Overview
The Bajaj Allianz Silver Health plan is a specialized health insurance policy designed for senior citizens aged 46 to 80 years. The plan comes with benefits like cashless and reimbursement options, pre-existing disease coverage starting from the second year, and a cumulative bonus (10% increase up to 100% of Base SI) for claim-free years., it offers a sum insured of up to 10 Lakhs, which is backed by a hospital network spanning over 12,000 healthcare facilities.
Experts Review
Written by Ishita Jain
Editor
The Bajaj Allianz Silver Health plan is a tailored solution for senior citizens, offering comprehensive coverage for medical expenses. Its short waiting period for pre-existing conditions (one year for complications, two years for full coverage) is a significant advantage. However, the plan includes a 20% co-payment clause for non-network hospitals (for Plan A) and 10% co-payment for all claims (for Plan B), has disease wise sub-limits (Cataract: 10% of Sum Insured, Max up to 40,000 per claim (whichever is lower)) and room rent restrictions (Single Pvt AC Room) which may increase out-of-pocket expenses. The premium for this plan is 10-15% higher compared to similar senior citizen plans for the same coverage, due to its specialized features and benefits for older adults.
Pros
Insurer has a solid track record with great claim and service metrics.
Cons
Not very feature-rich.
No Restoration Benefit, which is a notable gap.
Maternity benefits not offered, which could be a drawback for some.
Doctor consultations are not covered, which is a key feature.
Bajaj Allianz
Key Insights
Founded
2001
Bajaj Allianz was established 24 years ago and has built strong credibility over time, backed by its long-standing presence in the market.
Claims Experience
97% claims settled in 30 Days
Bajaj Allianz settles 97% of all claims it receives demonstrating strong credibility.
Network Hospitals
12,000+
Bajaj Allianz has a strong network with over 12,000 hospitals, ensuring wide accessibility and convenience for policyholders.
Complaints
3 complaints per 10,000 claims registered
Bajaj Allianz maintains a low volume of complaints, reflecting strong customer satisfaction and effective service.
Features
All
Great
Good
Bad
Co-payment
The policy will only cover 90% of the final bill. The rest is on you. They call this a co-payment.
Room Rent
You can share a room or you could have a single room for yourself. But if you are looking for anything slightly fancy, be ready to foot a part of the bill.
Customisable
Room rent restriction from a Single Private Room to null}% of the sum insured (max up to ₹undefined per day).
Disease sub-limit
Your insurance cover won’t be fully available in case you are treated for eye related diseases like cataracts, up to 10% of base sum insured max. of ₹40,000 will be covered.
Pre existing diseases waiting
If you’re already dealing with diabetes, cardiovascular problems or any such illnesses, the insurer will cover all costs arising out of these pre-existing problems after just 1 year. It’s probably the best deal you can get to be honest.
Pre/Post hospitalization
No worries if the doctor had to run a host of diagnostic tests before or after hospitalizing you. The insurer has your back. They will cover this amount in full for a pretty reasonable duration - 30 days before you are hospitalized and 60 days after discharge. This includes the cost of medication by the way.
Add-ons
Room Rent Modifier
Room rent restriction from a Single Private Room to null}% of the sum insured (max up to ₹undefined per day).
Room Rent Modifier
With this add-on, the insurance company modifies the room rent restriction from Single Private Room to 1% of Sum Insured maximum upto ₹7500/day.
Permanent Exclusions
Conditions or treatments that the policy clearly says it will not cover.
Expenses related to any admission primarily for diagnostics and evaluation purposes are excluded.
Diagnostic expenses not related or incidental to current diagnosis and treatment are excluded.
Expenses for admission primarily for bed rest and not for treatment are excluded.
Custodial care at home or in a facility for help with daily activities is excluded.
Services for terminally ill individuals addressing non-medical needs are excluded.
Disclaimer: For illustration purposes only - exact terms are in the policy wording.
Specific Illness
The following illnesses are not covered under the policy .
Surgery for gastric or duodenal ulcers
Benign prostatic hypertrophy
Hydrocele
Haemorrhoids
Dysfunctional uterine bleeding
Waiting Period
30 days Initial waiting period
1 years Pre-existing disease waiting period
Ditto's Take
◦ Excellent ◦
Waiting periods on this policy are excellent. There is no specific illness waiting period which is a plus and the PED waiting period is better than usual.
What's missing in the policy
No Restoration Benefit.
Maternity benefits not offered.
Doctor consultations are not covered.
Customer Reviews
A
Anjali
Good plan for my parents, suits senior needs.
R
Rohan
Found this one good for elderly family members.
S
Suman
It's designed for seniors, which is helpful.
R
Rajeshwari
Feels a bit too simple for comprehensive care.
V
Vivek
Very basic coverage, not many features.
M
Manoj
Simple plan for senior citizens.
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Frequently Asked Questions
Does Silver Health have waiting periods?
- 30-Day Waiting Period: Hospitalizations won’t be covered for the first 30 days of the policy unless it’s an accident.
- Specific Illness Waiting Period: There’s a 1 to 2-year waiting period for a list of diseases which is a mandate before you can start claiming.
- Pre-Existing Disease Waiting Period: There's a 1-year waiting period for any pre-existing disease you may have while buying the policy.
Does Silver Health have room rent restrictions?
Does Silver Health offer a restoration benefit?
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