12 min read
The primary and most important requirement during old age is your overall health. Unfortunately, it’s a fact that as we age, we experience deterioration of health and age-related diseases crop up. To combat the health issues at this stage of your life, two essential things are to be done – taking care of your overall health and purchasing a suitable and comprehensive health insurance policy. As healthcare costs are increasing and frequent hospitalization is more likely for older adults, it’s required to look specifically at health insurance for senior citizens. This will not only help policyholders pay for costly healthcare expenses, but it will make sure that seniors are assured that they’ll have sufficient financial assistance if there is any need.
Mr. & Mrs. Sharma are in their 60’s and retired from their respective job a couple of years ago. Their employer’s mediclaim policy took care of their healthcare needs during their service. After retirement, they are still looking for the best health insurance for senior citizens, and the search has only gotten aggressive, especially after the covid19 pandemic. Although many health insurers in India have strict terms and conditions to provide coverage for senior citizens, making it difficult for them to choose and buy. Mr. Sharma’s friend suggested that the government health insurance for senior citizens in India offered optimal health coverage for the couple. And thankfully, the premium was also on the lower side than the other plans. Mr. Sharma immediately bought it to cover himself and his wife, adding more mental peace to their family.
Indian government health insurance for senior citizens offers adequate health coverage for older people and other benefits provided by private health insurance companies. While some of these plans are supplied by state-run insurers, few are directly within the control of the government.
A health insurance plan is crucial for every individual. However, since senior citizens are prone to illness and severe health conditions, they need better and more comprehensive health coverage. Here are some important reasons why senior citizens must be covered under a health insurance plan:
The elderly are prone to greater health conditions even if they follow healthy ways of life. Hence, as people grow old their health concerns become severe. To tackle such health issues, it is important to have the support of health insurance. Even if you are not covered under a health insurance plan during your youth, it is very important to avail of a plan when you reach your 40s. This is because 40 to 60 years is the period when people are more prone to health deteriorations and this is the age when you must stay covered under a health plan.
When you are covered under a health insurance plan, it allows you peace of mind. You know that if any health emergency appears, your Mediclaim policy will support you with the expenses incurred for treatment.
Your savings are intact – You may have enough savings accumulated over the years using investment policies. However, rather than letting the money drain on your medical expenses, you better use it on other important things and let your health care policy take care of your medical needs.
Ayushman Bharat is a flagship program of the Government of India which was created in conformity to the National Health Policy 2017 to achieve the aim of universal healthcare coverage. PMABY is the most comprehensive government health card for senior citizens, including children and women. Some of its significant characteristics are:
This medical insurance for senior citizens is offered by United India Insurance Company, a public sector insurance enterprise. Here are its features:
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This Indian government mediclaim for senior citizens is available with National Insurance Company Ltd.
This is a senior-citizen-friendly insurance scheme offered by Oriental Insurance Company. A brief outline of the project is as follows:
This insurance scheme for senior citizens is open for people aged 60 to 80 years old.
This plan is available with a greater sum assured of up to INR 10 Lakh. Individuals within the age bracket of 60- to 80-years can avail of this plan. The insured has the facility to cover his/her spouse under this plan on a family floater basis.
Here are some features of the plan:
Health plans for senior citizens are comprehensive and cover a range of illnesses. They come with many interesting benefits as mentioned below:
Further, there are other costs such as ambulance charges, hospital room rent coverage, free medical check-ups once a year (In the case of some insurers), domiciliary expenses, Ayush treatment, organ donor expenses, and pre-and post-hospitalization expenses are covered under these plans.
Below are the key features of a government health insurance plan for the elderly:
Retired senior citizens working in the government sector can benefit from the health plans provided by the government. However, they need to contribute a certain amount from their salary during their job tenure to avail of this facility. This contribution can be either a one-time lump sum pay or maybe annual payment.
Let’s take a look at the health coverage that can be availed as per premium paid under some government health insurance policies for pensioners.
Besides these government plans, you can also avail of all-inclusive health insurance plans from reputed insurers in India for comprehensive health coverage.
IRDAI has set some criteria for senior citizen insurance schemes as mentioned below:
Below are the documents required:
Here are the steps to avail senior citizens health insurance:
Here are some rules set by IRDAI regarding health insurance for senior citizens offered by the government:
There are two ways of filing a claim for a senior citizen health insurance plan if the insured is hospitalized or if there is an emergency healthcare need. They are:
Cashless Claim– Under the cashless procedure, the insured should get admitted at a network hospital of the insurer. They must duly fill out the form of pre-authorization and submit it. The TPA will verify the form and accept the request. Once the insurer approves the claim, cashless treatment will start. The insured can go through the treatment, and at the time of discharge, the insurance company will clear the bill with the hospital directly.
Reimbursement Claim – Here, the insured individual is required to inform the insurance company while getting hospitalized. The individual must pay the bill including all the expenses incurred. They are expected to keep the bills, prescriptions, health reports, receipts of medicines, etc., safe. Once discharged, the insured can file a reimbursement claim after going through the terms and conditions of the insurance policy. Once the insured applies for the claim by submitting the required documents, it gets approved and signed by the TPA. And finally, the reimbursement amount is paid after the claim is accepted by the insurer.
Most of the plans for senior citizens initiated by the central government are available across India. However, there are some specific plans available in certain states/cities. The Central Government Health Scheme is one such plan that is available in Delhi, Kolkata, Mumbai, Pune, Nagpur, and Lucknow.
Alternatively, the Chief Minister’s health insurance plans of specific state governments such as the one initiated by the state of Tamil Nadu allow benefits to be received by the residents of the state only.
Karnataka also offers the Yeshasvini Health Insurance Scheme that allows farmers and peasants in the state to avail of healthcare facilities
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Government health insurance for senior citizens can be advantageous in many ways, as it promises financial freedom without worries about finances during older age. Moreover, the collected savings through this method will add to their retirement savings pool, leading to a fulfilling life. To ascertain whether a government health insurance scheme might be the right one to suit your needs refer to PayBima’s expert advice and get all information on the right products that suits your need.
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