Government Mediclaim Insurance for Senior Citizens – Senior Citizen Health Insurance Scheme by Government of India 2023


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Updated on Jul 27, 2023

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Government Mediclaim for Senior Citizens – Pradhan Mantri Health Insurance for Senior Citizens

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.

Let’s Understand More About the Government Health Insurance for Senior Citizens with an Example

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.

PayBima Health Insurance Advisor & Consultant

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.

Also Read: Best Health Insurance For Senior Citizens in India 2022

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5 Best Government Health Insurance for Senior Citizens

1.) Pradhan Mantri Ayushman Bharat Yojana or PMABY

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:

  • Pradhan Mantri health insurance worth 5 lakh rupees for each family per year in both public and private hospitals across India
  • Families with incomes less than the poverty level can receive these benefits.
  • It covers upto three days of hospitalization and 15 days of post-hospitalization expenses like diagnostics, medication, etc.,
  • All current medical conditions of the insured will be covered starting on the first day of the insurance coverage.
  • The participant in this scheme can visit any impaneled private and government hospital within India to receive cash-free treatment. The benefits of this scheme can be transferred across the country.

2) United India Senior Citizen Health Insurance

This medical insurance for senior citizens is offered by United India Insurance Company, a public sector insurance enterprise. Here are its features:

  • The entry age to this health insurance policy is 61 years to 80 years.
  • You may choose a sum insured from 1 lakh to 3 lakh.
  • This policy will cover the medical costs for treatments and surgeries when the duration of hospitalization stays exceeds 24 hours.
  • Hospitalization costs are reimbursable only if the treatment takes place at a government hospital or any other institution recognized by the government.
  • A family discount of 5% on the total premium will be granted, which includes the insured and any of the following dependent children, spouse, or dependent parents.

Also Read: Cheapest Health Insurance in India

3) Varistha Mediclaim Policy For Senior Citizens

This Indian government mediclaim for senior citizens is available with National Insurance Company Ltd.

  • The varistha mediclaim policy by government is available to all Indian citizens aged 60 to 80 years.
  • One lakh & 2 lakh are the two sum insured options available under this policy.
  • The insurance coverage applies to hospitalization expenses and treatment for critical illness costs and treatment costs.
  • Additionally, it provides insurance for diabetes and hypertension that are pre-existing conditions. However, policyholders must pay an additional premium to get the extra protection.
  • The policy provides the treatment of patients through cashless options at hospitals within its network. It also allows hospitals to cover treatment costs at hospitals that are not part of its network via reimbursement claims.
  • The policy coverage is for 30 days of pre-hospitalization and 60 days of post-hospitalization.

Also Read: Health Insurance for Senior Citizens Above 70 Years in India

4) Health of Privileged Elders (HOPE)

This is a senior-citizen-friendly insurance scheme offered by Oriental Insurance Company. A brief outline of the project is as follows:

  • The policy is open to all Indian citizens aged 60 and over for receiving hospitalization in India.
  • The policy can be purchased for a sum insured of Rs 1 lakh to 5 lakhs, with only coverage for specific diseases.
  • 20% of co-payment from the admissible claim must be paid at the time of hospitalization.
  • Policyholders can benefit from a considerable discount in premium when opting for voluntary co-payment.
  • While cashless claims are processed via TPA (third-party administrator), it is restricted only upto 1 lakh rupees.
  • The program includes Ayurveda, Yoga, Naturopathy, Unani, Siddha, and Homeopathy treatment system if conducted in any of AYUSH Hospitals.

5) The New India Assurance Senior Citizen Mediclaim Policy:

This insurance scheme for senior citizens is open for people aged 60 to 80 years old.

  • The maximum amount insured for each person under this plan is Rs.1 lakh or 1.5 lakh.
  • A 10% discount is available when the policyholder’s spouse is also covered under the same plan.
  • It offers limited coverage for hospitalization in government Ayurveda/homeopathic and Unani hospitals.
  • Hypertension and pre-existing medical conditions such as diabetes mellitus, hypertension, and complications are covered for up to 18 months of continuous coverage, but only upon payment of additional premiums.

Also Read: OPD Full Form in Medical

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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Feb 02, 2022
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PayBima is an Indian insurance aggregator on a mission to make insurance simple for people. PayBima is the Digital arm of the already established and trusted Mahindra Insurance Brokers Ltd., a reputed name in the insurance broking industry with 17 years of experience. PayBima promises you the easy-to-access online platform to buy insurance policies, and also extend their unrelented assistance with all your policy related queries and services.

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