Senior citizen mediclaim insurance plans offer health coverage to people between 60 years and 80 years. These health plans are a necessity today because healthcare costs are rising every year. Pension plans or other retirement savings are not always enough to bear these expenses. A sudden medical emergency can drain out all finances and at a ripe age, this is not something you will like to encounter, or let your elderly parents go through.
Government Rules for Health Insurance Policies for Those Over 60 Years of Age
According to the guidelines of IRDA, health insurance providers must provide coverage to individuals up to 65 years of age. The provision helps you to avail protection against financial downsides caused due to health issues in the later stages of life. If the proposal is rejected then the reason for it must be provided in writing. The insurance company cannot decline renewal of the policy except on the grounds of moral hazard, fraud, or misrepresentation.
Minimum 50 percent of the pre-insurance medical investigation can be reimbursed if the insured person accepts the risk. It is possible to even shift insurers in case of dissatisfaction. Thus, when it comes to searching a mediclaim policy for senior citizens over 60 years of age, there is no lack of options.
Features of Senior Citizen Medical Insurance Plans
The health plans for elderly people include the following salient features:
- The plans are for people between 60 and 80 years. There is no requirement for any pre-medical test.
- The customers can avail health check-ups every year.
- Cashless hospitalization service is available for those admitted in hospital for over 24 hours.
- The policy may come with free-lock in period.
- Facilities include coverage for doctor fees, ambulatory services, medical bills, room charges, post and pre-hospitalization based on the number of days.
- Coverage is given for specific ailments and pre-existing diseases once the waiting period is over.
Exclusions in Senior Citizens Health Insurance
Sometimes even the best mediclaim policy for family can have some mandatory exclusion. A few of these are mentioned below.
- Expenses because of self-inflicted acts and medication abuse.
- One or more medical conditions diagnosed in 30 days of taking the policy.
- Treatment of AIDS.
- Treatment cost of injuries inflicted due to a civil war or an act of a foreign army.
- Costs related to non-allopathic treatments.
- Cost of lenses/spectacles or dental treatment unless because of an accident.
- A cosmetic surgery.
Factors to Consider When Selecting a Health Plan for Elderly Individuals
Below-given are things to keep in mind when opting for a mediclaim policy for your parents over 60 years of age.
- Sum Insured
The sum assured is usually between Rs. 1 lakh to Rs. 2 lakhs on policies by public insurance companies, while the maximum cover from private companies can be between Rs. 15 lakhs and Rs. 20 lakhs. However, the premiums on the latter will also be more. So make sure to go for the maximum sum insured if you are looking for a greater coverage.
You will find several companies offering mediclaim insurance policies for elderly between the age bracket of 60 and 80 years, while other limit the age of the policyholder to only 69 years. Then some providers offer policies up to 90 years of age. But such plans are issued for a year, and have to be renewed at the yearend by making a payment of premium.
- Waiting Period
If the person has a pre-existing ailment, there could be a waiting period involved. But, you must compare policies to seek the one that has the lowest waiting period. The period could be anywhere between a year and two. Then there are companies that do not cover pre-existing illnesses at all.
Co-payment necessitates the policyholder to pay a pre-determined percentage of the claim amount. The remaining sum will be covered by the insurer. You may want to check out a mediclaim policy for senior citizen where the co-pay component is low on the part of the customer. At the same time if you opt for a higher co-payment then the premium amount may also reduce.
- Free-look Period
It is the timeframe where the policyholder has the rights to terminate the insurance contact in case he/she does not agree to the terms and conditions, and does not wish to continue the same. If the policy is cancelled within 15 days of receiving required documents, then no surrender charges or penalties will be charged.
How to Choose Right Mediclaim Policy for Elderly Parents?
Compare the policies in regards to affordability and extent of coverage. You must choose a plan that has a clause of renewal to the maximum age. The best mediclaim policy for family will cover critical and pre-existing illnesses with a low waiting period and co-payment.
In order to file a claim, the insured has to fill the claim form:
- The form will be available on the official website of the provider or its branch office.
- The elderly person must full the necessary details in the form and sign it, before submitting online/offline.
- Do not forget to attach medical reports and bills given by the hospital/doctor.
Tax Benefits of Medical Insurance for Senior Citizens
Medical insurance premium paid comes with tax benefits under the Section 80D of the Income Tax Act, 1961. If you are an individual and looking to purchase a policy for your dependent parents who have crossed 60 years of age, then you should go through following details:
- Tax rebate up to Rs. 30,000 is available if you have a mediclaim policy for your senior citizen parents.
- There is a provision of additional rebate of Rs. 5,000 on their annual preventive health checkups.
- If you earn and pay health insurance premium for your daughter or son, then you can get an additional rebate of Rs. 25,000.
- Thus, in total, combining both the scenarios, you can avail a deduction up to Rs. 60,000 under the Section 80D.
So when choosing a mediclaim insurance policy for your future or that for elderly parents over 60 years of age, you must keep the above-mentioned information in mind so that you can take an informed decision.