Health Insurance

Which health insurance policies are for senior citizens with the lowest premiums?

by SMCIB on Tuesday, 31 January 2023

Which health insurance policies are for senior citizens with the lowest premiums?

With increasing age, the possibility of certain illnesses or diseases also increases. As a senior citizen, your healthcare bills only increase over time. Meeting these expenses might be difficult for you as you may not have access to a regular source of income, except maybe a pension. With these limited finances, you have to settle all your responsibilities, and unfortunately, a major part is used up in availing healthcare services.

Having a health insurance plan will help you in such situations. With a good health insurance plan, you can easily secure your health and deal with all your old-age health issues. In this article, we will discuss the health insurance policies that are available for senior citizens at the lowest premiums. Let’s dive in.
 

Health Insurance For Senior Citizens

As a senior citizen, the best option for you is to purchase comprehensive health insurance because it offers you the best benefits with the lowest exclusions, financial limits, and conditions like copay, room rent limit, etc.

If you are finding it difficult to get a comprehensive plan, you can check out health insurance plans designed specifically for senior citizens. The plans may not require any medical tests. However, such plans might have financial limitations in the form of room rent limits, copays, sub-limits on diseases or treatments carried out, etc.

So, what are copays, room rent limits, and sub-limits on treatment/diseases?

  1. Copay:

    A co-pay clause in health insurance requires you to pay a predetermined percentage of the approved claim amount. The remaining amount will be paid by the insurance company.

    For instance, Gautam buys a health insurance policy with a sum insured of Rs 10 lakhs. His policy has a copay clause of 10%. He undergoes hospitalisation for knee surgery, which costs him Rs 2 lakhs. So, let’s say the total amount payable to the hospital is Rs 2 lakhs, out of which Gautam will have to pay Rs 20,000 (10% of 2,00,000). And, the insurance company will pay the remaining amount of Rs 1,80,000.

  2. Room Rent Limit:

    The ‘room rent limit’ is the maximum amount that your insurer will pay for a hospital room per day when you receive medical care. If you choose a room that costs higher than what you are eligible for, the insurer will deduct the difference in room charges as well as proportionately deduct all related medical expenses.

    For instance, Komal is eligible for a room with rent of Rs. 3000. But, she opts for a room that has a rent of Rs. 6000. She’ll have to pay the additional room charges, i.e., Rs. 3000 (6000 - 3000) as well as 50% (3000/6000*100) of all associated medical expenses out of her pocket.

  3. Sub-limits on treatments for specific diseases:

    Insurers might also impose sub-limits on surgeries for frequent and major lifestyle diseases or conditions. These do this to keep claims under control. Sub-limits are usually imposed on cardiac treatments, breakage of long bones, etc. Insurers may also standardise payments for small yet frequent surgeries like cataracts and hysterectomies.

    For instance, an insurance company may apply a limit of Rs. 25,000 under a Senior Citizen Health Insurance plan for cataract surgery. All costs above this amount for the treatment of cataracts will have to be footed by you in case you undergo a cataract treatment.

    Please note: Besides these, there can be several other financial limitations and restrictions. So, make sure you check the policy wording before you make the purchase.
     

Senior Citizen Health Insurance Plans With Low Premiums

Let us take a look at some of the best senior health insurance plans with affordable premiums below.

  Star Health Senior Citizen Red Carpet Care Insurance Care Senior NIVA Bupa Senior First - Platinum
Age Limits 60 - 75 years > 61 years 61 - 75 years
Sum Insured options 1 - 25 Lakhs for an individual cover 10 - 25 Lakhs for a Floater cover 3 - 10 Lakhs 5 - 25 Lakhs
Room Rent Limit 1% of Sum Insured for a cover of Rs. 1 to 5 Lakhs 6,000 for a cover of Rs. 7.5 to 10 Lakhs 1% of Sum Insured Single Private Room(10% copay for a higher category)
ICU Charges 2% of Sum Insured for a cover of Rs. 1 to 10 Lakhs 2% of Sum Insured Up to Sum Insured
Surgeon, Anaesthetist,Medical Practitioner, Specialist's fees covered Up to 25% of Sum Insured (per hospitalisation) Up to Sum Insured Up to Sum Insured
Anaesthesia, Blood, Oxygen, Operation Theatre charges covered Up to 50% of Sum Insured (per hospitalisation) Up to Sum Insured Up to Sum Insured
Co-payment Claims related to pre-existing disease - 50% Claims not related to pre-existing disease - 30% 20% per claim 20% per claim
Cooling off - Waiting Period 30 Days 30 Days 30 Days
Specified disease / procedure waiting period 24 Months 24 Months 24 Months
Pre-existing disease waiting period 12 Months (with exceptions) 48 Months 24 Months
Limits for specific treatments Sub-limits imposed based on Sum Insured Sub-limits imposed based on Sum Insured No sub-limits
Monthly Premium ₹2065 ₹3079 ₹5208

Please Note:

  1. Premiums are taken on 10.01.23 for a 66-year-old male. It is an individual policy.
  2. The sum insured is Rs. 10 Lakhs and the premium is inclusive of all taxes.
  3. No room rent limit option has been opted for, wherever applicable.
  4. These are standard premiums. The insurer may charge an additional premium of 10% to 50% depending on the adverse health conditions.
  5. This is not an exhaustive list.
     

Conclusion

A health insurance plan acts as a financial safety net for your health especially when you are a senior citizen. But it is crucial to choose an ideal health insurance plan that serves all your needs and requirements. What may work for you may not work for others. We hope the plans discussed will prove helpful to you to meet your requirements.

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