As you enter your golden years, your health needs often increase due to age-related conditions and chronic illnesses. This is especially true for senior citizens above 60. For those in this age slab, health insurance is more than just a safety net – it’s essential to manage their rising medical expenses and ensure access to good quality healthcare without worrying about the costs.
In this article, we take a look at health insurance plans for senior citizens above 60 years old and address their specific requirements so that senior citizens can lead healthier, stress-free lives without worrying about the financial burden of unforeseen medical emergencies.
Why Senior Citizens Above 60 Years Need Specialised Health Insurance Plans
Ageing comes with its own set of challenges – from managing your health to finances post-retirement and so many other factors. If you are a senior citizen above 60 years old, health-related expenses usually tend to increase, making health insurance policies a necessity.
This is why specialised health insurance plans for senior citizens above 60 years are made to address their specific needs – such as covering pre-existing diseases, offering OPD coverage, cashless hospitalisation that minimises out-of-pocket expenses, etc. These plans provide financial security and ensure timely access to good quality healthcare.
Senior citizen health insurance is crucial for managing the financial burden of chronic illnesses, age-related complications, and regular medical checkups. Moreover, these plans offer peace of mind to families, ensuring that elderly members can access the care they need without financial strain.
Heads up! We know that health insurance can be overwhelming – but it doesn’t have to! Our IRDAI-certified advisors at Ditto assess your healthcare requirements and can help you pick the right policy. And the best part? We don’t spam or pressure you to buy.
Features to Look for in Health Insurance for Seniors Above 60 Years
When choosing a health insurance plan for senior citizens above 60, it's important to consider features that align with their healthcare requirements. Here are some crucial aspects you need to evaluate:
- Coverage for Pre-Existing Diseases & Minimal Waiting Periods: Waiting periods can be a significant drawback for anyone, and more so for senior citizens above 60 years old. Many senior citizens suffer from pre-existing diseases such as diabetes, hypertension, or arthritis. A good insurance plan should cover pre-existing conditions after a minimal waiting period to ensure uninterrupted treatment.
IRDAI has recently mandated that the waiting period for pre-existing diseases must be capped at 3 years from purchasing the policy. This is indeed a step in the right direction.
- High Cover Amount: Healthcare costs have only been rising over the years, especially for treatments such as surgeries or managing critical illnesses like cancer or heart disease. Opting for a plan with a high coverage amount ensures adequate coverage for unexpected medical expenses after 1 year or 10 years down the line.
- Access to a Wide Network of Hospitals for Cashless Treatment: Cashless settlement is when the insurer directly pays the hospital your claim. A comprehensive network of hospitals for cashless treatment is invaluable as it allows you to receive good quality healthcare without worrying about immediate out-of-pocket payments.
- Wellness benefits and OPD Coverage (Optional): In your old age, you probably frequent hospitals and clinics for consultations more than any other place. While these costs may be small, they add up. While not mandatory, having coverage for outpatient department (OPD) expenses and other wellness benefits such as gym memberships or teleconsultation will add an extra layer of security, covering treatments and consultations that don’t require hospitalisation.
Waiting Periods for Pre-Existing Conditions for Senior Citizens Above 60 Years Old
As mentioned, most senior citizen health insurance plans include a waiting period before covering pre-existing illnesses. This duration varies between insurers and usually ranges from one to three years. Minimising this waiting period is essential for seniors above 60 years old, as delaying treatment for existing conditions can lead to complications. Review the policy document to understand the exact waiting period before finalising the plan.
If you need help reviewing your insurance policy document, you can always go through the Understand Your Policy page that we built at Ditto Insurance.
- Cost of Premiums for Senior Citizen Plans
Premiums for senior citizen health insurance policies tend to be higher due to the increased likelihood of claims. However, some insurers offer flexible payment options or discounts for multi-year policies. While affordability is essential, balancing an affordable premium with comprehensive coverage is equally important to avoid underinsurance.
- Tax Benefits Under Section 80D for Senior Citizen Policies
Health insurance for senior citizens also provides tax advantages under Section 80D of the Income Tax Act. You can claim deductions of up to ₹50,000 on premiums paid for senior citizens above 60 years old. This is apart from the ₹25,000 deduction you have for yourself, your spouse & kids. This tax benefit acts as an added incentive to secure good health insurance coverage for elderly family members.
- Restrictions in Senior Citizen Plans
While senior citizen plans offer a great deal of security, they often come with certain restrictions that you need to be aware of. Some of them are as follows:
- Co-payments: Co-payments are a standard feature in many senior citizen health insurance plans, requiring the policyholder to bear a fixed percentage of the claim amount. For example, a policy with a 20% co-payment clause means that the insured must pay 20% of the hospital bill while the insurer covers the remaining 80%.
While co-payments can reduce premiums, they also mean that you need to plan for out-of-pocket expenses during medical emergencies.
- Sublimits: Sub-limits are caps on specific medical expenses, even if the total claim amount is within the cover amount. Insurers generally apply these caps on room rent, and specific treatments such as cataract surgery, joint replacements, or room rent. For example:
- Room Rent Sub-limits: The policy may restrict room rent to, say, ₹5,000 per day or allow only a standard private room. Opting for a higher-cost room can lead to significant out-of-pocket expenses, as you may have to pay not only the additional room rent but also a proportionate share of the overall bill.
- Disease-Specific Sub-limits: Treatments for specific conditions, such as knee replacements or cardiac surgeries, might be capped at a pre-determined amount regardless of the total cover amount. For instance, a knee replacement surgery might have a cap of ₹1 lakh, even if the policy has a total sum insured of ₹10 lakhs.
- Deductibles: Deductibles are the portion of the claim amount that the policyholder must pay before the insurance coverage kicks in. For instance, if a policy has a deductible of ₹50,000, you must pay this amount out of pocket for any hospitalisation cost before the insurer settles the remaining amount.
How to Choose the Right Health Insurance Plan for Senior Citizens Above 60?
When selecting a health insurance plan for senior citizens, there are several features to consider so that you get comprehensive coverage. Here are a few of them:
- High Cover Amount: Senior citizens are more prone to critical illnesses and medical conditions, so opting for a higher coverage plan is essential to cover large hospitalisation costs.
- Coverage for Pre-existing Diseases: Many seniors have pre-existing health conditions such as diabetes, hypertension, or cardiac issues. Look for plans that offer coverage for these conditions with minimal waiting periods.
- Comprehensive Add-ons: Additional benefits such as annual health check-ups, lower waiting periods, consumables coverage, etc., can make a significant difference in providing complete care. Opt for a policy that either covers this by default or provides an add-on for such features.
- Compare Premiums Across Insurers: Evaluate different policies to find a balance between affordable premiums and comprehensive coverage.
- Check for a Robust Hospital Network: Ensure the insurer has a network of hospitals and clinics in close vicinity. This will make it easier to access cashless services and good-quality medical care.
- Home Care & Domiciliary Coverage: Home care and domiciliary coverage is essential for senior citizens who may prefer treatment at home.
- Co-Payment & Deductible: Although avoiding co-payments and deductibles is ideal, having a policy with such clauses is better than having no coverage at all.
Top Health Insurance Plans for Senior Citizens Above 60
| Top Health Insurance Pan | Waiting Periods | Other features | Insurer Metrics |
|---|---|---|---|
| Aditya Birla Activ One Max | PED WP: 3 years (add-ons can reduce it) SI WP: 2 years |
Pre & post hospitalisation cover: 90 & 180 days Restoration: 100% of base SI, unlimited times Renewal Bonus: 100% pa, up to 500% (irrespective of claims) |
Network Hospitals: 12k+ CSR: 95% ICR: 68% |
| HDFC ERGO Optima Secure | PED WP: 3 years SI WP: 2 years |
Pre & post hospitalisation cover: 60 & 180 days Restoration: 100% of base SI, once a year (Cost-effective addon to make it unlimited) Renewal Bonus: 50% pa, up to 100% (irrespective of claims) |
Network Hospitals: 12.5k + CSR: 98% ICR: 86% |
| Care Supreme | PED WP: 3 years (add-ons can reduce it) SI WP: 2 years |
Pre & post hospitalisation cover: 60 & 180 days Restoration: Up to Base SI, unlimited times Renewal Bonus: 50% pa, up to 100% (add-on can increase it to 100% pa, up to 500%) |
Network Hospitals: 11.4k+ CSR: 90% ICR: 59% |
| Niva Bupa ReAssure 2.0 (Titanium +) | PED WP: 3 years(add-ons can reduce it) SI WP: 2 years |
Pre & post hospitalisation cover: 60 & 180 days Restoration: 100% restoration of the base cover, unlimited times No-Claim Bonus: Carry forward unutilised cover up to 10x of base cover. |
Network Hospitals: 10,000 + CSR: 91% ICR: 58% |
| ICICI Elevate | PED WP: 3 years SI WP: 2 years (both can be reduced with add-ons) |
Pre & post hospitalisation cover: 90 & 180 days Restoration: 100% restoration of the base cover, unlimited times (with a 45-day cooling period for the same ailments) Renewal Bonus: 20% pa, up to 100% (Add-on can make it 100% per year with no capping on maximum amount) |
Network Hospitals: 10,800+ CSR: 85% ICR: 83% |
What are the Challenges in Availing of Health Insurance Policies for Senior Citizens?
Despite the availability of senior-citizen-specific plans, older individuals often face numerous hurdles, such as higher premiums, stringent medical screening, and sub-limits on treatments. Some insurers impose co-payment clauses, which require policyholders to bear a portion of the claim. Apart from this, going through the fine print of health insurance policies can be overwhelming. This makes it important to seek professional guidance when selecting a plan.
Why Talk to Ditto for Your Health Insurance?
At Ditto, we’ve assisted over 3,00,000 customers with choosing the right insurance policy. Why customers like Abhishek below love us:
✅No-Spam & No Salesmen
✅Rated 4.9/5 on Google Reviews by 10,000+ happy customers
✅Backed by Zerodha
✅100% Free Consultation
You can book a FREE consultation. Slots are running out, so make sure you book a call now!
Conclusion
Health insurance for seniors above 60 is not just a financial tool but a lifeline ensuring they receive timely and good quality medical care. By understanding the needs of senior citizens above 60 years old, you can secure a policy that provides comprehensive coverage and peace of mind.
