Factors to Consider while choosing Health Insurance for Senior Citizens

Insurance companies extend health insurance for senior citizens as well. While there are many such insurance plans, the examination of finer details prior to picking up a plan is paramount. Insurance companies consider people between the age group of 60 – 80 years to be eligible for Senior Citizen health insurance plans. If you are an existing health insurance policyholder, your policy can be renewed until the age of 65. According to a recent updated guideline issued by IRDA, health insurance providers have to provide coverage to individuals up until the age of 65 years. With this updated guideline, anyone looking to continue their health insurance policy can do so until the age of 65. Also, those who seek to switch insurance provider for better service quality can do so with fewer restrictions.

While there are several factors that one should consider before determining whether or not one should purchase a Health Insurance for Senior Citizens , this article calls out some of the important factors below:

a. Extent of Cover:

b. Co-Payment

c. Renewal Ceasing Age

d. Waiting Period

e. Coverage of

Pre-Existing Diseases (PEDs):

Extent of Cover:

While most insurance companies offer cover in the range of 1 – 2 lakhs, it is important to understand the upper limit offered by the plan you are interested to purchase.


Co-Payment is the percentage of the total bill that you agree to pay at the time of subscribing to a policy. For instance, if the claimable hospital bill is X, you will be required to pay 0.2X or 0.1X of the estimated hospitalization bill. The percentage varies from policy to policy. Therefore, it is advisable to look for the co-payment clause and understand the co-payment percentage you are expected to commit to. Usually, the higher the co-pay percentage, the lower your insurance premium.

Renewal Ceasing Age:

With the increasing life-expectancy, it is not a bad idea to extend your health insurance cover for a longer duration. The average life expectancy in India is currently 65 years – which is expected to increase to 75 years by 2050. Hence you should provision for a longer rope to be prepared for a higher life expectancy. Look for the renewal ceasing age in the senior’s health plan. This is the age post which, the cover will cease to exist.

Waiting Period:

Insurers apply a “Waiting Period” clause to policyholders that have taken up a new policy. The waiting period is a time frame during which certain pre-existing diseases and medical conditions are not covered. In other words, policyholders will have to wait for a specific period before which claims towards treatment are accepted. It is advisable to know the waiting period for the policy you intend to take-up.

Pre-Existing Diseases (PEDs): Medical conditions or diseases present prior to commencement of policy plan is referred to as PEDs. Insurers have varying procedures for issuing seniors’ plans to persons with PEDs. For instance, a higher premium loading for each Pre-Existing Disease. For chronic Pre-Existing Diseases such as cancer, cardiac ailments, etc., insurers may not issue the policy at all. Further, the waiting period might range between 2 – 4 years.

Benefits of having Health Insurance for Senior Citizens

There are certain obvious benefits of opting for a Seniors’ health coverage. Here are some plan benefits, you should be aware of:


Seniors are more prone to health risks than younger people. With increasing cost of hospitalization, it is important to have a safety net built around medical expenditure resulting from hospitalization. Subscribing to a Seniors’ health plan helps build that safety net.

Pre-Existing Diseases:

Pre-Existing Diseases are also covered subject to terms and conditions of the insurer.

Hospitalization Cover:

Hospitalization expenses are covered if the patient is hospitalized for over 24 hours. The expenses covered include room rent, doctors’ fees, expenses towards drugs, etc.

Pre & Post Hospitalization Expenses:

Pre & Post hospitalization expenses are covered. However, the expense heads and the number of days varies from insurer to insurer.

Tax Benefits:

The money spent on treatment of a dependent (in this case, your parent) is eligible for deduction under section 80DDB of the Income Tax Act. This deduction can be claimed by an individual or HUF (Hindu Undivided Family). Please note that only residents in India can claim this deduction. For the financial year 2015-16 (i.e., Assessment Year 2016-17) Rs.40,000 or the actual amount – whichever is less – is deductible. In case of senior citizens, Rs.60,000 or the actual amount – whichever is less – is deductible. In case of very senior citizens, (people in the age group of 80 and above), up to Rs.80,000 can be claimed for exemption from Income Tax.

Clearly, seniors’ health insurance provides protection to your loved ones and one can also avail other benefits from the same. It is recommend you make a thorough comparison of different health plans available in the market before you buy one. Compare online and keep your loved ones protected.

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