SENIOR CITIZEN INSURANCE

There are so many insurance companies in the market that offer insurance to healthy and young people. But, what will happen to the medical security of our parents who are senior citizens? There are very limited plans that are available in the market to provide medical cover to senior citizens. Senior Citizen Insurance is a kind of policy which provides medical cover to people already that are above 60 years of age. In case People covered under this policy are hospitalised then the insurance company is liable to bear the entire cost of hospitalisation up to sum assured.

HOW SENIOR CITIZEN INSURANCE IS DIFFERENT FROM NORMAL HEALTH INSURANCE?

POINT OF DIFFERENCE SENIOR CITIZEN INSURANCE NORMAL HEATH INSURANCE
Age Entry age is 61 Entry age is below 60 years
SUM ASSURED Starts from 50,000 and goes up to 10Lac Starts from 1Lac & goes up to 1Crore
MEDICAL CHECK-UP Compulsory for all age groups Compulsory after 45years
PREMIUM High Low
CO-PAYMENT OPTION AVAILABLE Yes No

WHAT ARE THE BENEFITS OF TAKING SENIOR CITIZEN INSURANCE?

Before buying the Senior Citizen Insurance one should go through following key features:
  1. Day care procedures are also covered as per the company list
Day care procedures include those diseases for which 24 hours of hospitalisation are not required due to technological advancement. Example cataract, dialysis etc
  1. Option of few Domiciliary treatments is also included by few companies
Domiciliary treatment is that in which the patient is treated at home because the patient is in critical situation and cannot be shifted to hospital/ if the hospital states that no beds are available
  1. Pre& Post hospitalisation medical expenses are also covered up to a certain limit. Number of days vary company to company
  2. Senior Citizen plans come with an option of Co-payment. In this individual will bear a fixed percentage of hospitalisation cost and rest will be paid by the company. Example 15%, 20%, 30% or higher. The benefit of taking co-payment option is that higher the percentage is borne by the client, less will be the premium cost.
  3. Emergency ambulance cover is provided by the company up to a specific amount. Example up to Rs 2000
  4. Portability option is available but only into a senior citizen insurance plan. One cannot port senior citizen policy into a comprehensive health insurance plan and vice-versa.
Points to remember
For most companies after a certain age if somebody wants to take insurance then they have to undergo medical test arranged by the company. In most of the cases after 45 years of age, Medical test becomes mandatory

WHAT IS THE TAX BENEFIT OF TAKING MEDICAL INSURANCE?

The tax benefit is provided under Section 80(d). The limit for tax benefit is that, If an individual takes senior citizen insurance policy for self then the amount paid as premium will be treated as saving up to INR 30000.

WHAT IS THE ELIGIBILITY CRITERIA FOR TAKING?

  1. Senior Citizen Insurance is for Individuals who are 61 years or above
  2. Few companies have a limit for entry as well example 70 years
  3. Senior Citizen Insurance can is taken for sum assured of INR 50,000 and goes up to 10 Lac
  4. Medical test is mandatory
  5. Senior Citizen Insurance is portable in nature

WHAT ARE THE EXCLUSIONS?

  1. Waiting period of 30 days covers except any accidental injury
  2. Any Pre-existing diseases/conditions will not be covered from day 1. Those diseases can be covered if the company has some waiting period clause
  3. 2 years exclusion for specific diseases like cataract, hernia, hysterectomy, joint replacement etc.
  4. HIV or AIDS
  5. Non-allopathic treatment
  6. Mental disorder
  7. Cosmetic surgery or weight control treatments

LIST COMPANIES AND SOME ACCEPT IT ON TEST BASIS WITH EXCLUSION

  1. Apollo Munich Health insurance
  2. Bajaj Allianz
  3. ICICI
  4. National
  5. New India
  6. SBI
  7. Star Health insurance
  8. United India
  9. Tata AIG
  10. Max Bupa health Insurance. Note – Max Bupa does not have any separate diabetic plan but it may accept the policy based on medical test reports with some waiting period
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