When you think of your old age, you know that the first thing that would become a concern is your health. It is a universal truth that with ageing comes deterioration of health and age-related illnesses. To deal with this phase of life, two things are important – taking care of your overall wellbeing and buying an adequate and comprehensive health insurance plan. Since chances of healthcare expenses shooting up and frequent hospitalisation are higher in the case of senior citizens, it is important to have a health cover, especially designed for the people of this age bracket. It will not just help policyholders bear the expensive healthcare costs but will also ensure that the elderly have the peace of mind that they would have adequate financial support whenever the need arises.
The government of India has launched some senior citizen health insurance schemes that provide adequate health cover to the elderly. Some of these schemes are sold through state-run insurers, while one comes directly under the purview of the government. Let's look at these schemes.
1) Pradhan Mantri Jan Arogya Yojana or PMJAY (also known as Ayushman Bharat Scheme)
Ayushman Bharat, a flagship scheme of the government of India, was launched as recommended by the National Health Policy 2017 to achieve the vision of universal health coverage. It is the largest government health scheme for senior citizens that also covers women and children. Some of its key features are:
- Healthcare cover of Rs 5 lakh per family per year for secondary and tertiary care hospitalisation across public and private empanelled hospitals in India
- Only families below poverty line eligible for these benefits
- Cashless access to health care services for the beneficiary at the point of service, that is, the hospital
- Covers up to 3 days of pre-hospitalisation and 15 days post-hospitalisation expenses such as diagnostics and medicines
- All pre-existing conditions are covered from day one
- Benefits of the scheme are portable across the country, i.e., a beneficiary can visit any empanelled public or private hospital in India to avail of cashless treatment
2) United India Senior Citizen Health Insurance
This health insurance scheme for senior citizens is sold by United India Insurance Company. Here are some of its features:
- Entry Age is 61 years to 80 years (of those taking a Mediclaim Policy for the first time)
- Sum insured can range from Rs 1 lakh to Rs 3 lakh
- The policy covers hospitalisation expenses for treatment/surgeries when stay is above 24 hours
- Covers Domiciliary Hospitalisation only when it is for a period exceeding three days
- For ayurvedic treatment, hospitalisation expenses are admissible only when the treatment has been undergone in a government hospital or in any institute recognised by the government
- A family discount of 5% of the total premium will be allowed, comprising the insured and any one or more of the following: spouse, dependent children, or dependent parents
3) Varistha Mediclaim For Senior Citizens Policy
- This government Mediclaim for senior citizens is offered by National Insurance Company Ltd. Here's all you should know about this policy: All Indian citizens aged 60-80 years are eligible to buy the National Insurance Varistha Mediclaim Policy
- Maximum age-limit for renewal of National Insurance Varistha Mediclaim Policy is 90 years
- Rs 1 lakh and Rs 2 lakh are two available sum insured options for covering hospitalisation costs and critical illness treatment expenses, respectively
- This policy offers additional coverage for pre-existing diabetes and hypertension as well. However, policyholders need to pay extra premium to avail additional coverage
- Provides cashless facility for treatments in network hospitals and reimbursement facility for treatments in non-network hospitals
- Covers pre- and post-hospitalisation medical expenses. Coverage is available for 30 days before hospitalisation and 60 days after hospitalisation.
4) Health of Privileged Elders (HOPE)
This is a senior citizen-specific diseases insurance scheme by the Oriental Insurance Company. Here is an overview of the scheme:
- This policy is available to any Indian citizen who is aged 60 years and above for hospitalisation in India
- Policy is available for sum insured of Rs 1 lakh, Rs 2 lakh, Rs 3 lakh, Rs 4 lakh and Rs 5 lakh
- Covers specified diseases only
- Compulsory co-payment of 20% on admissible claim amount
- Discount in premium for opting Voluntary Co-payment
- Cashless Service through TPA (third-party administrator) only and limited to Rs 1 lakh
- Covers telemedicine expenses
- Covers Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy systems of medicines if treatment is taken in any AYUSH Hospital.
5) The New India Assurance Senior Citizen Mediclaim Policy
- This senior citizen insurance scheme is available for people between the age of 60 and 80 years
- The sum insured per person is Rs 1 lakh or Rs 1.5 lakh
- 10% family discount is available in case the spouse is also covered
- Limited cover for hospitalisation in government ayurvedic/homeopathic and unani hospitals
- Pre-existing conditions like hypertension, diabetes mellitus and its complications are covered after 18 months of continuous insurance but only on payment of additional premium.