There is at least one elderly person in almost every house and we have seen that with increasing age, their body loses some strength and support, due to which they start developing new diseases and health problems. In such cases, they may need frequent health check-ups and treatment, which can be difficult to afford with the current inflation. As earning is not possible in old age due to lack of body strength, most elderly people depend only on money saved throughout their life to pay for medical expenses. Health insurance can help them with such payment even in old age. Health insurance plans for senior citizens i.e. senior citizen health insurance plans have been designed keeping in mind only the elderly.

If you are a senior citizen and have purchased a senior citizen health insurance plan, then you do not have to worry about medical expenses. This is because, from a regular health check-up to medical treatment for any disease, all are covered under your insurance plan. In such times, the senior citizen health insurance plan is nothing less than a boon for the elderly.

There are many companies that provide the facility of senior citizen health insurance. All these companies have their own different criteria, like age, health status and pre-existing diseases, through which they determine the premium and insurance term. If you are thinking of buying health insurance for senior citizens, then you must read the following article.

(Read more: Health insurance plans for family)

  1. What is senior citizen health insurance
  2. Benefits of senior citizen health insurance
  3. What is covered under senior citizen health insurance
  4. What is not covered in senior citizen health insurance
  5. Difference between senior citizen and general health insurance

Health Insurance for senior citizens is a special insurance policy that covers the medical expenses of persons who are above 60 years of age. When an elderly person suffers from an age-related illness, their hospitalization expenses are covered by the insurance plan taken by them. Senior citizen health insurance plan offers the convenience of affordable premiums, a comprehensive sum insured as well as some special benefits for older people so that they can live their life without worry and stress.

If you buy a health insurance plan for senior citizens, you need not worry about recurring age-related health problems, as you can get treatment without any hassle, even with the rising inflation. Health insurance premiums also increase rapidly with age, but with myUpchar Bima Plus Health Insurance, you can provide health insurance coverage up to Rs 3 lakhs to the elders of your household at a low premium also.

(Read more: What does health insurance cover)

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In senior citizen health insurance, the insured gets different types of benefits from general insurance but it also depends on the insurer. This means that each insurance company has its own plan, in which it offers a different set of benefits at different premiums. Senior citizen health insurance plans mainly cover the medical expenses of the elderly person, such as treatment of diseases, surgeries, accidents, expense of bed, ICU, ambulance etc. Health insurance for senior citizens, if renewed on time, provides you coverage till the age of 80 years. Coverage is also available for up to 99 years in many insurance plans.

Given below are some of the benefits of senior citizen health insurance:

  • Medical coverage to elderly people: This is the main feature of the health insurance plan for senior citizens. Individuals who are above 60 years of age can buy a senior citizen health insurance plan since normal health insurance plans usually cover your medical expenses till the age of 65 years.
  • Comprehensive coverage: After buying a senior citizen health insurance plan, you do not need to worry about the pre and post hospitalization medical expenses as they are covered by your insurance plan itself. Apart from this, if you do not require hospitalization and will be treated in a single day, then hospital expenses, as well as medical expenses at home, are also covered to a great extent.
  • Medical check-up before getting insurance: Most health insurance plans do not require you to get a medical test done before buying it. Whereas in senior citizen health insurance plans, elderly people are specially given the facility of getting medical tests done. This facility is beneficial for older persons so that any pre-existing diseases can be diagnosed. The main advantage of getting a medical test done is that you will know whether the disease you already have is being covered in this plan or not.
  • Cash is not needed: Like many other insurance policies, you also get a cashless facility in the health insurance plan for senior citizens. In this, if you have a disease or get hurt in an accident, then you can go to any hospital that comes under the network of the insurance company and get your treatment without paying any money. For example, if you do not have cash and suddenly your health deteriorates, then you do not need to arrange money before going to the hospital.
  • Peace of mind: As medical expenses continue to rise, paying hospital bills can create a stressful situation for older people. This situation may be prevented from arising with the help of a senior citizen health insurance plan. If you are thinking of buying a senior citizen health insurance plan for your parents, it may also help in maintaining your peace of mind.
  • Special discount: Since this insurance plan is for senior citizens, the facility of claim-free year is also given in it. This discount can also range from 20-100%, depending on different insurance companies and plans.
  • Tax benefits: Health insurance plan for senior citizens also gives you the benefit of a special tax rebate. You get a special discount every financial year in the premium paid under Section 80D of the Income Tax Act. So if you pay taxes, then a senior citizen health insurance plan can be beneficial for you.

(Read more: Cheapest health insurance policy)

If you are thinking of buying a senior citizen health insurance plan, then the first step is to find out all you can about the inclusions being offered in this plan. Although the coverage offered in an insurance plan depends on the insurer but there are common inclusions mentioned below:

  • Coverage of hospital expenses: If you are the insured, the insurance company bears all the hospitalization expenses in case you become ill. Hospital expenses usually include room, bed, ICU and machines. Apart from this, the fees of doctors and nurses is also covered by your senior citizen health insurance plan. Medicines, injections, needles and other equipment used in the treatment are included as well.
  • Other medical expenses: In old age, all the parts and systems of your body are not able to function as well as they used to. Keeping this in mind, senior citizen insurance includes the cost of radiotherapy, chemotherapy, dialysis, implantation of a sham or a spurious bone implant, etc. If you have to implant any device like a pacemaker or vascular stent then its cost is also covered by the senior citizen health insurance plan.
  • Medical examination expenses: All major pre-hospitalization and post-treatment tests, X-rays, blood tests, urine tests and others, are covered in the health insurance plan for senior citizens. 
  • Daycare treatment: If you have had a health problem that has required you to stay in the hospital for less than 24 hours, it is called daycare treatment. Health insurance plans for senior citizens cover the expenses incurred on daycare treatments.
  • Pre and post hospitalization expenses: If you have purchased a senior citizen health insurance plan and you have a medical emergency, the insurance company covers the pre-hospitalization expenses like doctor's consultation fees and post-hospitalization expenses like medicines, etc.
  • COVID-19: The elderly are at a higher risk of developing severe coronavirus infection if exposed. The health insurance plan for senior citizens has been designed keeping this in mind and covers the cost of COVID-19 treatment to a limited extent.
  • Organ donor expenses: Most companies offering senior citizen health insurance plans also cover the medical expenses of organ donation. For example, if an organ is to be transplanted, the cost is borne by the insurer.
  • Ambulance cost: If an ambulance has been used to take the insured to the hospital and drop him back home in case of a medical emergency, the expenses are covered by the senior citizen health insurance plan.
  • Coverage on pre-existing diseases: Most health insurance plans do not cover the treatment of pre-existing diseases. Whereas health insurance plans for senior citizens, medical coverage is given for the cost of treatment in case of conditions that already exist. However, there may be some diseases that, if pre-existing, are not covered by the plan.
  • Domiciliary medical expenses: Senior citizen health insurance plan provides coverage of all your medical expenses even if you are suffering from a disease that is being treated by the doctor at your home. Your insurance plan covers all expenses related to your medical treatment at home.

(Read more: The best health insurance)

If you are planning to get a senior citizen health insurance plan, then it is also very important for you to know which medical expenses are not covered in it. Although health insurance plans for senior citizens cover most medical expenses, there are some costs in certain situations that the insurer does not cover. These usually include the following:

  • Certain pre-existing diseases or injuries are not covered
  • Intentional injury and harm caused by attempted suicide
  • Health problems caused by taking narcotics and other illegal drugs
  • One or more diseases that developed within 30 days of purchase of insurance
  • Getting treatment by any other treatment process other than allopathic like Ayurveda etc.
  • Cosmetic surgery or any treatment related to beauty
  • Treatment of dental problems (if not related to an accident)
  • Replacement/replacement of glasses or contact lenses (if not related to an accident)
  • Medical expenses for the treatment of AIDS

(Read more: What is mediclaim insurance)

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You may wonder about the features that make health insurance for senior citizens different from normal health insurance plans. While general health insurance schemes are for almost everyone, the elderly are often unable to take advantage of them. Not only this, the benefits provided by general health insurance are usually not enough for an elderly person and senior citizen health insurance plans have been designed keeping this in mind.

Generally, depending on your age, you may need to get some medical tests done before getting general health insurance. After seeing the test reports, the company gives its decision. If you have any health issues that show up in your medical reports, you may be refused the insurance plan or your premiums may be increased.

So if you are thinking of buying health insurance, make sure that you are investing your money in the right plan for you. For example, if you are a senior citizen, it is beneficial to buy a senior citizen health insurance plan instead of general health insurance as it provides you benefits till the maximum age (approximately 80 years) without being a financial burden. This plan is designed keeping in mind the health problems faced by elderly people so that you can take full advantage of it and lead a worry-free life.

(Read more: What is not covered in health insurance)

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