What are Senior Citizen Health Insurance Policies?

Our world looks up to individuals in their Golden Years for wisdom and knowledge. Yet, while we draw benefits from their experience, more often than not, we are far in the dark about how their health continues deteriorating and find treatments to keep them healthy despite all age-related adversities.

Truth be told, no matter the kind of healthy lifestyle one leads, health complications are inevitable after a certain age threshold. Such individuals are the ones who need access to premium healthcare services. But these services do not come cheap, and since for those in their Golden Years, their source of income is already compromised (them being retirees), any quality medical treatment suggests a financial burden.

Taking into account the probability of a substantial financial dent in the savings of a lifetime and the higher chances of requiring healthcare treatment, it is only logical that they opt for Senior Citizen Health Insurance Policies.

However, when discussing Health Insurance Plans for retirees, multiple myths run around in the market - the primary being insurance gets pricey with your age. How true is this? Is there any way you can avoid it? What are some other myths regarding this coverage?

Let’s find out the truth about Mediclaim for Senior Citizens!

What are Senior Citizen Health Insurance Plans?

Senior Citizen Health Insurance Plans are policies offered by Insurance companies to People above the age of 60 years to cater to their medical treatment expenses. These plans are customized to specifically cater to the health scares commonly faced by retirees.

Let’s say you are 61 years old. Across your prime years, you and your finances have stayed caught up in catering to your family's needs, and hence, you have missed out on taking particular care of your own health.

Now, even though you do have considerable savings as your retirement funds, shouldn’t you avail of an option that helps fund your future medical needs?

In case you still need to understand why you should be opting for Senior Citizen Health Insurance Plans, here is a quick look into the reasons -

Why Should You Buy a Senior Citizen Health Insurance Policy?

• Higher the age, the higher the risk of ailments demanding expensive treatments

With age, we fall vulnerable to numerous diseases that our bodies cannot fight off on their own. So, professional medical care becomes pivotal to leading a healthy life. Thus, you are looking at sizeable expenses over gaining premium healthcare services. However, with suitable funding from the best health insurance providers in India, you will be financially secure against all such medical costs.

• Shield your retirement funds against the heavy, one-time outflow of finances

The Senior Citizen Health Insurance Policy exists to offer you the much-required financial aid during the years when you need it the most and hence help you spend the retirement funds on your long-term dreams and wishes. And again, it safeguards you against a huge outflow of your savings for medical treatment by requesting you to make regular outflows of smaller premiums to have access to a substantial fund.

• Home treatment options need to be available at nominal costs

Getting treatments for critical ailments during older years is already a stressful situation with higher risks of infections and other consequent complications. This gets a bit more comforting when treatments are conducted from one’s home. With an ideal health insurance policy, such domiciliary treatment charges are well funded, along with increased access to premium healthcare services from professionals.

Considering the aforementioned reasons for availing of a Senior Citizen Health Insurance Policy, now your interests must be piqued. However, all health insurance plans, no matter how lucrative, always come with a set of downsides.

Now, it is for you to decide if the pros outweigh the cons of the insurance for senior citizens or vice-versa.

What are the Advantages and Disadvantages of Senior Citizen Health Insurance Policies?

Pros of Mediclaim for Senior Citizens

• Access to substantial funding

With the best medical insurance for senior citizens, policyholders have access to a handsome fund to cater to their health-related expenses. This safeguards their lifetime savings from being eaten away by medical bills and still guarantees access to quality healthcare treatments across the nation.

• Coverage for pre-existing conditions

Insurance providers are aware that when potential policyholders are aged above 60, they are looking at higher risks of pre-existing conditions. And this is one of the reasons why senior citizens look forward to availing of mediclaims - to cover any future complications of their current ailments.

Hence, insurance providers offer coverage for pre-existing conditions (of course, with a waiting period).

• Pre & post-hospitalization expense coverage (including medication charges)

Hospitalization of any kind calls for a substantial expenditure for pre and post-period too. The major focus of this being on follow-ups and medicine. Taking into consideration how such channels may take a considerable bite out of the savings of policyholders who have already lost their steady source of income, pre and post-hospitalization charges are covered (that includes medicine bills as well). The days for which these expenses are covered, however, vary from one plan to the other.

• Minimal or no room rent restrictions

As a health insurance scheme for senior citizens offers minimal or no room rent restrictions, you are looking at an inconvenient hospitalization process sans worries about which room is vacant and which is covered by your insurer.

• AYUSH treatment coverage

Often senior citizens look out for alternative treatment methods rather than the conventional approach. They feel such alternative treatment channels help with their health far better than their prevailing counterpart. Hence, most of the health insurance policies targeted at retirees offer coverage for AYUSH (Ayurveda, Yoga and Naturopathy, Unani, Siddha, and Homeopathy) treatment.

However, while some plans offer uncapped funding, others have certain restrictions.

• Home Care Benefits

The lion’s share of medical expenditure for senior citizen parents goes towards offering them round-the-clock medical support, physiotherapy, and assistance with activities of daily living. With some of the best health insurance policies that are customized to fit senior citizen requirements, charges for home care services are covered as well.

• No-Claim Bonus

Well, it is true that premiums for senior citizen health insurance plans are relatively higher. This makes it difficult to avail extensive coverage, considering the financial strain that it would put on the savings of the retirees.

However, with perks like No-Claim Bonus, there is an option to increase the bandwidth of the coverage while keeping the premium low. All that you need to do is keep yourself healthy, choose a great plan, and not make claims! (In case you choose the Care Plus plan, you can make a claim of less than 25% and have your NCB still intact).

• Assured Tax benefits

With a mediclaim policy for senior citizens, as policyholders, you are entitled to enjoy the benefits of Income Tax deductions under Section 80D. And now, your perks of graying hair roll in, as your tax deductions claims get doubled! Confused? Read our blog on Section 80D and get a crisp idea of how to tap into these benefits!

• Free annual health check-ups

As said before, routine health check-ups are crucial and, yet, unreasonably expensive at times. Rather than making those payments out of your pocket, it is only logical that you choose a plan that offers you the benefit of free annual check-ups.

Cons of Senior Citizen Health Insurance Plans

• Chances of higher premiums

As policyholders grow older, they are increasingly exposed to higher chances of acquiring ailments. This means higher chances of claims and hence, for the insurers - an increased probability of a payout.

Thus, you are very easily looking at an exorbitant premium for minimal coverage that might raise questions if you should be availing of health insurance for senior citizens at all.

However, if you can lay your hand on a free senior citizen health insurance premium calculator, you can compare policies and opt for coverage with an optimum premium that best suits your financial stability and medical requirements.

• Copayment might be mandatory

Since senior citizen medical insurance plans carry a higher risk of payout, insurance providers are reluctant to offer plans sans a percentage of copayment. To know why you should be looking for any scope to opt out of this, read our blog on Co-payments across the Health insurance Sector.

This means you are still liable to pay a certain share (as dedicated in the underwritings of your policy) of the billed amount.

However, with the best health insurance for senior citizens (as has been listed below), such copayments are no longer a mandate.

• A waiting period for existing diseases

Honestly speaking, each health insurance plan comes with a certain waiting period for pre-existing illnesses. And while we try to look out for plans with a minimum waiting period, it doesn’t hurt us much to wait out the span because the chances of fatal complications of the same are minimum considering our age.

However, when it comes to policyholders in their golden years, the very same waiting period for their pre-existing ailments becomes a cumbersome hurdle.

Upon market analysis, we, however, have found a few senior citizen insurance policies that demand a lower waiting period (of 3 years minimum) and yet have a queue of lucrative perks. Take a look at the list of the best plans for retirees below.

• Loading charges

Let’s say you are a Senior Citizen with a pre-existing condition. You are looking for a senior citizen insurance plan. Insurers know that with your pre-existing ailment, you are a high risk for a payout over expensive treatments and hospitalizations. Thus, they will be looking at you for a loading charge to be paid on your premium. This is their charge for the already existing disease that you come with.

The only exception to this rule is Care Plus, which demands no loading charge irrespective of the policyholder's age.

After carefully considering the pros and cons of health insurance plans for senior citizens and proper market analysis, we have sorted the best plans. Considering the various complications in the plan, policies that are all ups and no downs are rare. So, do expect some cons for the policies mentioned below too.

The best thing would be to contact one of our Insurance Advisors and seek their guidance to get your hands on the plan that would suit your finances and health complications.

Best Health Insurance Plans for Senior Citizens

1. HDFC Health Suraksha

This policy is offered to policyholders till the age of 100 and demands no copayment. Coming from the stable of HDFC Ergo, this is one of the most affordable policies that offer a queue of benefits - home care coverage up to the sum insured, domiciliary coverage, daycare treatment coverage, no room rent restrictions, and more.

This plan requires a loading charge that ranges from 20 to 40% and may go up to 100% (for a single illness) and 150% (for multiple illnesses).

2.  Care - Care Plus Complete

This plan from Care is a bit more expensive than its counterpart from HDFC Ergo. However, since it demands no loading charges, it’s gaining popularity among potential policyholders (above the age of 65)  with certain pre-existing conditions. In addition, Care’s high Claim Settlement Ratio and extensive network of hospitals also give this plan its necessary edge.

3.  (Max Bupa) Niva Bupa Health Companion

Niva Bupa’s Health Companion is not exactly a robust or comprehensive plan compared to that from the stables of HDFC or Care. However, since this plan demands no copayment, this surely gets into our top choices for the best mediclaim policy for senior citizens.

This policy has a prominent downside: its No-Claim Bonus starts at a minimum of 20%, which is relatively lower than its counterparts.

4.  BAJAJ ALLIANZ Silver Health

The policy holds for those above the age of 46 and offers a minimum waiting period of 1 year on pre-existing diseases (there is a catch - read below). But, on the other hand, this policy isn’t cheap too.

However, the cons of this plan have a long queue - 20% copayment, no domiciliary coverage, and a 50% payment out of pocket if complications arise from pre-existing conditions.

Such said health insurance plans for senior citizens are a debatable insurance product. Some believe it to be worth its cons, while others say the product isn’t worth the compromises one must make. Because none of the best Health Insurance Policies for Senior Citizens in the market provide you with all the features required for a premium health insurance policy.

So, are senior citizen health insurance policies ideal for you? What could be the best alternative for this insurance policy to ensure coverage for your loved ones? Let’s find out!

Are Senior Citizen Health Insurance Policies Ideal?

The mediclaim policy for senior citizens can be ideal for you in a couple of conditions -

CASE 1: In case of accidents

With age, individuals are more susceptible to accidents. With senior citizen health insurance plans in place, you are covered for accidents and related hospitalization and treatments from Day 1. This helps you stay financially guarded.

CASE 2: In the case of minimum coverage, that comes at a considerably low premium.

When considering the medical expenditure for senior citizen parents, you know it's a considerable cash outflow. However, if you purchase even a small coverage that requires a lower premium, you still have funding to cover a share of the medical bills that cushion your savings to some extent.

CASE 3: In case you are weighing a heavy outflow of savings against a regular outflow of small disbursals of cash

Undeniably, health insurance policies for senior citizens ensure that one does not have to be on the suffering end of a large bite of savings for any medical expenses. With health insurance, you will pay off smaller amounts over premiums, shielding your life savings significantly.

However, high premiums, mandated copayments, and restrictions across pre-existing ailments make senior citizen insurance plans a risky insurance product. It would be better if you could look for alternatives when seeking coverage for yourself as a retiree or for your parents if they are above 60 years of age. Here are a few recommendations -

#1: Include your parents in your corporate health insurance plan. Corporate plans have a negligible waiting period, minimal restrictions, and assured chances of cashless treatments and/or reimbursements.

#2: Explore Super Top Up with Low deductible options. Instead of getting  a senior citizen health insurance plan that demands a high premium for a minimum coverage, you can always go for a Super Top-Up plan that offers a high coverage against a low premium and demands a nominal deductible (that you can choose).

Here’s the kind of difference that you will face with a senior citizen health plan and with a Super Top-Up Plan

So, while you pay a nominal deductible and a high premium, at least the coverage that you avail of is high enough to cover expensive treatments.

Additionally, availing of the best Super Top-Up plans gives you access to lucrative perks that are beneficial to the policyholders.

#3: Explore other group plans if you are part of a stable group like your Alumni association etc. Taking into account the growing importance of availing of significant funds for medical expenses, group health insurance is also gaining ground. Group Health Insurance also has its limitations and it will be more of a trade off between price and features.

Frequently Asked Questions