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Health Insurance for Senior Citizen

4 October, 2023

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Health Insurance is all the more important for senior citizens for the simple reason that as the person ages his proximity to diseases and other critical illness increases. Also with lack of monetary resources on offer, (in case the individual has retired or is surviving on pension) a medical emergency can result in severe financial crisis unless covered under a comprehensive medical insurance policy.

 

This blog will discuss government mediclaim for senior citizens and how it can be helpful for them.

 

Understanding Senior Citizen Mediclaims in India

Finding right health insurance policy for senior citizens in India was quite a difficult task at one point of time as most health insurance providers were reluctant to offer them coverage due to higher chances of claim. Health Insurance providers who did provide coverage to senior citizens charged exorbitant premium thus making it almost impossible for them to buy health insurance policy policy at later stages in life when they required it the most. Also one was deprived of choices with regards to health insurance providers if he/she was not satisfied with the current provider’s service.

 

To improve on this situation, the Government of India made amendments in the guidelines of health insurance coverage implemented on July 1, 2009 by all health insurance companies. According to the new guidelines, every health insurance provider has to offer coverage to individuals’ upto 65 years of age. These new guidelines will not only help individuals get coverage at later stages of their life but also will allow them to shift insurers in case they are not satisfied with their current health insurance provider.

 

If a health insurance provider denies coverage or rejects a senior citizen's healthcare insurance application, the reason/condition must be provided in writing. The reason must also be rational and fair. Furthermore, the premium charges must be reasonable and affordable. This new policy will allow senior citizens to enjoy coverage even after the age of 65, allowing them to live a stress-free life.

 

Government Mediclaim for Senior Citizens

In India, the government provides best health insurance for senior citizens through the National Senior Citizen Mediclaim Policy (NSCMP). The scheme is offered by the Ministry of Health and Family Welfare and is one of the best mediclaim schemes available specifically for senior citizens.

 

The National Senior Citizen Mediclaim Policy is a health policy that provides insurance coverage to the elderly. It covers expenses for inpatient treatment (allopathy, ayurveda, and homoeopathy), as well as domiciliary hospitalisation, that are reasonably and customarily incurred for the treatment of a disease or injury contracted/sustained during the policy period. It  also includes pre-existing conditions.

 

Depending on the plan chosen, the following expenses are covered:

 

  • Hospitalisation and post-hospitalisation expenses
  • 140+ daycare procedures/surgeries
  • Organ donor's medical expenses
  • Hospital cash and ambulance charges
  • Doctor's home visits, nursing, and attendant charges during post-hospitalisation
  • Funeral expenses
  • Reinstatement of the sum insured due to a road traffic accident
  • Regular medical consultation charges

     

Optional coverages include pre-existing diabetes and/or hypertension, outpatient treatment, critical illness, and personal accident.

 

Government mediclaim for senior citizens is a great way to provide access to quality medical care without having to bear the high costs of medical care. It is also an important tool for the government in controlling the costs of medical care and ensuring that senior citizens are able to access necessary healthcare services.

 

The situation for senior citizens further improved with introduction of health insurance providers like Niva Bupa the best health insurance company in India which offers features like “No age restriction for enrollment” and “assured renewability for life” which are indeed a boon in case of senior citizen health insurance. Niva Bupa can be relied on with its customer-friendly policies and excellent claim settlement ratio.

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  • 2 Since Inception refers to claim data from 2010 till December 2023.
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  • 4 Aspire Premium: The premium is including taxes and for Gold+ Variant, for a 25-year-old individual living in Delhi.
  • 5 Senior First Premium: The premium is including taxes and for Gold Variant, for a 65-year-old individual living in Delhi.
  • 6 Health Premia Premium: The premium is including taxes and for Silver Variant, for a 25-year-old individual living in Delhi.
  • 7 SmartHealth + Disease Management Premium: The premium is including taxes and for Disease Management Gold Variant rider when bought with ReAssure 2.0 Bronze variant with Base Sum Insured of 5 lacs, for a 25-year-old individual living in Delhi.
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