As people grow old, they become prone to numerous ailments and critical diseases. Compared to the younger lot, older generations suffer more due to deteriorating health. Moreover, their treatment go on for long and are more expensive. Thus, it is more critical for senior citizens or elderly people to have a health insurance plan. An insurance allows them financial security for health and keeps them away from the worries of paying expenses for their medical treatments in old age.
Let us get into a little more detail about the health insurance for senior citizens to help you buy the best plan for yourself or your parents.
What do you understand by Senior Citizen health plans
People above the age of 60 years are considered senior citizens. A senior citizen health insurance plan offers coverage for medical costs incurred by senior citizens. These plans include coverage for precautionary health check-ups, hospitalization (cashless) in network hospitals, cover against already existing diseases, critical diseases, Covid19 treatment etc.
Benefits of Senior Citizen insurance plans
Here are some of the benefits of medical insurance for senior citizens:
- These plans offer coverage to people above the age of 60 years as compared to family health plans where coverage is given mostly up to the age of 65 years.
- Most of these plans do not need the elderly to undergo medical tests before purchasing the policy, which is a requirement of the normal health policies.
- The senior citizen plans offer coverage against a wide range of health costs including pre and post hospitalization as well as in-patient hospital costs etc.
- These plans provide cashless medical facilities that the elderly can avail at any of the network hospitals. The condition is to stay admitted for 24 hours and beyond.
- The senior citizen plans allow No Claim Bonus facility to elderly to avail discount at the time of renewal for each claim-free year. The discount can range from 20% to 100% depending on the plan.
- Most of these senior citizen plans come with renewability for lifetime facility.
- These plans also provide tax benefits. The insured can avail exemptions on tax under 80D section of Income Tax Act, 1961.
Also Read: Buying a senior citizen health insurance policy? Look out for these points
Need of health insurance for Senior Citizens
Senior citizens are all the more prone to diseases and thus need better health coverage as compared to the young people. As such, the health issues become severe with age and need immediate attention. Thus, it is crucial for the elderly to have a health insurance policy.
Here are some prominent reasons to have health plans for the elderly:
- Help meet the growing costs of health care
- Provides cover against critical diseases
- Provides health check-up facility annually
- Provides health security, and a stress-free life
Inclusions of Senior Citizen insurance plans
Here is a list common coverage available under the senior citizen mediclaim policy:
- Covers cost of Hospitalization, which include doctor fee, rent of room, nursing costs, charges of medicine, ICU costs, OT charges, and so on.
- Also covers cost of prosthetic devices, diagnostics, artificial limps, implants etc.
- Covers day care procedures where hospitalization of less than 24 hours is required.
- Covers expenses for pre hospitalization as well as post hospitalization.
- Provides coverage against Covid19 virus
- Covers organ donation costs
- Also covers already existing diseases
- Covers costs incurred for AYUSH treatment and
- Covers domiciliary hospitalization costs
Exclusions of Senior Citizen Plans
Here is a list of things not covered under the senior citizen health insurance plans:
- Expenses of pre-existing injuries
- Costs of injuries caused by insured himself/herself
- Charges caused due to drug/alcohol overdose
- Any medical issue diagnosed within the first 30 days of buying the plan (except accidents)
- Non-allopathic medical charges
- Aesthetic surgeries
- Dental treatment, lenses etc (except caused due to accident)
- AIDS/HIV costs
Important things to note while buying senior citizen plans
As elderly people are vulnerable to diseases, it is very important for them to have a health insurance. However, there are certain things to consider while buying the best health insurance for senior citizens:
- Check if the policy offers facility of day care procedure
- Ensure that the plan offer cashless hospitalization
- Check the ratio of claim settlement and the time taken to settle claims
- Make sure that the insurer provides discount of No Claim Bonus
- Ensure that you get free medical health check up facility
- Check if you can buy a policy offering co-payment clause
- Ensure that the policy offers lifetime renewability
- Check the waiting period for pre-existing illnesses
- Check if the provision of domiciliary hospitalization is available
Process of Claim settlement for Senior Citizen Plans
There are two ways to proceed with your claim settlement, Reimbursement Process and Cashless Claim Process.
- Here, you need to inform the insurance company immediately after hospitalization
- Pay the medical bills after the treatment. Collect the receipts and discharge documents
- Fill the claim form and submit it along with other documents to the insurance provider
- The insurer will review the claim, verify it, and then settle the claim to reimburse the amount
Cashless Claim Process
- Inform the insurance company
- Take the patient to a network hospital of the insurance company
- Fill the form of pre-authorization there
- The hospital will send the form to the Third Party Administrator
- The form will be approved by the insurer
- They will process the cashless claim request
- Once approved, you can start getting the treatment
- Once discharged, the insurer will settle your claim
Health concerns become severe as you grow old and they need immediate attention. In many cases, hospitalization becomes necessary for elderly to ensure their well-being and to give them the best medical facilities.
So, to avail the best health facility and to enjoy a life free of medical worries, it is important for elderly people to have health insurance policy. The health plan for senior citizens is one of the best plans meant especially for the aged people and their medical needs.
However, it is important to compare and read different plans and their features/benefits to choose the health insurance for senior citizens in India that would suit the requirements of the elderly at your home.