With developments in the Indian Health Industry, health insurers are offering newer and better plans with attractive features. While a few years ago, health insurance plans for senior citizens was not available, now, more and more insurance companies are offering health insurance plans for senior citizens where individuals aged above 70 years can avail of the insurance plans. The market is currently flooded with a range of health insurance plans which are specifically designed for the geriatric population of India.
Absence of income post retirement and the rise of incidence of diseases in the older ages, have given rise to concerns among the population on how to bear the ever increasing medical costs incurred in the later stages of life. In such a scenario, senior citizen health insurance plans are a blessing for the common man, who can avail coverage in the older ages to take care of the rising cost of medical treatments commonly faced in the ripe old age.
The various senior citizen plans available in the market have certain common features which you should know before you venture to invest in the plans either for yourself or for your parents. Let us take a detailed look at the common features of senior citizen health plans currently available in the market.
• Co-pay clause – co-pay clause is usually applicable for senior citizen policies wherein the insurer insists on the claim being shared by the individual in a certain predefined ratio. The ratio usually ranges in the zone of 10-30% and defines the proportion of claim that is to be paid by the policyholder every time a claim is raised. For instance, a plan with a co-pay limit of 20% indicates that in case of any claim that arises under the plan, 20% of the amount of claim will have to be borne by the policyholder and the insurer will honour the rest 80% of the claim. So for a Rs.10, 000 claim under the plan, you will have to shell out Rs.2000 yourself and your plan will pay Rs.8000.
• Limits on Sum Assured – the Sum Assured available under the senior citizen plans is usually limited in amount. Since it is common knowledge that senior citizens present a higher risk of medical contingencies, insurers usually cap the maximum amount of coverage that can be availed. In general, the amount of cover granted ranges between Rs1-3 lakhs with an exception Star Health Insurance Red Carpet Plan.
• Pre-existing clause – as is common in other health plans, pre-existing conditions which mean that the ailments you are suffering from at the time of buying the plan is excluded from the scope of coverage for some years. This is called the waiting period and senior citizen policies also have a waiting period clause for the coverage of pre-existing diseases. The waiting period ranges from 2-4 years.
• Medical examination –senior citizen plans may include a compulsory health check-up of the individual before the cover is granted. This is done by the insurance company to assess the overall risk presented by the individual. The cost of the required medical examination may either have to be borne by the customer or the company or both in a specified proportion.
Besides the above features, almost all other features of the senior citizen plan are similar to those present in normal health plans. Now, it is time to spoil you with the choices of senior citizen health plans available in the market and the respective features of each. Though many companies have policies which cover senior citizens, here we have chosen 4 insurance companies that offer specially designed senior citizen plans. Let us take a look:
1. New India Assurance Senior Citizen Mediclaim Policy – A policy which can be availed by individuals aged 60-80 years and which can be continued till the individual reaches 90 years of age if the plan is continuously renewed with the company. The basic coverage includes pre and post hospitalization cost, ambulance charges, hospitalization expenses for illnesses and injuries to name a few. To know more about this plan click here
2. Star Health Senior Citizens Red Carpet Policy – A plan which you can avail if you are aged 60 years and above and till 75 years. The plan can be renewed continuously for the entire lifetime. The coverage includes hospitalization expenses including pre and post hospitalization, ICU charges, surgeon’s fees, etc. To know more about this plan click here
3. Tata AIG Medi Senior Plan – The plan can be availed by individuals aged 61 years and above with no maximum entry age limit. The plan provides inpatient hospitalization, domiciliary treatment, organ donor expenses and ambulance charges among others. To know more about this plan click here
4. Apollo Munich Optima Senior Plan – A plan designed for individuals aged 61 years and above. Among the list of coverage’s provided, the basic ones include in-patient treatment, pre and post hospitalization, day-care procedures, ambulance charges, etc. To know more click here
The following table lists a comparative analysis between the above mentioned plans for a quick reference:
| Plan Name | New India Assurance Senior Citizen Mediclaim Policy | Star Healtd Senior Citizens Red Carpet Policy | TATA AIG Medi Senior Plan | Apollo Munich Optima Senior Plan | United India Senior Citizens Healtd Plan |
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| Entry Age | 60-80 years | 60-75 years | 61 years onwards | 61 years onwards | 61-80 years |
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| Renewability | Till 90 years | Lifelong | Lifelong | Lifelong | Lifelong |
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| Sum Assured Range | Rs. 1 lakhs or Rs. 1.5 lakhs | Rs. 1 or 1.10 lakhs | Not mentioned | Rs. 2,3 or 5 lakhs | Rs. 1-3 lakhs |
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| Coverage Included | Hospitalisation Expenses, Pre and Post hospitalisation, Ambulance Charges, Ayurvedic Charges, Unani or Homeopathic treatment upto a limit | Hospitalisation Expenses, Ambulance Charges, ICU Charges, OPD Cost | Hospitalisation Expenses, Pre and Post hospitalisation, Ambulance Charges, Day car procedures, Domicilliary treatments, Organ donor | In Patient treatment, Pre and Post hospitalisation, Organ donor expenses, Day care Procedures, Domiciliary | Hospitalisation expenses, Day care treatments, Ayush treatments, Domiciliary hospitilisation |
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| Co-pay Ratio | 10% | 30% | 15%-30% | 15%-30% | 20% |
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| Pre-existing waiting period | 18 months | 12 months | 48 months | 36 months | 48 months |
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| Medical Examination Requirement | Medical Examination is required before the policy is granted at the cost of the customer. The expenses will be reimbursed after a block of 4 claim free years. | No medical examination is required before granting the policy. | Medical Examination is required before the policy is granted 50% of the cost of which will be paid by the company on policy acceptance | Medical Examination is required before the policy is granted 50% of the cost of which will be paid by the company on policy acceptance | Medical Examination is required before the policy is granted 50% of the cost of which will be paid by the company on policy acceptance |
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This comparison table will help you build your confidence in buying the most suitable health insurance plan for yourself or your parents without ambiguity.
