Birla Activ One MAXNiva Bupa Reassure 2.0 Platinum +
(Individual Plan): Age 65₹65,257₹45,847₹50,164₹56,699
(Family Floater, 2A): Ages (65, 66)₹98,251₹94.035₹87,805₹98,897
(Family Floater, 2A): Ages (71, 72)₹1,30,352₹1,25,878₹1,10,516₹1,22,885

Note: Premiums for a ₹15 lakh S.I., residing in Delhi - 110010, including necessary and mandatory add-ons. Exact premiums can vary depending on city, underwriting, discounts, and insurer repricing. 

Inclusions and Exclusions of Senior Citizen Health Insurance Plans

What’s CoveredWhat’s Not Covered
In-patient hospitalizationInvestigation and evaluation only
Pre-hospitalization expensesRest cure, rehabilitation, and respite care
Post-hospitalization expensesObesity or weight control treatments
Day care treatmentsGender change or related treatments
Organ donor expensesCosmetic or plastic surgery
Modern treatments (robotic surgery, stem cell therapy, etc.)Hazardous or adventure sports injuries
AYUSH treatments (Ayurveda, Homeopathy, etc.)Treatment breaching the law
Road ambulance chargesUnproven treatments or experimental procedures
Domiciliary treatmentsSterility and infertility treatments
-Maternity (unless specifically covered)
-Wellness or rejuvenation therapies
-Dietary supplements or alternative substances
-Substance abuse or alcohol-related treatments 

It’s worth noting that coverage and exclusions may vary slightly across insurers and plans. It's recommended to check the policy wording of the specific plan you are interested in.

What to do if Your Application gets Rejected?

1) Group Plan for Immediate Cover

If you can get on a group policy (through your bank, social clubs, or alumni groups), it is often the fastest way to get insured because group plans have little to no medical underwriting. Group plans still come with waiting periods, but usually less than retail plans. 

Just remember: group cover is tied to the group, so it can end when the membership changes.

2) Use Your Children’s Employer Cover

Many employee health insurance policies let you add your parents as dependents, and this can be a practical backup while you keep trying for an individual plan. Corporate plans come with a 0 waiting period and no scrutiny for pre-existing disease

Do not treat it as permanent, though. Corporate cover is not “owned” by you, and it can stop when you switch jobs or retire. 

3) Back-up Plans to Consider

If comprehensive plans are getting declined or heavily loaded, you can explore plans built for specific health profiles. For example, Care Freedom is for people with chronic conditions and has a 24-month pre-existing disease waiting period, but it comes with restrictions that you should read carefully.

Similarly, Aditya Birla Activ One VYTL is made for people with chronic health conditions and offers in-built day 1 hospitalization cover for listed chronic conditions.

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Things to Keep in Mind Before You Buy Health Insurance for Senior Citizens

01

Check Policy Restrictions

Before you compare “features,” check for co-pay, room rent limits, and sub-limits because these are the most common reasons payouts get reduced during claims. Even a high sum insured can feel useless if these restrictions are tight, so review them upfront before shortlisting any plan.

02

Waiting Period Reduction

Most plans have waiting periods, especially for pre-existing diseases, but some insurers offer paid add-ons to shorten them. Check if these add-ons apply to your PEDs and how long you have to keep paying for them.

03

Review Old Policy Before Switching

Do not switch just because you found a lower premium, because you might restart waiting periods if there is any new diagnosis. If you do want to move, portability is meant to help you switch at renewal without breaking continuity, so follow the correct portability process and disclose your medical history.

04

Expect High Premiums due to Loading Charges

Final premiums can increase if the insurer applies a loading based on pre-existing diseases or overall risk, and that extra cost continues for future renewals. This is why the premium you see online is often not the final premium after underwriting.

Why Talk To Ditto For Health Insurance

At Ditto, we’ve assisted over 8,00,000 customers with choosing the right insurance policy. Why customers like Abhinav below love us:

Health Insurance For Senior Citizens
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Ditto’s Take

For most senior citizens, start by trying to get a comprehensive plan and treat it as a long-term policy you renew every year. It is usually better to pay a bit more for reliable claims than save on premiums and get surprised later.

    • Shortlist 2 to 3 plans, then quickly check key limits like co-pay, room rent caps, disease caps, and waiting periods
    • Apply with clean, complete medical disclosures
    • If underwriting comes back with a rejection or heavy conditions, switch to a fallback plan such as group cover as a temporary bridge or a senior-focused plan with fewer restrictions

Keep it sustainable: choose a premium you can pay every year, and if budget is tight, use a two-layer setup with a solid base plan plus a super top-up for large bills.

Quick Note

Ditto currently partners with HDFC ERGO, Care Health, Aditya Birla Health, and Niva Bupa. Some insurers on this list are non-partners, and we’ve still included them here because the rankings are unbiased and based entirely on published data, not on commercial relationships.

For a detailed explanation of our process, partnership policy, and disclaimers, please see our [Editorial Policy & Disclaimers] document.

Finally, this analysis is based on publicly available information and should not be treated as personalized advice. Always read the policy brochure carefully and consult a licensed advisor before purchase.

Frequently Asked Questions

What sum insured is actually enough for senior citizens in India?

For most seniors, a lower coverage can run out quickly because hospitalization costs rise sharply with age, especially in metro cities. A practical approach is to start with a solid base cover of  ₹15-25L, keeping in mind rising medical costs. 

Should parents be on an individual plan or a family floater at older ages?

For older parents, a family floater can work well if it is a comprehensive plan with strong bonus and restoration features, since the total usable cover can rebuild and stay sufficient for both. But if the plan is more restrictive, it is usually better to buy individual covers so one parent’s claim does not reduce the other parent’s available coverage.

What happens to a senior citizen’s policy after 75 or 80? Can the insurer stop renewing it?

Individual/Retail health insurance plans are designed to be renewable for life as long as you renew on time and do not misrepresent information. This renewal protection is given by the IRDAI. That said, the premium can increase with age and insurer re-pricing, so the focus should be on buying a plan you can keep renewing comfortably.

What are the tax benefits of senior citizen health insurance?

Premiums paid for health insurance can qualify for the deduction under Section 80D (old tax regime), and the limit is higher when the insured is a senior citizen. If you are paying for your parents’ policy, you can claim up to ₹50,000 for their premium (or the actual premium paid, whichever is lower).

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