Best Health Insurance for seniors in India

Nowadays, healthcare is among the most expensive essentials. Since many health insurance policies are prohibitively costly or include comprehensive medical testing that may be difficult to undergo. Seniors might have difficulty selecting the best health insurance available for senior citizens in India. Given the annual increase in medical costs, health insurance for senior citizens in India is a need for parents and senior citizens. Healthcare expense is often increasing by 15% to 20% a year, however, an important observation is that 75% of Indians’ medical costs come from their own pockets.

Why opt for health insurance for parents and seniors?

Individual health insurance plans are economical rather than family floater plans if you stay with dependent parents older than 60. The reason for this is in family floater plans, the premium rates are set after considering the most senior family member’s age. Some other factors to opt for this cover for parents and seniors are:

• The expense of healthcare is rising faster than the general rate of inflation.
• After retirement, parents’ income could be uncertain or limited.
• Parents could rely on their heirs for financial support.
• They are more prone to accidents or diseases. 
• There could be an unexpected need for financial assistance. 
• After retirement, their employer’s plan might no longer exist.

Key Characteristics of Senior citizens Health Insurance:

The following are some of the essential characteristics of these policies for seniors in India:

• Coverage for hospitalisation includes room and board costs.
• Payment-Free Hospitalisation.
• Costs associated with daycare result from technological improvements.
• The expenses of ambulances are covered.
• Depending on the insurance company, pre-existing conditions are covered.
• Before obtaining medical insurance, no medical examination is necessary. It is based on the insurance company.
• Higher insurance coverage limits
• Coverage for existing diseases
• Quicker and easier settlement

Exclusions – What are the limitations of Senior Medical Insurance?

Here are a few of the most general exclusions from senior citizen insurance plans: 

• Existing illnesses or injuries
• Any diseases acquired within 30 days of purchasing the insurance
• Any alternative treatment
• Costs associated with self-inflicted wounds
• Costs associated with drug abuse
• Costs associated with dental work and eyewear (except arising out of accident)
• Medical expenses related to treating AIDS
• Certain conditions, like joint replacement, are only covered two years after the coverage is purchased.
• Cosmetic procedures
• War injury, a foreign army’s action, etc.

Carefully observe the following when considering senior citizen health insurance plans:

• Co-payment clause

Co-payment refers to the policyholder bearing a portion of the claim settlement. For instance, in an 80%-20% provision, the policyholder would be responsible for 20% of the cost while the remaining 80% might be reimbursed.

• Sub-limit

The providers may set limits for particular conditions or therapies. For instance, even though the policy sum insured could be as much as Rs 3 Lakhs, the policyholder can only claim Rs 20,000 for a cataract procedure. The better insurance has higher premiums but no sub-limits

• Pre-existing ailments

You should determine whether the coverage covers pre-existing conditions. Some policies might include all currently recognised ailments, while others may require the policyholder to wait several years before filing a claim.

• Waiting Time

Before filing a claim, the policyholder must wait a predetermined time (usually 30 days).

• Alternative Therapies

Some insurance plans also cover complementary therapies like Ayurveda, homoeopathy, etc.

• Critical Conditions

Check the plan’s coverage of severe illnesses and see whether there are any corresponding sub-limits.

The Best Senior Health Insurance Plans 

The following are a few of the most popular senior health insurance plans on the market. Go through their key features to choose the best plan in India.

1. Star Health Red Carpet

Star health insurance for senior citizens is one of the top-recommended plans. It provides substantial coverage with an elevated entrance cap of 65 to 75 years. It is amongst the earliest insurance plans created in India specifically to address the unique medical requirements of seniors.

Major features:

Premium: 4450-18000 (excluding service tax)

• Charges for in-patient hospitalisation include ICU costs, nursing costs, surgeon’s costs, specialist’s costs, blood and oxygen costs, medicine costs, diagnosis costs, etc.
• Up to 7% of pre- and post-hospitalisation costs are covered.
• Coverage of emergency ambulance costs
• Treatment only available at network hospitals
• Home health care is covered
• No medical examination is necessary
• Pre-existing conditions are covered after the initial 30-day waiting period without coverage.
• 24-hour toll-free assistance
• Direct internal payment

2. National Insurance Varistha Mediclaim

It is one of the most economical healthcare plans with great features. It has a solid reputation among clients and insurance carriers for developing effective programmes and providing straightforward claim resolution. In terms of premium and coverage, it is one of the most senior-friendly policies.

Major Features:

Premium: 4180-6890 for Mediclaim; 2007-2288 of severe illnesses

• Hospitalisation costs are covered, including nursing costs, boarding costs, ICU costs, nursing costs, surgeon’s fees, blood costs, oxygen costs, medicine costs, pacemaker costs, etc.
• Housing costs are paid.
• The costs of organ donors are covered.
• Optional coverage for critical illness.
• Pre-existing conditions are automatically covered with a 10% higher premium.
• Entry allowance of 60–80 years.

3. Oriental Insurance “HOPE” (HEALTH OF PREVILEGED ELDERS)

This insurance plan, which offers extensive coverage, including treatment for specific disorders, is open to all seniors over 60. This policy provides a broad array of services in addition to cover. It is renowned for having high ratios of claims incurred to claims settled, making it one of thebest health insurance for seniors over 70.

Major Features:

Premium: 4500-29000

• Hospitalisation costs include boarding, nursing, ICU, doctors, surgeons, anesthesiologists, consultants, or specialist fees.
• The cost of an emergency ambulance is compensated.
• Anaesthesia, blood, oxygen, operating room fees, surgical equipment, and imaging tests like X-rays all are covered.
• The cost of prescription pharmaceuticals, consumables, and prosthetic equipment, including pacemakers and artificial limbs, are covered.
• Advantages of domiciliary hospitalisation
• Reduces the cost of the voluntary co-payment premium.

4. Bajaj Allianz Silver Health

As you age, healthcare expenditures increase; this policy guarantees full coverage of all medical expenses. This plan will cover you and your spouse when you require pricey medical care. Under the reputable name of Bajaj Allianz, it is a thorough health care plan that provides a high degree of flexibility with price assured.

Major Features:

Premium: 1995-29039

Entry-exit age gap: 46-70

• The insurance plan provides to pay up to 3% of allowable hospitalisation costs.
• The costs of both pre-and post-hospitalisation are covered.
• A maximum of Rs. 1,000 in ambulance fees is reimbursed in an emergency.
• Pre-existing conditions are covered beginning with the second policy year
• There is a 5% family discount that applies to the insurance.
• Copayment waiver if the policyholder contributes a higher premium is available
• Tax advantages for dividends paid by section 80D Income tax act

5. New India Assurance Health Insurance

It is a beneficial plan for seniors because it covers hospitalisation expenditures, including pre-and post-hospitalisation fees. This plan covers Ayurveda, Homoeopathic, and Unani treatments as well. This plan includes insurance for diabetes mellitus and hypertension for an additional 10% premium payment.

Major Features:

Premium: 3850-7650

• The entry-exit age gap: 60-80
• For 30 days, pre-hospitalisation costs are covered, and 60-day post-hospitalisation expenses are covered
• Hospitalisation costs for treating illnesses and injuries are covered
• The cost of an ambulance is covered.
• If a patient is admitted to a licensed homoeopathic, ayurvedic, and government hospital or Unani hospitals
• Only patients who have maintained their policy with the company for at least 18 months are eligible for pre-existing disease coverage.
• Pre-existing conditions like diabetes, hypertension, and other conditions are covered after the policy has been in effect for 18 months and the additional premiums have been paid.
• Based on the customer’s preferences, the sum assured could be either Rs. 1 lac or Rs. 1.5 lacs.

6. PMJAY (Pradhan Mantri Jan Arogya Yojana) Scheme

The Government of India funds the Pradhan Mantri Jan Arogya Yojana (PMJAY), a major national health protection programme. Ayushman Bharat Yojana sometimes referred to as the AB-PMJAY scheme, incorporates the Senior Citizen Health Insurance Scheme (SCHIS) and Rashtriya Swasthya Bima Yojna (RSBY). The Ayushman Bharat Yojana initiative benefits rural and urban poor homes since it helps the poor and rural families.

Major Features:

• PMJAY has the following other significant characteristics in addition to being a life-saving programme for lower middle-class people:
• This Pradhan Mantri health insurance for senior citizensis a plan with a 5 lakh rupee payout assured for each enrolled household.
• This initiative’s target demographic is anyone with access to the internet or online health plans who lives below the poverty line.
• This programme enables its beneficiaries to receive cashless medical care services anywhere at public or private hospitals.
• Additionally, it reimburses the beneficiary for any transportation expenses paid before and during the hospitalisation.
• This insurance plan also covers the beneficiary’s daycare and medical treatment costs.
• The PMJAY scheme also covers several of the specified pre-existing conditions.
• The government has predetermined a package rate that will be used to calculate the compensation for medical expenses.

Reasons Seniors People Need Health Insurance

In the modern era, the value of health insurance cannot be overstated. When it comes to seniors, this significance is increased. The natural ageing process makes the human body more susceptible to various ailments. Therefore, it is preferable to be proactive and choose a plan for seniors as soon as possible.

• Rising illness rates

Growth in the prevalence of diseases affects individuals in semi-urban and rural places as well. Compared to a few years ago, this makes developing an illness more likely. An excellent strategy to protect the family’s finances if aged family members contract diseases or have medical problems is to purchase a health insurance plan.

• The rise in Health Care Costs

The growth in illnesses has been paralleled by the development of medical innovation that provides treatment for such diseases. Therefore, purchasing plan makes financial sense for senior citizens to counteract the rising expense of medical care and be prepared in an emergency.

• Pricier health insurance policies

An individual’s age significantly influences the cost of the insurance for healthcare insurance plans. As a person ages, the prices rise. To cut premiums costs, it is preferable to choose medical insurance for seniors early on.

• Full-coverage health insurance

Many companies include group health insurance as part of their benefits package for employees. In rare cases, the parents of the employee are also included. Does it, however, provide sufficient coverage? Instead of getting individual policies for each family member, some choose to get a Family Floater plan that covers the entire family. Furthermore, such floater plans fall short of insurance requirements when offering substantial personal coverage. Therefore, a comprehensive personal policy is the best choice for full insurance coverage.

• Fight Critical Illness

A critical illness plan by insurance providers covers costly and potentially fatal diseases. These plans offer a lump sum payment if a vital illness is discovered. Before obtaining such a plan, it is essential to thoroughly examine the terms and conditions because such policies are frequently susceptible to pre-existing conditions.

• Facilities for Annual Health Checkups

Several senior citizen healthcare plans include free annual health checks for their members who are over 65. This service can reduce out-of-pocket costs because they frequently undergo medical screening. However, some plans might provide this option after two or three years of being claim-free.

Emoha App

With the Emoha app, you get access to 24/7 emergency support for non-medical & medical emergencies alike that can be availed from any place in India within seconds. You also get exclusive benefits like travel booking assistance, special discounts on travel & medicines, a helpdesk for daily support, and much more. You can also read exclusively tailored blogs for seniors on several topics ranging from health to well-being to entertainment. Download the app from Google Playstore or iOS App Store.

Conclusion 

Health care can become prohibitively expensive for senior citizens. Your upcoming visit to the hospital can be hassle-free if you choose the best plan for you and your dear one, and you’ll also be able to retain your funds in your bank account. You should select the ideal plan for you and your family. So, don’t wait for anything awful to happen. Compare all options, pick the best one from a reputable provider, and enjoy an insured life.

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