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Senior Citizen Healthcare Insurance
As medical expenses continue to rise, having health insurance becomes essential for elderly individuals. Universal Sompo’s health insurance for senior citizens provides financial security and access to quality healthcare without the stress of high medical costs. Read on to know more.
Benefits of
health insurance for senior citizens
Investing in health insurance plans for senior citizens has several advantages. Here are some key benefits –
01. Extensive medical protection
As individuals grow older, they are more likely to experience health issues requiring frequent doctor visits, hospitalization, or specialized treatments. A senior citizen health policy provides comprehensive coverage for these needs, including hospitalization, surgery, doctor consultations, and even post-hospitalization expenses.
02. Financial security against medical inflation
According to a 2023 report by the National Health Authority, medical inflation in India is rising 12-14% annually. As healthcare is becoming increasingly expensive for elderly individuals, it is crucial to have health insurance plans for senior citizens for adequate coverage.
03. Coverage for critical illnesses
Senior citizens are more susceptible to critical illnesses like heart disease, cancer, and diabetes. A mediclaim policy for senior citizens offers coverage for these illnesses that are more common in older age, giving seniors the necessary support when needed most.
04.Access to high-quality healthcare
Older adults may not have easy access to top-tier healthcare. The best health insurance for senior citizens provides them access to a vast network of hospitals and specialists. This way, they will receive prompt, high-quality care without the worry of expenses.
05. Reduced stress for seniors and their families
A health insurance policy for senior citizens offers peace of mind by eliminating the worry about unaffordable medical bills. Financial aid during illness lessens stress and allows seniors to focus on recovery.
06. Tax benefits under sections 80D
A senior citizen health insurance policy also offers tax benefits under Section 80D of the Income Tax Act, 1961. You can claim tax deductions of up to –
- ₹50,000 on premiums paid for a policy covering themselves or their parents.
- Additional ₹25,000 for premiums paid for dependent children.
- ₹5,000 for preventive health check-ups.
- ₹1 lakh for treatment of critical illnesses
Features Of
Health Insurance For Senior Citizens
With Universal Sompo, the elderly get
Comprehensive coverage
The extent of hospitalization expense coverage under senior citizen health insurance is detailed within the policy's limits. In addition, medical expenses arising 30 days before hospitalization are included under the policy. This covers necessary pre-hospitalization tests and consultations. Similarly, payments for post-hospitalization treatment are covered for up to 60 days after discharge, helping you manage follow-up care without financial strain.
Daycare treatments
Universal Some medical procedures do not require a full 24-hour hospital stay but are still essential for treatment. Senior citizen mediclaim policy covers specific daycare treatments and surgeries, which allows necessary medical attention without extended hospitalization.
Ambulance charges
In case of a medical emergency, the cost of using an ambulance to reach the hospital is reimbursed under the policy with Universal Sompo. This coverage is limited to 1% of the sum insured, or ₹1,500, or actual amount incurred in such transportation whichever is lower. If the actual ambulance expense is lower than this amount, the policy will cover the exact cost incurred.
Domiciliary hospitalization cover
If a doctor prescribes treatment at home due to the unavailability of a hospital bed or the patient's inability to move, the policy covers these expenses. The mediclaim for senior citizens provides domiciliary hospitalization coverage, which is limited to 50% of the sum insured or the actual cost incurred, whichever is lower.
Health check-up
A senior citizen's health insurance in India includes coverage for periodic medical check-ups. After completing three consecutive claim-free years (the charges incurred for medical check-up once in a block of every 3 claims free years), eligible senior citizens can get a health check-up reimbursement of up to 1.25% of the average sum insured [STUM1] or the actual cost, whichever is lower. For floater policies, this limit applies collectively to two insured family members.
Daily allowance
For each continuous 24-hour period of hospitalization, the senior citizen health policy provides a daily cash allowance, limited to the lower of 0.1% of the sum insured or ₹250, with an overall policy maximum of ₹2,500.
Expenses of the accompanying person
When an insured individual is hospitalized, a caregiver may be needed. The senior citizen health plan with Universal Sompo reimburses the expenses of the accompanying person, up to 1% of the sum insured or the actual amount, whichever is lower. It helps cover costs for a companion staying at the hospital to assist the insured senior citizen.
Why you should buy
Healthcare Insurance from us
Tailor-made Plans
Affordable Premium
Flexible Sum Insured
Wide Hospital Network
What to consider while
buying senior citizen health insurance
When looking to buy health insurance for senior citizens, evaluate
Coverage benefits
Review the coverage benefits, including hospitalization, critical illness coverage, ambulance charges, and pre-existing disease coverage before purchasing a senior citizen health policy.
Waiting period
Most plans have a waiting period before pre-existing diseases are covered. Choose a policy with a shorter waiting period to access benefits sooner.
Co-payment clause
Some mediclaim policies for senior citizens have a co-payment clause. It needs the insured to pay a percentage of the claim amount. Pick a policy with a low or no co-payment.
Network hospitals
Verify the insurance provider's network of hospitals offering cashless treatment. A broad network facilitates access to quality medical care.
Claim settlement ratio
A high claim settlement ratio indicates that the insurance provider processes claims efficiently. This ensures a smooth claim process when required.
Premium and affordability
Identify the best health insurance for senior citizens in India with the most benefits within a reasonable budget. Don't let a low price mean sacrificing necessary coverage.
How To Buy senior citizen health insurance?
Purchasing the best health insurance for senior citizens requires a well-informed approach. Follow these steps –
Assess your healthcare needs
Examine your current health condition, medical history, and expected future expenses before you finalize a senior citizen health plan.
Compare different policies.
Evaluate various health insurance plans for senior citizens based on coverage, premiums, benefits, and exclusions. Use online comparison tools for better decision-making.
Choose an adequate sum insured.
Select an appropriate sum insured amount to cover hospitalization and critical illness costs. A higher sum insured can help cover major medical expenses.
Check the waiting period and exclusions.
Understand the waiting period for pre-existing diseases and check for any exclusions in the senior citizen health insurance before purchasing.
Look for additional benefits.
Some policies offer add-ons like wellness programs, annual health check-ups, and domiciliary hospitalization. These added benefits enhance the overall coverage.
Buy online for convenience.
Many insurance providers like Universal Sompo offer an easy online application process. Buying a mediclaim policy for senior citizens online is quick, paperless, and convenient.
Cover Highlights For You And Your Loved Ones
Inpatient
Treatment
Pre & Post
Hospitalisation
Domiciliary
Hospitalisation
Cost of Health
Check-up
Ambulance
Charges
Know What Our Senior
Citizen Health Insurance Offers You
Health Check-up
The charges incurred for medical check-up once in a block of every 3 claims free years up to 1.25% of the average Sum Insured or the actual amount incurred whichever is less. In case of floater policies, the limit of 1.25% shall be for the two family members covered under the Policy. Show MoreShow Less
Expenses of accompanying person
Expenses incurred up to 1% of Sum Insured or the actual amount incurred whichever is less for the person accompanying you shall be payable under the policy.Expenses incurred up to 1% of Sum Insured or the actual amount incurred whichever is less for the person accompanying you shall be payable under the policy. Show MoreShow Less
Change-of-Gender treatments
Expenses or treatments for Change-of-Gender treatments is not included.
Cosmetic or Plastic Surgery
Any expenses realted to cosmetic or plastic surgery is not incured.
Rehabilitation
Admission primarily for rest Cure, rehabilitation and respite care.
Surgical Treatment Safety
Expenses related to the surgical treatment of obesity that do not fulfill certain conditions.
Sports Activity Experience
Expenses related to any treatment necessitated due to participation in hazardous or adventure sports.
Drugs
Treatment for Alcoholism, drug or substance abuse or any addictive condition and consequences there of.
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Prospectus Get Claim in 3 Easy Steps
1Initiation
Set the ball rolling by requesting for cashless approval through a network hospital. Post which we evaluate and approve/reject the request.
2 Hospitalisation
After approval, go ahead with the hospitalization.
3Claim Settlement
The claim gets settled directly with the hospital upon discharge.
1Initiation
Settle the bill with the hospital and share the original documents and invoices with us.
2Verification
We authenticate the documents.
3Claim Settlement
The approved amount gets deposited in your bank account.
Claim process for health insurance
Health insurance for senior citizens with Universal Sompo has a smooth claim settlement process. Here is the process -
Cashless claim process
For cashless hospitalization, follow these steps –
- Get admitted to a network hospital.
- Fill out the pre-authorization request form at the hospital.
- The hospital will send the request to the insurance provider for approval.
- Insurance company will process the cashless request based on policy terms.
- After discharge, the insurer will settle the bill with the hospital.
Reimbursement claim process
If you receive treatment at a non-network hospital, you can file a reimbursement claim -
- Inform the insurer about the hospitalization as soon as possible.
- Pay the hospital bills and collect all necessary documents, including the discharge summary and other invoices.
- Submit the claim form along with the required documents to the insurer.
- The insurance company will verify the claim and reimburse the expenses based on policy terms.