Health Insurance Plans for Senior Citizens

Introduction

Everybody grows old, and as they grow older, they become more susceptible to various health issues. This also coincides with Retirement - a phase of life that begins with a drastic reduction in active income. So, securing a health insurance plan becomes a wise choice. While premiums can be higher for senior citizens, they are still generally lower than the potential costs of unexpected medical treatments. In light of these challenges, choosing the right insurer and plan can provide valuable benefits, offering peace of mind and financial protection during these golden years.

List of the Top 5 Health Insurance Plans for Senior Citizens In India 2024

Features: HDFC ERGO Optima Secure offers extensive coverage for hospitalisation as well as homecare and domiciliary treatments, making it beneficial for senior citizens who may not be able to travel to the hospital. A notable feature of this policy is the Secure Benefit, which offers 2X coverage from Day 1, effectively doubling the cover amount. The plan also includes AYUSH treatments, which seniors may prefer over allopathic treatments. Another feature that stands out in this policy is the loyalty/renewal bonus, which offers a 50% bonus up to 100%, regardless of whether a claim is made.

Drawbacks: One potential drawback is the higher premium compared to other plans. There is also the fact that HDFC does not offer any add-ons to reduce the waiting periods for pre-existing conditions. This is something that people who are older than 60 are likely to have.

Final Verdict: HDFC ERGO Optima Secure is a robust option for senior citizens seeking extensive coverage with unique benefits like immediate 2X coverage and a generous loyalty bonus. While the higher premium may be a factor, the comprehensive benefits and high Claim Settlement Ratio (CSR) make it a strong contender for those prioritising reliability and extensive coverage.

Features: Care Supreme is an affordable and comprehensive health insurance policy with no loading charges, disease-wise sub-limits or room rent restrictions. This plan essentially has no upper age limit, and people up to 99 years old can buy the policy. It provides extensive benefits, including unlimited restoration and domiciliary treatments, making it an attractive choice for the elderly. A stand-out feature is that it also provides add-ons that reduce the pre-existing disease waiting period from 3 years to 30 days!

Apart from this, the loyalty bonus can also be increased to 100% of the base cover amount up to 500% with an add-on, against the standard 50% (up to 100%). Care Supreme also offers a wellness discount of up to 30% on the renewal premium if your exercise regularly.

Drawbacks: Unlike most insurers, this policy does not include annual health check-ups but offers it as an add-on. Additionally, the insurer has a slightly higher complaint ratio compared to its peers.

Final Verdict: Care Supreme is a good option for senior citizens seeking comprehensive coverage at an affordable price. It offers a good balance between cost and coverage for those willing to look over the slightly higher complaint volume.

Features: Aditya Birla Activ One Max is a comprehensive health insurance plan with notable features for senior citizens. It provides unlimited restoration of the cover amount, an excellent loyalty bonus of 100% up to 500%, and built-in coverage for consumables such as gloves and syringes, which are often excluded. Apart from this, the inclusion of AYUSH treatments provides you with alternative medical options, which seniors often prefer.

Final Verdict: Aditya Birla Activ One Max is a well-rounded option for senior citizens, which offers comprehensive coverage and valuable features such as unlimited restoration and a substantial no-claim bonus. While Aditya Birla is a relatively new insurer, the plan remains solid for those seeking a broad range of benefits with economic premiums.

Drawbacks: Aditya Birla has had considerable success in the last couple of years and has managed to maintain good metrics such as CSR & Incurred Claim Ratio (ICR). This is an impressive feat for a new player. However, there has been a slight increase in the complaint volume of late. While the increase is not significant, it is worth keeping an eye on it.

Features: Niva Bupa's Health Companion is a good health insurance plan that offers coverage that most senior citizens need. The policy has no co-payment, room rent restrictions, and disease-wise sub-limits. So, this plan meets all the basic requirements.

It doesn’t have any stand-out features, but it’s a well-rounded plan that seniors can purchase.

Drawbacks: However, there are some considerations to keep in mind. Niva Bupa’s complaint volume isn’t really encouraging (average complaint volume = 43 for 2021 - 2024, while the industry average is 24.69). This can be a hindrance if you want a hassle-free claim settlement process. Additionally, while the plan offers a no-claim bonus of 20% per year, it is capped at 100%, which is lower compared to some other policies that offer higher cumulative bonuses. The restoration amount is also only once a year, as compared to its peers, who offer unlimited restoration either in-built or as an add-on.

Final Verdict: Niva Bupa's Health Companion is a good choice for senior citizens as a last resort. The absence of co-payment and room rent restrictions, along with extensive pre and post-hospitalisation coverage, make it appealing. However, you should also consider the insurer’s metrics when making the final decision.

Key Features: Health Insurance Plans For Senior Citizens

Senior citizens often require extensive medical care and multiple hospitalisations, so opting for a higher cover amount provides sufficient coverage for hospitalisation and treatments. Sometimes, having a high coverage amount with your primary health insurance plan may become expensive. In this case, you can opt for Super Top-Ups that offer a high cover amount at significantly lower premiums.

Look for plans that have minimal waiting periods, especially for pre-existing conditions. This will ensure you don’t have to wait long to have these ailments treated. Some health insurance plans even offer add-ons to reduce this waiting period or get rid of it altogether. However, you also need to note that insurers may reject policies based on severe pre-existing conditions such as cancer or cardiac issues.

With advancing age, hospitalisation might not always be feasible. You may fall and slip a disc or trip on the staircase only to find yourself not being able to walk. Either way, if your health insurance plan covers homecare treatment, you need not worry about travelling to the hospital to claim your insurance.

Domiciliary treatment, on the other hand, covers medical care administered at home when hospital beds aren’t available. By ensuring that necessary treatments can be conducted at home, domiciliary coverage provides peace of mind and continuity of care without the need for hospital admission.

While co-payments or deductibles may seem disadvantageous, and we generally don’t recommend them unless necessary, choosing a voluntary co-pay or deductible can sometimes help secure policies for seniors, particularly those with pre-existing conditions. As a rule of thumb, keep in mind that deductibles are preferable over co-payments.

Benefits of Buying Health Insurance Plans for Senior Citizens

For senior citizens, one significant concern is managing finances without a regular income. Medical expenses—from diagnostics to hospitalisations—can quickly drain savings, affecting their standard of living, which relies primarily on pensions and savings.

Without adequate funds, seniors may not prioritise their health or settle for lower-quality treatments, compromising their recovery and quality of life. A health insurance plan specifically for seniors provides essential financial support, ensuring they can access the healthcare services they need without sacrificing quality.

For example, having a dedicated health insurance plan allows seniors to focus on their well-being, knowing they won’t have to compromise on the care they receive.

As individuals reach the age of 60, many start exploring alternative treatment options alongside standard medical care. This shift often arises from the desire to avoid the side effects associated with conventional treatments. With a health insurance policy, seniors can access AYUSH treatments—Ayurveda, Yoga, Naturopathy, Unani, Siddha, and Homeopathy—at registered facilities recognised by their insurer, allowing them to pursue the care they prefer without additional costs.

Health insurance plans for seniors also offer valuable benefits like daycare and domiciliary coverage. Many common issues, such as cataracts and renal conditions, can now be treated in just a few hours without hospitalisation. The best health insurance plans will fully cover these procedures without limits.

Additionally, if a senior citizen needs immediate care but is unable to go to a hospital, insurers often provide home healthcare services. This domiciliary coverage includes medications, doctor visits, and medical equipment, ensuring that seniors receive the care they need comfortably at home.

Things to Keep in Mind Before Buying a Health Insurance Plan for Senior Citizens

Senior citizens are likely to have pre-existing medical conditions (chronic or lifestyle-related). Even those who haven't faced health issues yet are at an increased risk of developing them as they age.

Insurers view these profiles as high-risk, leading them to require co-payments in health insurance policies. The copayment restriction will force you to foot a portion of the bill. And while opting for a plan with copayment often also entails lower premiums, they can ultimately cost more in the long run, as you may end up paying more out-of-pocket than you saved on premiums.

It's worth noting that many insurers include mandatory co-payments for senior citizens. Therefore, if you find a policy that offers excellent features but includes co-payments, it may still be a good choice overall.

When considering health insurance, it’s essential to steer clear of plans that impose room rent restrictions. If you find yourself needing a room that exceeds the pre-set cap, you’ll end up paying a pro-rata share of the total bill, which can quickly add up. Opting for a plan without these restrictions can help protect your savings, ensuring you get the care you need without unexpected costs.

Many insurers place caps on the maximum coverage available for specific ailments, known as disease-wise sub-limits. As a senior citizen, you’re already investing a significant amount in premiums, so it makes sense to avoid plans that require you to pay out-of-pocket for treatments.

Health insurance providers may add loading charges based on your medical history, which can significantly raise your premiums. To keep costs manageable, look for plans with minimal or no loading charges.

To make an informed choice that benefits your finances, consider using a free comparison tool to evaluate the best health insurance plans and their premiums. This approach will help you find coverage that meets your needs without straining your budget.

As individuals age, the likelihood of frequent hospitalisations increases, making it essential to find the right coverage amount in health insurance for seniors. A smart choice is to select a plan that offers unlimited restoration for partial exhaustion and covers both the same and different ailments.

This restoration feature allows your coverage to be replenished every time you make a claim without limits on the number of claims (up to the base cover amount for one single claim) you can file in a single policy year. Importantly, this replenishment applies regardless of any prior ailments treated within the year.

The unlimited restoration feature is typically included at no extra cost, making it an affordable way to enhance your coverage without increasing your premiums.

As senior citizens, annual health check-ups are a priority to ensure the early diagnosis of any medical conditions. However, they tend to be on the expensive end.

On the other hand, if you make the perfect move, you can choose a health insurance policy that offers a free annual health check-up (that covers certain tests and up to a certain limit, based on the total sum insured).

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 Kishore 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 with our team. Slots are running out, so make sure you book a call now!

How to Choose the Best Health Insurance Plans for Senior Citizens in India?

• Claim Settlement Ratio: This is one of the primary metrics used to determine an insurer's credibility. It measures the number of claims settled by an insurer across a year against the number of claims raised to the insurer for the year. A credible insurer’s rating should be 90 or above. On the other hand, any insurer with a CSR of 80 or below is not worth approaching!

  While CSR is a crucial metric, it can often be misleading if considered solely when determining the top health insurance providers.

  Here is a quick look at the CSR (average of the last 3 years) of all the health insurance players in the industry -

  

  
• Incurred Claim Ratio (ICR): When choosing a health insurance provider, a quick look at the company's incurred Claim Ratio (ICR) can save time and help you consider the insurer's future financial sustainability and claim settlement potential.

  The ICR of a health insurer is computed by dividing the total amount paid in claims by the total amount earned by the insurer in premiums over a year.

  A credible insurer with transparent and steady future sustainability should have an ICR between 50 and 70; any number below 50 indicates that the insurer is heavily leaning towards setting its business profits straight, and that would indicate higher chances of partial or rejected claims. Again, any provider with an ICR of 80 or higher might seem like an excellent choice for the short term since they are settling claims in full, but in the longer run, such brands (unless they have an extensive track record that proves otherwise) might run into some financial crunch.

  Here is a quick look at the ICR (average of the last 3 years) of the current health insurance players in the industry -

  

  
• Complaint Volume: The complaint volume of a health insurance provider records the number of claims filed against the insurer across a year per 10,000 claims. This can be the perfect metric that will help you gauge the quality of the claim settlement experience for the existing policyholders of the insurer (since most complaints stem from issues across the claim settlement process/amount).

  In short, the lower the complaint volume (preferably lower than 20), the better the insurer. Here is a quick look at the complaint volume of the health insurance providers across the industry -

  

  
• Annual Average Business Income: Now, traditionally, an insurer's annual average business income is not listed as its credibility-checker. Nevertheless, this metric sheds light on the insurer’s business vertical - whether you are dealing with a small-sized, medium-sized, or large-sized company. A larger business capital-holding insurer can seem more promising, considering it appears to be financially stable to clear your claim settlement requests.

  However, as mentioned before, multiple other metrics must be considered before finalising that choice.

  Here is a look at the top health insurance providers with their annual average business income (average of the last 3 years) -

  

  

• Choose a plan with no room rent restrictions.
• Opt for a plan with no disease-wise sub-limits.
• Avail a top health insurance policy with unlimited restoration.
• Go for a plan that offers coverage for AYUSH, daycare and domiciliary coverage up to the sum insured (no cap).
• Choose a health insurance plan that offers free annual health check-ups and Hospital Cash Rider/In-Built.
• Make sure to compare the best health insurance policies available in the market before finalising one. This will help you get a clear idea about the most comprehensive and affordable option out there.