The first concern that comes to mind when one hears the phrase “old age”, is that ageing can result in health deterioration and the onset of other age-related ailments. It is a universal truth that seniors are more prone to certain health conditions and diseases compared to younger individuals. Two things are important when dealing with this facet of life : (a) Caring for & maintaining your holistic well-being (b) Taking a comprehensive and appropriate health insurance plan. Seniors, due to their waning immunity, take longer to recuperate, are more frequently hospitalised and have more expensive healthcare. It is therefore crucial for seniors, to have a suitable health cover to bear the exorbitant health care costs in India today. They also gain peace of mind knowing that they have appropriate financial backing if ever the need arises on a rainy day.
11 Key Points To Consider When Buying A Mediclaim Policy
A senior mediclaim policy delivers health insurance cover to susceptible senior citizens that may need costly medical treatments in the future. The following points need to be taken into consideration while purchasing a mediclaim policy for senior citizens:
1.Free Medical Health Check-up Facility
Choose plans that allow seniors to track their health regularly by providing free medical check-ups annually. Some health plans offer free medical check-ups every year while others after 2, 3, 4, or 5 consecutive claim-free years.
2. Day Care Treatments
Opt for a plan covering maximum daycare treatments, i.e. require less than 24-hours of stay in hospitals like chemotherapy, radiology, dialysis, etc.
There may be circumstances where seniors require treatments at home (domiciliary hospitalisation), owing to the non-availability of hospital beds or because health conditions have limited mobility. On such occasions, senior mediclaim plans should cover the domiciliary treatments after being advised by a qualified medic.
4. Inpatient Hospitalisation
If a senior is admitted for at least 24 hours in the hospital, the mediclaim plan should cover the costs incurred. This includes room rent, doctor’s consultation fees, nurse’s fee, surgeon’s fee, and other medical expenses on consumables etc.
5. Pre-hospitalisation and Post-hospitalisation Expenses
Senior health insurance plans should cover pre-hospitalisation (before admission in the hospital) expenses and post-hospitalisation (after discharge) expenses of an ambulance, diagnostic tests, doctor’s consultations, medicines, etc.
A co-payment clause is where part of the amount claimed has to be paid by the senior insured and only the remaining claim amount is paid by the insurance firm. So, purchase the plan with low to zero co-payment.
7. AYUSH Treatments
If needful to you, please check whether non-allopathic treatments like Ayurveda, Unani, Homeopathy, and Siddha are covered by the mediclaim plan or not.
8. Organ Donor Treatments
Senior healthcare plans should also include coverage for expenses incurred during organ transplantation.
9. Covid-19 Health Insurance For Seniors
Coronavirus treatment can wreak havoc on your savings. So, for COVID-19 treatments, either get seniors insured in a family floater plan or buy a separate comprehensive plan for seniors with COVID cover.
10. No Claim Bonus
If no claim is made by the policyholder in the previous year, the insuring company should allow a no claim bonus discount in the consecutive year. This discount is offered by either increasing the sum insured at the same premium rate or lessening the renewal premium cost.
11. Efficacy of Insurance Settlement Claims
When purchasing a senior health insurance policy, always go for the company with the shortest claim settlement time and highest claim settlement ratio.
Top 5 Mediclaim policies for senior citizens in India in 2022
Following are the top 5 extensively bought, senior health insurance plans:
1. Optima Senior Plan from HDFC ERGO General Insurance Company:
- Medical e-opinion is provided if the senior suffers from a critical illness
- Cashless treatments at more than 10,000+ network hospitals across India
- Organ donor treatments and Domiciliary treatment covered up to the sum insured
- Sum insured up to Rs.5 lakhs
- Lifelong Renewal
- Entry age – 61 years onwards
- This Plan also covers inpatient hospitalisation, pre-hospitalisation, and post-hospitalisation costs
- 5% premium discount as no claim bonus
2. Oriental Senior Citizens HOPE Insurance Plan
- All doctors’ (including the surgeon, anaesthetist, specialists) charges are covered under the policy in addition to all the costs related to procedures they perform (dialysis, chemotherapy, blood transfusion, oxygen, surgical appliances, radiotherapy, etc.)
- If intensive care is required, then ICU will be covered up to 2% of the sum insured each day
- Hospitalisation costs, including boarding, room, & nursing expenses, ICU expenses, surgeon fees, medical practitioner fees, etc., are covered in this plan
- Domiciliary hospitalisation expenses including the pre-post hospitalisation expenses are covered
- This plan covers 11 specified diseases including knee replacement, accidental injury, chronic renal failure, cardiovascular diseases, cancer, orthopaedic ailments, etc
- Non-allopathic treatments such as Homeopathy, Ayurveda, Unani treatments also covered
- This policy includes ambulance charges up to 1000/- rupees or the actual expenses incurred
3. IFFCO Tokio Individual Medishield Plan
- This plan covers hospitalisation, pre-post hospitalisation costs in addition to organ donor expenses
- Ayurveda and homoeopathy treatment is covered
- As an add-on, 12 major critical illnesses can also be covered
- Under the same plan, 5% discount on premium is provided on insuring 2 members and 10% premium discount is offered for insuring more than 2 members
4. Senior Citizen Mediclaim Policy by New India Assurance
- Hospitalisation expenses including the pre-post hospitalisation expenses are covered
- Organ donor costs in case of transplant is included
- Ambulance charges (up to Rs 1000) covered
- Hospitalisation cover for government and/or registered homeopathic, ayurvedic, and unani hospitals provided
- Health check-up cost reimbursement (once in every 4 claim-free years)
5. Kotak Health Care Plan
- Hospitalisation costs, including pre and post-hospitalisation costs are covered
- Lifetime renewability benefit and no restrictions on maximum age limit
- Daycare treatment cover
- Ambulance expenses are also covered
- For every claim-free year, a cumulative bonus of 10% is provided
- Hospital Daily Cash + Donor Costs + Convalescence benefits
- Free health check-up per year for every insured member above 18 years
In addition to the aforementioned five plans, a plethora of mediclaim policies are available for senior citizens. Please go through the needs, benefits, expenses, and policy terms carefully before investing.
Senior Citizen Mediclaim Plan Benefits:
· Tax benefit on the insurance premium paid (IT Act section 80D)
· Treatment and medical facilities in reputed hospitals across the nation
· Cashless hospitalisation treatment and daily allowance (relies on the insurer)
· Domiciliary Hospitalisation cover
· Free-look period
· Reload of the sum insured
· Unlike regular plans most mediclaim policies do not need seniors to undergo medical screening
· Preventive health check-ups
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Frequently Asked Questions
Yes! Purchasing a senior citizen health insurance policy becomes costlier as you get older hence it is advised to buy a senior mediclaim policy as soon as you are eligible.
Yes, every health insurance company in India, through their affiliated hospitals, offers cashless hospitalisation options to their customers.
The following documents are required to purchase a senior citizen mediclaim policy:
Duly filled proposal form
Pre-insurance health test reports (if sought by the insurer)
Yes, the senior health insurance policies with no entry age limit provide mediclaim insurance to seniors even if they are 80 years old or above.