Even a minor injury or illness can become serious after the age of 60, requiring repeated doctor visits, frequent medical tests and longer hospital stays. If covered under a family floater plan, this increases the financial burden and the risk of inadequate coverage.

Here is why a separate health insurance policy is important for senior citizens:

Increased Hospital & Doctor Visits: Elderly people are more vulnerable to age-related diseases and critical illnesses, requiring frequent hospitalization, surgeries, and post-operative care. A dedicated policy ensures a sufficient sum insured to cover treatment charges.
Specialized Needs: Older people are more likely to develop health conditions like hypertension, diabetes, cataract, heart disease, arthritis, etc. Senior citizen health insurance plans are designed to meet the specific medical needs of elderly people.
Post-Retirement Coverage Requirement: After retirement, a person's employer insurance coverage ceases, exposing them to unexpected financial risks. Buying a separate senior citizen health insurance policy ensures continuous financial protection against medical expenses.
Insufficient Coverage from Regular Plans: An individual or family health insurance plan may get exhausted faster and may be insufficient to cover the healthcare needs of older people. A separate senior citizen insurance plan offers features more relevant to them without affecting the whole family's shared coverage.
Financial Independence: Most older people have to rely solely on their children or on their savings during medical emergencies. With health insurance for senior citizens above 60 years, they can easily cover medical expenses without depending on others.

Hence, getting separate health insurance for senior citizens is important to ensure adequate coverage and protect life-long savings from being drained at once.

Directly from Experts

When you buy from Policybazaar, you are ensuring your well-being is prioritized during the time of need. Our dedicated 50-member claims team exclusively deals with health insurance claims, offering support to individuals, families, and even the elderly living alone.

We also offer on-ground claims support across more than 120 Indian cities, helping with every claim-related phase, including paperwork and coordinating with the insurer and the hospital.

Our 'Claims Samadhan Diwas', a customer-centric initiative, helps customers settle under process or rejected claims with their insurance company. You can be confident that you are getting more than just an insurance policy – you are getting a partner who will be with you at every step of the way.

Siddharth Singhal

Business Head – Health Insurance

Best Health Insurance Plans for Senior Citizens in 2026

To choose the best health insurance plan for senior citizens, you must compare various factors, such as the PED waiting period, pre-policy medical check-up, etc.

Below is a comparison table of various online health insurance plans for senior citizens based on major features:

Senior Citizen Health Insurance Plans	Entry Age	Sum Insured (Rs)	Pre-existing Diseases Covered	Medical Check-up
Aditya Birla Activ Care Health Insurance Plan	55-80 years	3 lakh to 25 lakh	From the 3rd year	Required
Bajaj Allianz Silver Health Plan	46-80 years	50,000 to 10 lakh	From the 2nd year	Required
Care Senior Health Advantage Plan	Elite: 45 years onwards Premium: 60 years onwards	1 lakh to 3 crore	From the 2nd year	Required for people above 50 years of age
Cholamandalam Flexi Health Supreme Plan	18-75 years	5 lakh to 5 crore	From the 3rd or 4th year, depending on the variant	Required
Digit Health Insurance Plan	18 years onwards	Up to 3 crore	From 2nd/4th/ year (as per plan coverage)	May be required
Generali Central Varishta Bima Plan	60 years onwards	2 to 10 lakh	From the 2nd year	Required for Rs 7.5 lakh SI and above
HDFC ERGO Optima Senior Plan	61 years onwards	2 to 5 lakh	From the 4th year	Required
ICICI Lombard Golden Shield Plan	56 years onwards	3 to 50 lakh	2 years	Required after 70 years
IFFCO Tokio Individual Health Protector Plan	18-65 years	50,000 to 20 lakh	From the 4th year	Required after 45 years
IndusInd Health Gain Insurance Plan	18-65 years (No age restriction for sum insured of ₹3 lakh)	3 lakh to 1 crore	From the 4th year	Required after 50 years
Liberty HealthPrime Connect Plan	18-65 years	10 lakh to 1 crore	From the 4th/5th year, depending on the variant	Required
Magma HDI One Health Senior Plan	56-75 years	3 lakh to 25 lakh	From 2nd year	May be required
ManipalCigna Prime Senior I Plan	56-75 years	3 lakh to 50 lakh	From 3rd year	Not required
National Senior Citizen Mediclaim Plan	60-80 years	1 lakh to 10 lakh	From the 3rd year	Required
New India Assurance Senior Citizen Mediclaim Policy	60-80 years	1 lakh, 1.5 lakh	After 18 months	Required
Niva Bupa Senior First Insurance Plan	61-75 years	5 lakh to 25 lakh	From the 3rd year	Not required
Oriental Health of Privileged Elders Insurance Policy	60 years and above	1 lakh to 5 lakh	From the 3rd year	Required
Raheja QuBE Health Insurance Policy	18-65 years	1 lakh to 50 lakh	From the 5th year	Required after 55 years and/or with sum insured of ₹10 lakh & above
Royal Sundaram Lifeline Insurance Plan	18 years onwards	2 lakh to 1.5 crore	From the 3rd/4th/5th year, depending on the variant	N/A
SBI General Super Health Insurance Plan	18 years onwards	3 lakh to 50 lakh	From the 3rd year	Required
Star Senior Citizens Red Carpet Health Insurance Plan	60-75 years	1 lakh to 25 lakh	From the 2nd year	Not required
Tata AIG Elder Care Plan	61-85 years	5 lakh to 25 lakh	From the 3rd year	Required
United India Individual Health Insurance - Senior Citizen Plan	61-65 years	2 lakh to 5 lakh	From the 5th year	May be required
Universal Sompo Senior Citizen Health Insurance Plan	60-70 years	1 lakh to 5 lakh	From the 3rd year	Required
Zuno Health Insurance Plan	18-65 years (No age restriction for the Platinum variant)	1 lakh to 1 crore	From the 3rd/4th/5th year, depending on the variant	Required after 50 years
Zurich Kotak Health Premier Plan	18-65 years	2 lakh to 2 crore	From the 4th/5th year, depending on the variant	Required

See More Plans

*Disclaimer: The list mentioned is according to the alphabetical order of the insurance companies. Policybazaar does not endorse, rate or recommend any particular insurer or insurance product offered by any insurer. This list of plans comprises insurance products offered by all the insurance partners of Policybazaar. For a complete list of insurers in India, refer to the Insurance Regulatory and Development Authority of India website www.irdai.gov.in.

Benefits of Health Insurance for Senior Citizens

Health insurance for senior citizens offers a variety of coverage benefits to elderly people. Below are some of the advantages of buying health insurance for senior citizens in India:

Coverage for Age-related Diseases

As people age, they become more prone to health conditions requiring hospitalization or long-term treatment. They are at a higher risk of:
- Hypertension
- Diabetes
- Arthirtis
- Heart diseases
- Cataracts
- Neurological disorders
- Kidney failure
- Alzheimer's
- Cancer
These conditions require advanced treatment, regular monitoring, frequent doctor visits and repeated tests, which increases the overall hospital bill. Health insurance for senior citizens covers hospitalization expenses, surgery costs, doctor's fees, nursing charges, pre- and post-hospitalization expenses, etc., thereby reducing the medical expenses.
Financial Protection Against Rising Medical Expenses

With increasing age, medical expenses for elderly people also increase. Moreover, healthcare costs in India are rising rapidly due to medical inflation (approximately between 12-14% annually). Health insurance for senior citizens allows them to manage medical expenses without losing their hard-earned money.
Coverage for Pre-existing Diseases

Most senior citizens already have one or more health conditions when they buy the policy. Health insurance plans cover pre-existing diseases (PEDs) after a waiting period of up to 3 years. Some disease-specific plans offer a shorter waiting period, while some specialized plans offer PED coverage from Day 1.
Cashless Treatment

Senior citizen health insurance plans allow elderly people to receive cashless treatment without paying a large sum of money upfront. It is specifically helpful in cases of medical emergencies, allowing patients and their families to primarily focus on treatment rather than arranging funds.

Moreover, with the ‘Cashless Everywhere' facility, senior citizens can get cashless treatment at any hospital, even if it is not in the insurer's network list.
Lifetime Renewability

All health insurance plans for senior citizens offer lifetime renewability. This means that once the policy is activated, senior citizens can continue to receive coverage till they pay the premium, without any limit on the maximum age.
Coverage for Critical Illnesses

Treatment for critical illnesses like heart problems, cancer, stroke, kidney problems, etc., is not only expensive but also requires long-term medication. Senior citizen policy with critical illness cover provides a lump-sum amount when diagnosed with a life-threatening critical condition.
Preventive Health Check-ups

Senior citizens can avail free annual health check-ups for preventive care under most plans. Regular screening helps to identify early signs of a health condition, resulting in its timely treatment and better management.
Peace of Mind

Having the right health insurance policy allows senior citizens and their families to focus more on the treatment rather than worrying about arranging finances.
Tax Benefits

Senior citizens can avail a tax exemption of ₹50,000 for health insurance premiums paid for themselves and their spouse under Section 80D of the Income Tax Act.

Government Health Schemes for Senior Citizens

The central government also offers various health schemes for senior citizens to reduce their out-of-pocket medical expenses. These government health insurance schemes provide financial support for hospitalization, OPD treatment, diagnostics and medicines, depending on their specific eligibility criteria and coverage.

The table below shows a quick comparison of various central government schemes for senior citizens:

Government Scheme	Eligibility	Coverage	PED Waiting Period
Ayushman Bharat PMJAY	All senior citizens above 70 years, irrespective of income	Free health cover of ₹5 lakh per eligible family for secondary and tertiary hospitalization. Covered: - Medical treatment - Daycare procedures - Surgeries - Medicines - Diagnostics - 3 days of pre-hospitalization expenses - 15 days of post-hospitalization expenses	No waiting period
Central Government Health Scheme (CGHS)	Central government officials and pensioners, and their eligible dependents	Subsidized or cashless medical treatments across allopathic and AYUSH systems of medicine. Covered: - Hospitalization expenses - OPD treatments - Diagnostics - Medicines - Specialist consultations	No waiting period
Ayushman CAPF Healthcare Scheme	Serving personnel from eight forces, CISF, CRPF, BSF, Assam Rifles, SSB, NSG, NDRF & ITBP, and their eligible dependent family members	Coverage for treatment at CGHS empanelled private hospitals and all hospitals under AB PMJAY schemes. Covered: - Hospitalization - Pre & Post-hospitalization - OPD - Diagnostics - Medicines	No waiting period
Ex-servicemen Contributory Health scheme (ECHS)	Retired defence pensioners and their eligible dependents	Cashless coverage for all diseases, including heart problems, kidney issues, cancer and joint replacement. Covered: - Hospitalization - Surgeries - OPD treatment - Diagnostics - Specialist consultations	No waiting period

Which Health Insurance is Best for Senior Citizens?

The best health insurance plan for senior citizens is usually the one that offers a shorter waiting period, lower or no co-payment, fewer sub-limits, no room rent capping, lifetime renewability, a large network of cashless hospitals and a convenient claim process.

For instance:

A health insurance plan for senior citizens with a 10% co-payment is better than one with a 30% or 50% co-payment, as you will have to pay lesser out-of-pocket expenses.
A plan with no or lesser waiting period for pre-existing diseases is better than one with a fixed 3-year waiting period.
A plan with no restrictions on coverage for treatments like cataract surgery, knee replacement, etc., is better than one that puts a limit on its costs, as this means it will cover the complete treatment cost rather than paying for it partially.
An ideal health plan for senior citizens must meet their specific coverage requirements. For instance, if a senior citizen requires frequent doctor consultations, their chosen plan must cover OPD expenses as an in-built benefit.

Hence, there is no single best health insurance plan for senior citizens; the right plan depends on the elderly’s specific medical condition, coverage requirements and budget.

What is Covered by Health Insurance for Senior Citizens?

Health insurance plans for senior citizens cover the following:

In-patient Hospitalization Expenses – It pays for hospitalization expenses, including room charges, doctor fees, medicine costs, ICU charges, orthopaedic implants, etc. of senior citizens.
Day Care Treatments – It covers day care procedures that require less than 24 hours of hospitalization, like chemotherapy, dialysis, etc.
Pre and Post-Hospitalization Expenses – It pays for medical costs incurred on doctor consultation, diagnostic tests, etc., before getting hospitalized and after getting discharged from the hospital.
Pre-existing Diseases – It covers any pre-existing diseases of the insured senior citizen after a waiting period of 1 to 3 years.
OPD Expenses – It pays for the cost of doctor visits, diagnostic tests, and medicines availed on an outpatient department (OPD) basis.
Modern Treatments – It covers the medical expenses incurred on availing 12 modern treatments as listed by the IRDAI, including robotic surgeries, oral chemotherapy, etc.
Home Care Treatments – It pays for expenses incurred on treatment done at home on a doctor's advice, which would have otherwise required hospitalization.
Cataract Treatments – It pays for the cost of undergoing cataract surgery by the insured senior citizen.
AYUSH Treatments – It covers treatments taken through Ayurveda, Yoga, Unani, Homeopathy and Siddha in a government-recognized AYUSH hospital or institute.
Ambulance Charges – It pays for ambulance charges incurred on transporting the insured to the nearest hospital.
Organ Donor Expenses - It covers the donor expenses incurred for the organ transplant surgery of the insured senior citizen.
Domiciliary Hospitalization – It pays for domiciliary hospitalization of the senior citizen if the doctor suggests home treatment.
Consumables Cover – It covers the cost of consumables or non-medical expenses incurred by senior citizens during hospitalization, such as the cost of gowns, cottons, syringes, etc.
COVID-19 Cover – It pays for the cost of coronavirus treatment resulting from the COVID-19 disease.
Mental Illness Cover – It covers the medical expenses incurred on the treatment of mental illnesses, including anxiety, depression, PTSD, etc.
Preventive Health Check-ups – It pays for the cost of availing preventive health check-ups by the insured senior citizen.

₹1000 Cr worth of claims assisted in 2022-2023

How we helped our customers

What is Not Covered by Health Insurance for Senior Citizens?

Health insurance for senior citizens does not cover the following medical expenses:

Dietary Supplements - It does not cover the cost for nutritional supplements and substances that can be bought without the doctor's advice.
Self-inflicted Injuries - It does not pay for the treatment of injuries or illnesses caused by intentional self-harm or suicide attempt.
Treatment for Alcoholism - It does not cover the treatment of alcoholism or drug abuse, or their consequences.
Cosmetic Surgery - It does not pay for the expenses incurred on cosmetic procedures or plastic surgeries unless medically necessary.
Non-accidental Dental Treatments - It does not cover dental treatment expenses other than those resulting from accidents.
War-like Events - It does not pay for injuries resulting from war, war-like events or civil protests.

Note: The list of exclusions may vary from one plan to another.

Does Senior Citizen Health Insurance Cover Pre-existing Diseases?

Yes, pre-existing diseases (PEDs) are covered by health insurance plans for senior citizens.

PEDs are covered in health insurance after a waiting period of up to 3 years. However, most senior citizen policies offer an option to reduce PED waiting period, while a few also provide PED coverage from Day 1.

The proposer can choose to reduce the PED waiting period or opt for health insurance plans offering day 1 coverage of pre-existing diseases, depending on the severity of the senior citizen's pre-existing conditions.

Why is it important to check for the PED waiting period in senior citizens health insurance?

Older people usually have pre-existing conditions like high BP, diabetes, thyroid irregularities, asthma or heart risks. If there is no relaxation in coverage of PEDs, the insurer can deny claims where these conditions are an underlying reason for hospitalization.

Hence, checking PED coverage is crucial when buying a health insurance plan for senior citizens. Check how soon the plan covers pre-existing conditions and choose a plan that offers an option to reduce the senior citizen PED waiting period.

Cashless Hospitalization for Senior Citizens

Cashless hospitalization for senior citizens is a health insurance benefit that allows them to avail treatment without paying the medical bills upfront. This reduces paperwork and the financial burden on family members at a time of medical crisis.

The chances of a medical emergency happening are higher for a senior citizen, cashless hospitalization can help them and their families focus more on the treatment rather than worrying about arranging large sums of money. Since the hospital bill is directly settled by the insurer, it ensures that there are no delays in treatment due to financial hurdles.

Always check the number of top hospitals under the insurer's network that are in your neighborhood, as more hospitals mean more flexibility during an emergency situation. It is important to choose a hospital that has quality emergency care, expert specialists and advanced treatment facilities.

How to Upgrade Coverage for Senior Citizen Health Insurance?

You can upgrade the coverage for a health insurance plan for senior citizens by increasing the sum insured at renewal, opting for an add-on, adding a top-up health insurance plan or porting the policy.

The simplest way to upgrade coverage is to increase the base sum insured when renewing a senior citizen health insurance plan.
Another way is to buy a top-up or a super top-up plan with a senior citizen health policy. This lets you increase coverage at a lesser cost than simply buying another policy with a higher base sum insured.
Health insurance add-ons or optional covers, such as non-medical expenses cover, second medical opinion, reduced waiting period, room rent flexibility, etc., offer real value to senior citizens. You can upgrade coverage by opting for relevant add-ons.
You can also port the senior citizen health insurance plan to another insurer to get better policy features and strengthen your coverage.

What is the Cost of Health Insurance for Senior Citizens?

The cost of health insurance plans for senior citizens depends on various factors, such as age, location, medical history, chosen sum insured, co-payment options and selected policy benefits.

Here is a brief description of how each factor affects the cost of health insurance plans for senior citizens:

Age: The higher the age, the higher the premium
Location: Healthcare costs are usually higher in metropolitan and tier-1 cities, implying higher premiums
PEDs: The premium for a senior citizen with PEDs will be higher than that for one with no PEDs
Sum Insured: A higher sum insured usually means a higher premium
Co-payment: A higher co-payment means a lower premium, but more out-of-pocket expenses

For instance, a senior citizen health insurance plan for a person living in a metropolitan area can range from ₹1,300 to ₹2,800 per month, while for someone from a tier-3 city, it can be between ₹900 and ₹1,800 per month.

You must also keep in mind that a lower premium may imply lower coverage or more restrictions. A plan with a higher premium may have broader coverage, fewer limitations, or better claim support.

For instance, a senior citizen health plan with a higher co-payment may have a lower premium as compared to a plan with no co-payment or lower co-payment. However, this means you will have to pay more out of your own pocket for every claim. Hence, a cheaper senior citizen health insurance plan may not always be better or offer greater value.

Pro Tip: Instead of just checking the premium cost, pay attention to the coverage you are getting for the premium you are paying.

Health Insurance Premium Chart for Senior Citizens of Different Ages

Here is an illustration of health insurance premium chart for senior citizens in different age groups:

Age Group	Estimated Premium
60-65	₹1,332 - ₹3,539
66-70	₹2,439 - ₹4,803
71-75	₹3,136 - ₹5,858
76-80	₹3,870 - ₹7,428
81-85	₹3,870 - ₹9,349
86 or above	₹4,578 - ₹9,349

It is to be noted that these premium amounts are indicative based on the calculations done at Policybazaar.com for an elderly without any pre-existing diseases and living in Delhi. The exact premium will be based on your profile, specific health requirements and current health status.

What are the Factors Affecting Health Insurance Premium Prices for Senior Citizens?

Since health insurance plans for senior citizens already have high premiums, it becomes essential to understand the factors that can impact the premium prices for elder care insurance.

Age - It is one of the most important factors that affect the health insurance premiums. As the age increases, the policy premium also rises. Hence, the premium for a health insurance plan for a 70-year-old senior citizen will be higher than the premium for a senior citizen insurance plan for a 65-year-old.
Pre-existing Diseases - Health insurance for senior citizens with pre-existing diseases usually costs more than that of an elderly person who does not have any pre-existing condition.
Pre-policy Medical Test Results - While some insurers may not require the senior citizen to undergo a pre-policy medical test, most of them have made it a necessary requirement. If your pre-policy medical check-up results show potential health risks, the premium can increase.
Co-payment - Choosing a senior citizen mediclaim policy with a higher co-payment allows one to avail a higher discount on the policy premium. However, one must remember that the policyholder has to pay this amount from their own pocket.
Geographical Location - The location of residence also impacts the premium prices for mediclaim for senior citizens. For instance, tier-1 cities usually have a higher premium than tier-2 or tier-3 cities as residents in metropolitan cities are more exposed to pollution and lifestyle-related health risks.

Key Factors to Consider While Buying Health Insurance for Senior Citizens

Take a look at the various factors to consider while buying medical insurance for senior citizens:

Sum Insured

Senior citizens are more vulnerable to diseases & infections due to their increasing age and may require medical attention more frequently than younger people. As a result, the best health insurance for senior citizens could be the one with a higher sum insured of at least ₹15-25 lakh, depending on the city of residence and individual health conditions.
Maximum Entry Age

Every senior citizen health insurance policy has different entry age criteria. Thus, before choosing a mediclaim for senior citizens, it is essential to check the maximum entry age and determine if the senior citizen is eligible to buy the policy.
Policy Coverage

Before buying health insurance for elderly, one should check the coverage offered by the policy to know exactly what they are covered for. It is better to choose a senior citizen plan that covers them for day care procedures, modern treatments, OPD expenses, second medical opinions, domiciliary hospitalization, etc., for which they are more likely to raise a claim.
Pre-existing Diseases Waiting Period

Elderly people are more likely to have pre-existing diseases that are expensive to treat and can exhaust all their savings. Therefore, they should opt for a senior citizen insurance plan that comes with a minimum waiting period for pre-existing diseases. In fact, several plans today offer PED coverage from day 1 on the payment of an additional premium.
Pre-policy Medical Check-up

Most health insurance policies require the senior citizen to undergo pre-acceptance medical check-ups. However, there are a few senior citizen health plans that do not require them to undergo the pre-acceptance check-up, regardless of the senior citizen's age or the sum insured.

Before finalising the medical insurance, you must thoroughly read the pre-policy medical check-up conditions, especially if you have pre-existing conditions, as this may lead to higher premiums or rejection of the policy.
Restoration of the Sum Insured

Senior citizen health plans that come with unlimited restoration of the sum insured can prove to be exceptionally beneficial for older people. With this benefit, the coverage amount of the policy is restored by 100% unlimited times in a year if it gets exhausted due to claims. However, check if the policy activates the restoration benefit for claims related to the same or unrelated illnesses.
Co-payment

Most health insurance for senior citizens above 60 years come with a co-payment clause, where the policyholder agrees to pay a part of the claim amount during claim settlement. Only the remaining portion of the claim amount is paid by the insurance company. Hence, health cover for senior citizens should have low to zero co-payment.
Free Annual Health Check-ups

Most health plans provide preventive health check-ups after a block of every few years, depending on the claim history. A good health insurance plan for senior citizens offers free annual health check-ups. Therefore, they should opt for a senior citizen health policy that includes a free preventive health check-up benefit, preferably once every year.
Policy Exclusions

Every senior citizen medical insurance policy comes with certain exclusions for which the insured is not covered. Therefore, senior citizens must carefully review the policy document carefully to check the exclusions and understand what exactly they are not covered for, thereby preventing claim rejections.
No Claim Bonus/ Cumulative Bonus

Almost all insurance companies provide a no claim bonus discount or cumulative bonus if no claims are filed by the policyholder in the previous year. This results in either a decrease in health insurance premiums for senior citizens or an increase in the sum insured amount. Thus, elderly people should opt for a policy with a higher no claim bonus or cumulative bonus benefit.
Efficacy of Health Insurance Claims

The claim settlement ratio and the claim settlement time taken by the insurance company should also be considered while buying a senior citizen health policy. If an insurance company's claim settlement time is shorter and the claim settlement ratio is above 90%, it means the chances of claims getting settled quickly are higher, ensuring a stress-free claim process at the time of need.

Health Insurance for Senior Citizens with Diabetes/ BP

Diabetes and hypertension are common health conditions that most older people face and have to deal with on a daily basis. Buying health insurance for senior citizens with diabetes or high BP may seem difficult, but most insurers offer plans that cover these conditions.

So, if you are wondering if senior citizens with diabetes or high BP can get health insurance coverage, the answer is yes. However, their coverage may come with certain terms and conditions.

High BP and diabetes are considered pre-existing conditions. Hence, the PED waiting period applies, and the coverage may not start immediately. Remember to declare these conditions when buying a mediclaim policy.
The senior citizen may be mandatorily required to get a pre-policy medical check-up.
The policy may have a higher premium or a higher co-payment clause.

Policy features to look for:

Some insurers provide a reduced waiting period of up to 30 days or even Day 1 coverage. Choose according to the severity of your condition.
Some plans offer disease management programs for chronic conditions (such as hypertension and diabetes) that help patients to better manage their conditions in the long term.
Some insurers provide diabetes-specific health insurance plans to provide comprehensive coverage to diabetic patients.

Explore the list of health insurance plans for diabetes and high BP. Always ensure the plan provides coverage not just for the base condition, but also for its related complications.

Health Insurance for Heart Patients Above 60

One of the most common queries is whether heart patients above 60 years can get health insurance. Since cardiac diseases are treated as high risks, getting insurance for elderly people with heart problems may seem challenging;however, it is certainly possible. Many insurers cover heart conditions with certain terms and conditions.

Simply put, senior citizens with heart conditions can get health insurance. However, they must take care of the following points:

If a senior citizen already has heart conditions or has undergone heart surgery, it will be treated as PED. And a PED waiting period (of up to 3 years) will apply, implying immediate coverage may not be available. They must always disclose all heart-related conditions at the time of policy purchase.
Health insurance premiums may be higher for heart patients or those at high heart risk.
Such plans may have higher co-payments or deductibles.
Insurers may ask for additional pre-policy medical tests or impose stricter underwriting guidelines.

Policy features to look for:

Some plans offer the option to reduce waiting periods or opt for Day 1 coverage.
Some insurers provide special plans for heart patients that provide better coverage for heart problems and their management.
Ensure that the sum insured is higher(at least ₹10-30 lakh or above) as heart treatments are usually costly. Opt for a plan that does not have any room rent limit, since a change in room type can lead to unexpected, large increases in the medical bill.
A wider network of cashless hospitals offers more options of hospitals with cardiac specialists and advanced heart treatment facilities.

Here is a list of health insurance plans for heart diseases that you can explore to understand their coverage. Choose a plan that offers lower co-pay and wider coverage for various heart-related complications and related conditions.

Can Senior Citizens Get Health Insurance Without a Medical Test?

Yes, senior citizens can get health insurance without pre-policy medical check-ups. Generally, insurers require you to go through medical tests before issuing the policy to understand your current health condition and assess risk.

While most insurers require these medical tests for individuals above the age of 45 or 60 years, some insurers do offer plans that do not require pre-policy medical tests even for senior citizens. However, there are certain conditions associated with it, such as:

There may be limitations in coverage or benefits
Policy premiums may be higher
Some medical conditions may have stricter coverage terms
Co-payment may be higher
The proposer is required to declare more honestly

While no medical check-up plans for senior citizens provide faster and hassle-free policy issuance, those who require more coverage or fewer restrictions should avoid it.

8 Common Mistakes to Avoid When Buying Senior Citizen Insurance

Here are some common mistakes that you must avoid when buying health insurance plans for senior citizens:

Choosing a Plan due to Low Premium

A senior citizen health insurance plan with a lower premium may seem like a better option, but it may have lower coverage, higher co-payments or more restrictions. Hence, it is important that you check what benefits the plan actually offers rather than just choosing the plan because of a lower premium.
Buying Too Late

Buying late may result in higher premiums, more restrictions, stricter underwriting, fewer plan options or compulsory pre-policy medical tests. Hence, it is better to buy health insurance for senior citizens as early as possible.
Ignoring Co-Payment and Deductible

In many senior citizen health insurance plans, you have to pay a part of the bill yourself because of a mandatory co-payment or deductible. Failing to check its proportion means you will have to pay a large amount from your own pocket.
Not Checking Waiting Period for Pre-Existing Diseases

If a senior citizen already has conditions related to BP, diabetes, thyroid, etc., it is crucial to check when these will be covered. Some plans may have a fixed PED waiting period without the option to reduce it.

Not checking the waiting period for pre-existing diseases in senior citizen health insurance plans may mean you do not get coverage when you need it most.
Not Disclosing Pre-Existing Diseases

It is one of the mistakes that people think will not matter much. Not disclosing or underreporting pre-existing conditions can delay claim processing or even result in rejection. Hence, such conditions must always be declared honestly when buying the plan.
Not Checking Room Rent & Sub-limits

Some policies put restrictions on room rent or specific treatment procedures (like cataract surgery, knee replacement, immunotherapy, etc.) This means the insurer will not pay beyond the mentioned limit. So, you must always check if the plan has any coverage cap or sub-limit, else you may have to incur unexpected expenses.
Not Taking Medical Inflation into Account

Medical treatments are becoming costly year after year. Hence, a sum insured that seems adequate today may not meet future healthcare costs. Hence, the coverage amount for a senior citizen health insurance plan must be sufficient to cover rising medical costs.
Ignoring Policy Exclusions

Most people focus on what is covered in the policy and forget to check what is not. Ignoring policy exclusions means expecting coverage for something that is not covered. Hence, you must always check permanent exclusions, disease-specific restrictions, non-payable items and waiting period exclusions.

Tax Benefits of Senior Citizen Health Insurance

A senior citizen health policy not only covers medical expenses but also allows policyholders to avail a tax exemption under Section 80D of the Income Tax Act, 1961. It provides an income tax deduction of up to ₹50,000 per financial year on the premium of a mediclaim policy for senior citizens.

Policyholders can also avail a tax rebate of ₹5,000 on payments made towards preventive health check-ups every financial year. However, this amount is a part of the total Section 80D tax rebate limit. Moreover, they can also get a rebate of up to ₹1 lakh under Section 80DDB if the senior citizen undertakes treatment for a critical disease.

Moreover, senior citizens who pay health insurance premiums for their children can avail of an additional income tax rebate of ₹25,000 per year. This means they can avail a total tax deduction of up to ₹75,000 in a financial year under Section 80D. Or if they are paying a premium for their parents (who must also be senior citizens), they can avail a total tax rebate of up to ₹1 lakh.

How to File a Claim for Senior Citizen Health Insurance?

Senior citizens can file a cashless or reimbursement health insurance claim if they get hospitalized for a planned or emergency medical treatment. The process to file a cashless claim and reimbursement claim under senior citizen health insurance plans is given below:

Senior Citizen Health Insurance Cashless Claim Process:

Step 1: Get hospitalized at any hospital of your choice.

Step 2: Notify the insurer about your planned hospitalization at least 48 hours before, and an emergency hospitalization within 24 hours.

Step 3: Fill out the pre-authorization form available at the hospital and give it to the hospital authorities.

Step 4: The hospital will send the pre-authorization request to the TPA or the claims team of the insurer to initiate cashless hospitalization of the insured elderly person.

Step 5: The claims team will verify the document and approve/reject the cashless claim request.

Step 6: If approved, obtain the treatment and get discharged from the hospital.

Step 7: The insurance company will settle the claim with the hospital directly.
Senior Citizen Health Insurance Reimbursement Claim Process:

Step 1: Inform the insurer about your emergency hospitalization within 24 hours. In case of planned hospitalization, notify the insurance company at least 48 hours in advance.

Step 2: Obtain treatment and collect all medical documents during hospital discharge.

Step 3: Fill out and sign the claim form and submit it to the TPA or the insurer along with all the required documents.

Step 4: The claim will be settled by the insurer’s claims team after careful review, and the approved claim amount will be reimbursed to the policyholder’s bank account.

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Documents Required to File a Health Insurance Claim for Senior Citizens

The following documents must be submitted to file a reimbursement claim under a senior citizen health insurance policy:

Claim form
Copy of the health insurance policy
ID, age and address proof
Hospital bill with payment receipts
Certificate of hospital admission and discharge
Doctor's consultation papers & pathological reports
Chemist bills supported by a doctor's prescription
Any other document required by the insurer

Common Reasons for Claim Rejection in Senior Health Plans

Most common reasons for claim rejections in senior citizen plans include non-disclosure, waiting periods and exclusions. Here is a list of the top reasons due to which the insurer rejects claims:

Non-disclosure of pre-existing conditions
Claiming during the waiting period
Claiming for a policy exclusion
Not disclosing medical history or ongoing medications
Hospitalization or treatment deemed as not medically necessary
Policy lapse (if you fail to renew the policy timely)
Incomplete documentation
False or misleading information
Claiming a cashless claim at a non-network hospital
Submitting a reimbursement claim after the specified time period is over

Understanding your policy details and following the claim process correctly can significantly reduce the chances of claim rejections for senior citizens.

Benefits of Buying Senior Citizen Health Insurance from Policybazaar

Policybazaar Insurance Broker Private Limited offers multiple benefits to policyholders when buying a medical insurance policy for senior citizens. Take a look at them below:

30-Minute Claim Support – By buying health insurance from Policybazaar.com, senior citizens can get 30-minute claim support in more than 120 cities across India.
24x7 Claim Assistance – Policybazaar offers round-the-clock claim assistance to elderly people after purchasing the policy.
Online Comparison - Elderly people can make an unbiased online comparison of various senior citizen health insurance policies available in the market to find the most suitable policy according to their health needs.
Senior Citizen Health Insurance Calculator - The health insurance premium calculator on Policybazaar.com allows senior citizens to check the estimated premium for various policies before making an actual purchase.
Expert Advice - A qualified team of experts is available to answer all queries and help elderly people buy the right senior citizen health insurance policy.
Quick Policy Purchase - Senior citizens can purchase a mediclaim policy on Policybazaar.com within minutes without the hassle of long paperwork, thus saving a lot of time.

Health Insurance for Senior Citizens: FAQs

Q1. Which health insurance policy is best for senior citizens?

Ans: The right health insurance policy for senior citizens may vary from one person to another due to their varied health needs. Senior citizen health insurance that provides comprehensive coverage, high sum insured, lower premiums, no (or minimum) co-payment, lower PED waiting period, free annual health check-ups, critical illness cover and cashless hospitalization is usually considered the best for the elderly.
Q2. Why should you buy health insurance for senior citizens?

Ans: As a person ages, the possibility of developing lifestyle diseases like diabetes and their severity increases. As a result, older people often end up incurring higher healthcare costs without a regular source of income. Paying for expensive medical treatment with their limited income can be difficult to manage. Buying a senior citizen health insurance policy can help them get the best medical treatment without burdening their savings.
Q3. Can a 60-year-old get health insurance?

Ans: Yes. A 60-year-old person can buy health insurance in India. They can opt for a comprehensive plan or get covered through specialized senior citizen health insurance.
Q4. Can I buy health insurance for senior citizens above 65 years?

Ans: Yes. You can buy a health insurance policy for senior citizens above 65 years. However, they may be required to under a pre-policy medical check-up.
Q5. What is the waiting period for senior citizen health insurance?
Ans: The waiting period usually associated with senior citizen health insurance is as follows:
- Initial waiting period: 30 days
- Pre-existing disease waiting period: usually 2 to 3 years
- Specific Illness waiting period: between 1 to 2 years
Q6. Is a pre-policy medical check-up required for senior citizens?

Ans: Most senior citizen health insurance plans require the policyholder to undergo pre-policy medical check-ups.
Q7. Can a 70-year-old get health insurance?

Ans: Yes, a 70-year-old senior citizen can get health insurance. This is because many insurers offer health insurance for senior citizens above 70 years in India.
Q8. How to get health insurance for a 70-year-old in India?

Ans: You can buy health insurance for senior citizens above 70 years by contacting the health insurance company or Policybazaar.com. You can buy health insurance online by visiting their official website. However, the senior citizen may be required to undergo a medical test before the policy is issued.
Q9. Which health insurance company is best for senior citizens?

Ans: No single health insurance company is best for all senior citizens. This is because the needs of senior citizens and the coverage offered by various insurers are not the same. Hence, you must compare multiple health insurance plans for senior citizens across insurers online on Policybazaar.com to find the most suitable policy.
Q10. Is ₹5 lakh sum insured available for senior citizens?

Ans: Yes. Several health insurance plans in India offer ₹5 lakh sum insured to senior citizens. You can visit Policybazaar.com to find the list of plans with a ₹5 lakh sum insured that senior citizens can buy. However, you must check if this amount is sufficient for the elderly, as senior citizens are often more prone to falling sick or developing critical illnesses that may incur high treatment costs.
Q11. How can I check the senior citizen health insurance cost?

Ans: You can use a senior citizen health insurance premium chart available on the website of the insurer to know the estimated cost of a policy. You can also use a health insurance premium calculator on Policybazaar.com to calculate the estimated cost of the premium.
Q12. How to apply for the senior citizen health insurance plan?

Ans: To buy senior citizen health insurance, you must compare different plans by visiting Policybazaar.com or the insurer’s website. Once you select the plan based on the elderly’s requirements, fill in the personal and complete medical details. You can then buy a health insurance plan for senior citizen by making an online payment for the premium.

However, it is to be noted that most health policies may require the senior citizen to undergo a pre-medical check-up before the policy is issued.

Compare the plans based on various critical factors like waiting period, co-payment, sum insured, etc., while considering the senior citizen’s complete medical history.
Q13. Is a preventive health check-up for senior citizens eligible for tax deduction?

Ans: Yes, a preventive health check-up for senior citizens is eligible for a tax deduction of up to ₹5,000. However, this amount is a part of the overall tax deduction limit available under Section 80D.
Q14. What should I look out for in a senior citizen medical insurance policy?

Ans: When buying health insurance for senior citizens, you should look out for a higher sum insured, lower PED waiting period, entry age, critical illness cover, co-payment, OPD cover, free preventive health check-ups, domiciliary treatment, etc.
Q15. What are the documents required to buy a senior citizen mediclaim policy?
Ans: The following documents may be required to buy a mediclaim policy for senior citizens:
- Age proof
- Identity proof
- Address proof
- Income proof
- Duly filled proposal form
- Pre-insurance medical test reports(if applicable)
Q16. Do I need to go through a medical screening before buying a senior citizen health plan?

Ans: Yes, you may need to undergo a medical screening before buying most senior citizen health plans. This is because older people are more vulnerable to critical diseases and medical conditions, and are more likely to file a claim. However, some insurance companies may not require elderly people to undergo a medical screening before buying a policy.
Q17. Do all health insurance companies offer cashless hospitalization?

Ans: Yes, all health insurance companies in India offer a cashless hospitalization facility to their customers at network hospitals. The ‘Cashless Everywhere’ benefit enables the insured to receive cashless medical treatment even at non-network hospitals.
Q18. Do senior citizens get continuity benefits if they port their health insurance policy?

Ans: Yes. When senior citizens port their health insurance policy from one insurance company to another, they can carry forward their continuity benefits, such as No Claim Bonus or cumulative bonus and waiting periods, to the new policy. However, they must port to a plan with similar coverage to ensure continuity of benefits. Thus, elderly people must contact their insurer beforehand to understand the terms and conditions related to health insurance portability.
Q19. Do insurance companies offer free annual health check-ups under senior citizen health policies?

Ans: Many health insurance companies offer free annual health check-up facilities to the insured under a senior citizen health policy. However, some companies may offer this benefit after every few claim-free years. So, it is best to carefully read the terms & conditions of a senior citizen mediclaim policy to know the frequency of free medical check-ups.
Q20. Are critical illnesses covered under health insurance plans for senior citizens?

Ans: Yes. Several senior citizen health insurance plans cover critical illnesses, such as cancer, heart attack, etc. While some plans offer coverage for critical diseases as an in-built, others offer it as an add-on cover available at an additional premium. In either case, the coverage is available after a waiting period of up to 90 days.
Q21. Do senior citizen health insurance plans come with individual or floater cover?

Ans: Most senior citizen health insurance plans provide the sum insured on an individual basis. However, some plans offer floater coverage as well.
Q22. Does health insurance cost more as you get older?

Ans: Yes. Buying a health insurance policy will become more expensive as your age increases. If you need to buy insurance for your parents who are senior citizens or are approaching 60 years, you are advised to buy a senior citizen health insurance policy for your parents as soon as possible.
Q23. What is the Pradhan Mantri Senior Citizen health Scheme?

Ans: The Indian government, under the leadership of PM Modi, is offering free health insurance to all senior citizens above 70 years under the Ayushman Bharat Yojana.
Q24. What is the limit of medical insurance for senior citizens?

Ans: The sum insured amount varies across health insurance plans. Mediclaim policies for senior citizens in India come with a sum insured amount ranging from ₹50,000 to ₹5 crore.
Q25. What is the 80D limit for medical insurance premium for senior citizens?

Ans: As per Section 80D of the Income Tax Act, the tax deduction limit for medical insurance premiums for an individual senior citizen taxpayer is ₹50,000 per financial year.
Q26. To whom should I submit claim documents for senior citizen health insurance?

Ans: You can submit the claim documents for your senior citizen health insurance policy to the TPA of your insurance company, except in cases where there is no TPA and the insurer has an in-house claim settlement team.
Q27. How Much Does Health Insurance for Senior Citizens Cost at 60, 65 and 70 Years?
Ans: The age of the insured directly affects the premium for a senior citizen health insurance plan. The older the age, the higher the premium.
Here is an example of how the premium for a senior citizen mediclaim policy changes with age for an individual in a metropolitan city without any pre-existing disease.
- For a 60-year-old senior citizen, health insurance plans may range between ₹1,300 and ₹2,800 per month.
- For a 65-year-old senior citizen, the same plans may range between ₹1,800 and ₹3,400 per month.
- For a 70-year-old senior citizen, the same elderly care plans may range between ₹2,400 and ₹4,600 per month.
Q28. Which Health Insurance Company is Best for Senior Citizens?
Ans: The best health insurance company for senior citizen plans in India is the one that:
- Has a higher claim settlement ratio
- Provides a wide range of plans
- Offers plans customized for senior-specific needs
- Has a trusted reputation
- Has a stronger network of cashless hospitals
- Has an easy claim process
- Extends 24/7 customer support
- Provides comprehensive coverage balanced with wellness benefits
Hence, when comparing health insurance companies in India, thoroughly review all the factors that can directly impact your experience.
Q29. Why is health insurance for senior citizens expensive?

Ans: Usually, senior citizen medical insurance is costlier than regular health plans. Elderly people may already have pre-existing conditions like BP, diabetes, thyroid problems, heart diseases, etc., which increase their chances of raising a claim. This increases the insurer’s risk and expected claim costs, making health insurance for senior citizens more expensive than regular plans.

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Disclaimer: The list mentioned is according to the alphabetical order of the insurance companies. Policybazaar does not endorse, rate or recommend any particular insurer or insurance product offered by any insurer. For complete list of insurers in India refer to the Insurance Regulatory and Development Authority of India website www.irdai.gov.in