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Health Insurance for Senior Citizens Offered by Government-owned Insurers

By Juhi Walia
26 September 2022, 5:24 PM

There are a lot of concerns about old age, but the primary one that would come to everyone's mind is health and security. People are scared about the health issues that come with old age, and you cannot entirely control these age-related health issues either, but a health insurance policy is the closest solution. It helps manage any unfortunate and unforeseen circumstances that may arise. Moreover, even in healthy old age, people need medication as their dependence on their family increases. Medical health insurance for the elderly is by far the most efficient way to cope with these situations.

Regarding health insurance, there are many options available, but a few are specific to the needs of the elderly. There are also government health insurance schemes for senior citizens. These insurance schemes, offered through state-owned insurers, are directed exactly at making the lives of senior citizens better and their financial liabilities on medication and treatment to the minimum. In this guide, we have compiled some government schemes available for senior citizens in India and why senior citizens need to have a mediclaim or health insurance policy. Let us check it out in deep:

Importance of Health Insurance for Senior Citizens

Before getting to the government-sponsored plans, let's check why health insurance is needed for senior citizens. Read on to get to know these.

1. Financial Independence

Health insurance can reduce the dependence on family or anyone else in a matter of finances. Old age can cause you unforeseen illnesses. It can also allow you to be self-reliant without having to depend on your family for financial support.

 2. Protect Savings

Senior citizens have saved most of their income. Instead of blowing all your savings on health costs, you can invest it and give it as a family legacy. Given the affordable premium options available, you can easily get health insurance without blowing a hole in your pocket.

 3. Security

Medical problems can happen to you even if you lead a healthy lifestyle. Health insurance can greatly benefit you and your family members in these cases. It can protect you from a heavy financial burden while getting the best treatment from a quality hospital.   

Types of Government Health Insurance Plans

Several different government health insurances are available for senior citizens through state-owned insurers in India. Following is a list of some of these with their salient features:

1. National Senior Citizens Mediclaim Policy (NSCMP)

National Senior Citizens Mediclaim Policy is for seniors aged 60 to 80. This policy offers coverage for up to INR 10 lakhs. It also allows you to cover your spouse on a family floater basis.

Let us discuss in detail what all is covered under the national senior citizens Mediclaim policy:

  • It covers the ambulance charges.
  • It provides coverage for fees charged by a physician, an MD, a surgeon, or an anesthesiologist.
  • It pays for the injection charges, transfusion, and other utility charges.
  • It covers the room charges.
  • This policy provides coverage for organ donor costs.
  • It also covers Ayurveda and homoeopathy treatments.
  • It provides coverage against HIV and any expenses arising due to it.
  • This policy also covers the charges and expenses of a mental condition.
  • It provides for a cashless facility at all its network hospitals.
  • You are also eligible for tax benefits under section 80D.

It is important to note that the waiting period is 24 months for any pre-existing conditions under National Senior Citizens Mediclaim Policy.

2. United India Senior Citizen Health Insurance

This health insurance is provided by United India Insurance Company, a public sector health insurer. The eligible age group for this policy is 61 to 80 years. The insurance amount is between INR 1 to 3 lakhs. Let's discuss what all is covered with this insurance:

  • It provides coverage for any pre-existing diseases after 48 months.
  • It covers the fees of an anesthesiologist, a surgeon, a physician, etc.
  • It covers all the expenses of medication and other hospital charges like rooms, blood, anaesthesia, drugs, etc.

This is notable health insurance that covers basic medical issues.

3. Health Of Privileged Elders (HOPE)

This is a health insurance plan brought by Oriental Insurance Company specifically focused on the diseases and treatments senior citizens require. This health insurance provides for the hospitalization cost of anyone above the age of 60 years. There are certain specifications about the coverage. Let us discuss them below:

  • The sum insured is only in the slab of INR 1 lakh, INR 2 lakh, INR 3 lakh, INR 4 lakh, and INR 5 lakh.
  • This policy only covers some specific diseases. These diseases are related and relevant to old age.
  • There needs to be a payment of 20% by the insurance holder. This 20% is the co-payment of the total claim money.
  • If you opt for voluntary co-payment, you also become eligible for a discount on the premium.
  • It provides cashless services at the network hospital for a maximum amount of INR 1 lakh.
  • It covers medical expenses for virtual sessions.
  • It covers Ayurveda, yoga, naturotherapy, and any homoeopathy treatments taken at AYUSH hospitals.

HOPE is an elaborative health insurance plan that comes with a lot of specifications to go through. It provides quality coverage if you want to go through the specifications of the health insurance plan.

4. The New India Assurance Senior Citizen Mediclaim Policy

This policy applies to senior citizens between the age of 60 to 80 years. The insured person needs to know the following specifications of the policy:

  • The policyholder can claim the sum of INR 1 lakh and INR 1.5 lakh for the policy amount.
  • It covers pre-existing diseases with a waiting period of 18 months.
  • It covers your hospital charges 30 days before the admission and 60 days after the procedure.
  • If you cover your spouse with this policy, you are offered a discount of 10%
  • It provides for the medical expenses of pre-existing ailments like diabetes, blood pressure, etc., after 18 months.

This is a functional and up-to-date policy that takes into consideration diseases as well as ailments.

5. National Varistha Mediclaim Policy

National Health Insurance Company provides the National Varishta Mediclaim Policy. This insurance policy covers senior citizens between the age of 60 years and 80 years. But it offers for the renewal of the policy, which can stretch up to the age of 90. The policy period for this Mediclaim plan is only a year, though. Let us check out the coverages provided by this Mediclaim policy:

  • It provides for the coverage of medicines, drugs, blood, transfusions, oxygen, diagnosis charges, etc.
  • 8 critical illnesses are also covered as a part of this policy.
  • The insurance amount covered for the policy is INR 1 lakh for hospitalization and other similar charges and INR 2 lakhs in case of any critical illnesses.
  • It also provides INR 1000 for emergency charges of an ambulance.
  • A pre-specified amount is covered for critical issues such as cataracts, organ transplants, hyperplasia, etc.
  • It provides for the fees and consultation charges of professionals, surgeons, physicians, etc.
  • Treatment for deadly diseases such as cancer, stroke, or any other detrimental issues is provided under this policy without hospitalization.
  • You are eligible for tax deductions under act 80D and premium deductions up to the amount of INR 15000.

This comprehensive policy covers all the major and minor inclusions that one can need in old age. If you are someone who has a pre-existing condition, this could be the insurance policy for you.

Conclusion

The health plan is a primary requisite for senior citizens. This allows them to have a realistic idea about their finances. It aims to free them from the worries of old age illnesses. This information can be useful to you if you are a senior citizen or are the child of a senior citizen looking for health insurance plans for your parents. This list is aimed to provide information on all the necessary features of different health insurance policies available from government-owned insurers. You can check out each of these specifications and make an informed choice.

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FAQs

1. Is Government health insurance for senior citizens more economical than private insurance?

Yes, Government health insurance is a more economical option than private insurance as it is curated for the usage of the majority of senior citizens, keeping in mind those who might be from financially weaker sections. 

2. Can I get a Government health insurance plan for my parents if I don't live in India?

Yes, you can purchase Indian Government health insurance for your parents, provided they are Indian citizens. 

3. Will the Government schemes provide for changes in health insurance?

Yes, if any ailment arises, you can inform your insurance provider, and they will make the necessary changes.

4. After how much time does the premium amount in a government health plan change?

If the premium amount changes, it changes at the end of every tenure of the policy. This is true for all plans, including government plans.

5. Can I be added to my parent's Government health insurance plan?

No, you cannot avail of its benefits.

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