Why should senior citizens choose the Senior Citizen Health Plan instead of a regular health insurance plan?

Your golden years are the most precious, it is what you look forward to for most of your working years. If you have not hedged your health risk appropriately, it can become a complete nightmare. Dipping into your investment corpus which you have put together to live a stress-free retired life can deplete very quickly if you have not planned for your medical expenses appropriately. 

Difference between regular health insurance and medical insurance for senior citizens:

There are a few specific differences between regular health insurance plans and medical insurance for senior citizens. 

Point of difference Regular health insurance plans Medical insurance for senior citizens
Age at entry The age at entry is lower as compared to senior citizen health insurance. People above 60 years are automatically recommended senior citizen health insurance plans It has a very high age at entry, typically between 60 – 80 years
Renewability Typically restricted to 75 years Renewability is allowed for a lifetime (often restricted at 90+ years) provided premiums are paid promptly
Coverage scope Narrow coverage with add-on features which come at additional costs Wider coverage with specific senior citizen related coverage which forms part of the base plan
Waiting period 2-4 years typically for pre-existing diseases Up to 2 years (slightly lower than regular health plans. Many of the items that have a waiting period under regular health plans do not have waiting periods under senior citizen health insurance plans)
Pre-existing diseases Covered after waiting period Covered after a lower quantum of a waiting period
Emergency services Add-on features Many insurers offer ambulance, emergency services as part of the base plan
Premium costs The premium cost is lower the for the young applicant and one who is medically fit Typically high premiums are due to a higher risk of illness and disease among aged
Tax benefit Premium paid to the extent of Rs. 25,000 can be claimed under section 80D Premium paid to the extent of Rs. 50,000 can be claimed under section 80D. Preventive checkup of Rs. 5000 is allowed for a tax deduction

Inclusions under medical insurance for senior citizens:

Although the inclusions are similar to the coverage under regular health insurance plans, there are a few differences:

  1. Hospitalization expenses:
    While the hospitalization expenses are covered in all other plans, senior citizen plans also offer pre and post-hospitalization coverage. Pre-hospitalization coverage is allowed for up to 60 days of admission, consultation is allowed. Post-discharge expenses for 180 days will be covered along with hospitalization expenses.  
  2. Cashless or Reimbursement of expenses:
    The choice of cashless is allowed for treatment in-network hospitals. Reimbursement is allowed for expenses incurred in non-network hospitals.  
  3. OPD / Day-care cost:
    Most of our medical requirements are outpatient treatments or day procedures that require less than 24 hours of hospital stay. Such expenses are covered under the senior citizen health plans.  
  4. Ambulance cost:
    Typically under the regular plan, the ambulance cost is an add-on feature. Senior citizen plans offer ambulance charge coverage and even an air ambulance is covered in case of emergency.  
  5. Pre-existing diseases:
    The waiting period may vary across plans, some plans offer coverage of pre-existing diseases for a lower waiting period. You should choose the plans that offer coverage within the shortest period. 
  6. Tax benefit:
    There is enhanced benefit as stated above under the medical insurance for senior citizens as indicated in the table above.  
  7. Pre-medical checkup:
    Most of the plans allow for at least 1 medical checkup every year, this is a preventive mechanism and enables early detection of any medical condition. 
  8. Scope of coverage:
    There are no sub-limits or restrictions on consultation, rooms, medicine costs, etc., however, if you opt for any restrictions such as co-pay, or room restrictions, it could bring down the premiums substantially

Also, if your senior citizen parents are included in your family floater health insurance plan, it is a good idea to get them separate medical insurance for senior citizens, instead of including them in your family floater plan. This is because senior citizens are prone to higher claims and you would end up sacrificing your no-claim bonus because of multiple claim incidences. Instead, if you have a separate family floater plan for yourself, your spouse, and dependent children and a separate health insurance plan for your senior citizen parents, you can save your no-claim bonus even if your parents are hospitalized and need to file a claim! Also, the premium for a health insurance plan depends on the age of the highest person insured. So, the average premium for your entire plan would be comparatively higher as compared to two separate health insurance plans.

As a senior citizen, you are more prone to illnesses and diseases, you should be prepared for such unforeseen circumstances. Medical inflation is huge, making it tough for any individual to fend for hospital bills. It is even tougher when you are no longer an earning member. It is ideal if you can avail of medical insurance for senior citizens which are specifically curated to cover all aspects which are critical for senior citizens. 

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