What is a Senior Citizen Health Plan?


Getting a suitable health cover has always been an issue for the elderly. From high premiums to extensive medical tests, the entire process of getting a health plan is strewn with multiple difficulties. Now, with the new IRDA guideline of extending the maximum age of health insurance, individuals above the age of 65 years have a better avenue to get themselves a health cover. In force is exclusive health plans for senior citizens. Senior Citizen Health plans are designed for those aged 65 years to 80 years of age, addressing their most basic concerns of specific ailments, renewability and waiting periods.

Common Concerns of the Elderly

  • Higher likelihood of contracting ailments: With age comes a greater likelihood of contracting illnesses. Critical ailments, treatments and diagnosis, are what the elderly may have to face. And the costs associated with these could be a financial strain on them.
  • Insurers’ reluctance: A very common issue faced by senior citizens is the reluctance of insurers to offer them a health cover. From the insurers’ side, insuring them would mean a higher chance of claims. So if they do cover them, exorbitant premiums are charged.
  • Financial planning & support: Limited source of income, little or no support from children and almost nil financial planning puts senior citizen in a pretty tight situation financially. Any medical emergency could be a drain on their limited financial resource.

Stemming from these concerns is the need for an exclusive health cover for senior citizens.  Such insurance policies shield them against risks of medical emergencies. There are many health insurance plans dedicated to senior citizens. Where most of the features are common, additional benefits may differ from policy to policy. So take your time and choose a plan that is most suitable.

What’s in Store-Features of a Senior Citizen Health Plan?

Health insurance needs of the aged are different from those of the young. Thus are senior citizen health plans. Here are the most common features of a senior citizen health plan.

  • Entry age: The entry age of senior citizen health plans is between 60 to 80 years of age. This however could vary from company to company. The renewable age too of senior citizen health plans are higher, with many insurers sometimes even offering lifetime renewability.
  • Ailments and coverage: Senior citizen health plans cover some of the most common critical ailments. Ailments the elderly are most vulnerable too such as heart complications, kidney failures or surgeries are covered in a single policy. Plans also offerdomiciliary treatment, where treatment taken at home is covered.
  • Waiting period for Pre-existing diseases: Senior citizen plans are characterised by lower waiting periods in comparison to regular health plans. Where regular policies may insist on a waiting period of 3 to 4 years to cover pre-existing diseases, senior citizen health plans are much lower with 1 to 2 years.
  • The co-payment clause: Senior citizen plans also specify a co-payment clause. In a co-payment clause, a part of the claim is taken care of by the policy holder and the rest of the claim would be entertained by the insurer. The lower the co-payment clause, the better, as this would mean what goes out of the policy holders pocket is lesser.

Regular Health Plan versus Senior Citizen Health Plans

Senior citizen health plans differ in various aspects from their counterpart- the regular health insurance plan. To begin with, the risks associated with each of them greatly differ. Where in a regular health plan, the risk of a claim is perceived to be much lowering a senior citizen health plan, the chances of a claim is far higher. Because of this higher risk perceived, the premiums associated are higher too. Senior citizen health plans generally cost a bit more than regular health plans.

In a regular plan, insurers do not insist on a medical test before policy initiation for those below the age of 45 years. When we look at a senior citizen health plan, where the policy starts from the age of 60 years, a medical test is called for and mandated. The cover offered too differs in its nature. Senior citizen health plans, concentrate on protecting critical illnesses in a single plan, where in a regular health plan a separate plan may be required to cover critical ailments.

As for the tax benefits, where regular policies offer a tax deduction of Rs. 15,000 under Section 80D, senior citizen plans offer Rs. 20,000.

What to Watch Out For?

  • Premiums: Senior citizen plans do quote higher premiums than regular health plans. Further, the premium also increases with age. Thus, the sooner you get a plan the better it is.
  • Inadequacy in sum assured: Senior citizen health plans do not come with a high sum assured. Most often the sum assured offered may seem inadequate, as senior citizens are more vulnerable to higher medical expenses.
  • Exclusions: Non- allopathic treatments are excluded under senior citizen plans. However these modes of treatment have always been a favourite among the elderly, so they do end up paying from their pocket for the treatment.