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5 Senior Citizen Health Insurance Schemes
Rising medical expenses and inflation have made healthcare expensive and health insurance necessary. The problem is exacerbated with senior citizens, who are prone to more serious medical conditions and typically have to pay higher mediclaim premiums. To aid the nation’s elderly, the Government of India has created several health schemes for senior citizens that offer quality healthcare services and prevent the depletion of their savings.
Government-sponsored schemes, such as the Ayushman Bharat Yojana, Pradhan Mantri Vaya Vandana Yojana (PMVVY), and others, provide free or subsidised healthcare services and other benefits. In this blog, we will explore the top senior citizen health insurance schemes of this year and learn what benefits they offer.
What Is a Senior Citizen Health Insurance Scheme?
A senior citizen health insurance scheme is a specialised type of health insurance that serves the needs of those aged 60 years or older. These plans usually provide high sum insured amounts and coverage for pre-existing medical conditions and critical diseases. Senior citizen insurance schemes specialise in covering age-related medical risks and high healthcare expenses, safeguarding older policyholders from catastrophic medical bills.
Unlike regular health insurance plans that have upper age limits, senior citizen plans have less stringent eligibility criteria. They cover hospitalisation expenses, medicines, diagnostic tests, and other medical essentials. One can get senior citizen health insurance coverage from both private insurance companies as well as via various government health insurance/assurance schemes.
In India, the central and state governments have created several senior citizen schemes to ensure older people can access basic medical care. Many of them are focused on senior citizens in lower socio-economic sections. The Ayushman Bharat Yojana is a popular government scheme offering free medical care to anyone above 70 years. The Rashtriya Swastha Bima Yojana (RSBY) covers senior citizens aged 60 and older living in poverty.
Other senior citizen schemes include the Central Government Health Scheme (CGHS) for pensioners, and the Pradhan Mantri Suraksha Bima Yojana (PMSBY) for accidental insurance.
Why Do Senior Citizens Need Health Insurance Coverage?
A health insurance plan is not a luxury but a necessity for most senior citizens due to their higher risk of life-threatening diseases and chronic health issues. Here are the top reasons why senior citizens need health insurance coverage:
High Risk of Chronic Diseases: According to data from the Longitudinal Ageing Survey of India (LASI), 21% of elderly people suffer from at least one chronic disease. Elderly people are prone to conditions such as hypertension, diabetes, cardiovascular conditions, joint diseases, and lung diseases, making insurance a necessity.
Helps to Beat Medical Inflation: India has very high medical inflation rates, at around 13-14% per year, much higher than the general inflation rate. The rising cost of healthcare makes it difficult to bear medical care out of one’s own pocket. The expense of hospitalisation bills can deplete one’s savings and retirement benefits.
Covers Necessary Expenses: Many senior citizens buy health insurance as it covers a wide range of medical expenses. One can buy health insurance online to cover hospitalisation costs, medicines, diagnostic bills, surgeries, ambulance charges, and even daycare expenses.
Regular Health Checkups: Prevention is better than cure, and therefore, regular health checkups are better than expensive and painful hospitalisations. Senior citizen insurance schemes offer free preventive health checkups to monitor one’s health and detect diseases early.
Stress Free Retirement: Large medical bills can be very distressing for senior citizens, as they can threaten one’s retirement corpus. Besides the actual safety that health insurance provides, simply knowing that one’s finances are covered in an emergency ensures peace of mind for retirees.
Also Read: Reasons to Buy Health Insurance Early
Top 5 Senior Citizen Insurance Schemes in India
The following are some of the biggest government healthcare and health assurance schemes in India that cover senior citizens:
1. Ayushman Bharat Yojana- PMJAY
The Pradhan Mantri Jan Arogya Yojana, or PMJAY, is a health assurance scheme under the Ayushman Bharat initiative covering economically weaker members of society. It provides free coverage of up to ₹5 lakh per year to every eligible family for secondary and tertiary healthcare. Since September 2024, the scheme has included every senior citizen aged 70 years or more, regardless of their economic status.
Every senior citizen of 70+ years can avail free and cashless healthcare using a unique health ID card at any empanelled private or public hospital or medical centre. Senior citizens whose families were already covered before can get an additional ₹5 lakh top-up for themselves. As of November 2025, 86 lakh senior citizens are covered under the Pradhan Mantri health insurance for senior citizens.
Key Highlights of AB-PMJAY
| Name of the Scheme | Ayushman Bharat Pradhan Mantri Jan Arogya Yojana |
|---|---|
| Scheme Launched on | 23rd September 2018 |
| Who Is Eligible? | Poor families with occupations such as domestic workers, ragpickers, labourers, etc., and all senior citizens in India |
| Coverage Amount | ₹5 lakh/family/year + ₹5 lakh for eligible senior citizens |
| What’s Covered? | Secondary and tertiary healthcare, 1929 procedures |
| Pre-and Post-Hospitalisation Cover | Up to 3 days of pre-hospitalisation cover and up to 15 days of post-hospitalisation cover |
| Pre-existing Diseases | Covered from the first day |
| Other Coverage | Treatment, consultation, diagnostic tests, laboratory tests, ICU charges, medical implantation, room rent, etc. |
2. Central Government Health Scheme
The Central Government Health Scheme, or CGHS, is a GOI initiative that provides comprehensive and quality healthcare services to Central Government employees, retired personnel and their dependents. The PM Yojana for senior citizens allows the beneficiaries to get healthcare services for a nominal fee, from ₹250 to ₹1000 per month.
Beneficiaries of the Central Government Health Insurance Scheme for senior citizens can get many services, from consultations, diagnosis, medications, and outpatient expenses to allopathic and AYUSH treatments. Additionally, the scheme covers OPD (outpatient department) expenses, maternity expenses, family welfare, child care, medical device implantation, etc. One can get treated at any empanelled hospital, polyclinic or wellness centre across 80 Indian cities with cashless coverage or reimbursement.
Key Highlights of CGHS
| Name of the Scheme | Central Government Health Scheme |
|---|---|
| Scheme Launched on | 1st July 1954 |
| Who Is Eligible? | Central Government employees, pensioners and their families, current and retired judges, workers of the Railways Board and other government offices |
| Coverage Amount | No fixed ceiling, reimbursement as per the CGHS rate |
| What’s Covered? | Indoor treatment, OPD, specialist consultation, diagnostics, investigations, device implantation, AYUSH, maternity and child care, etc. |
| Number of Procedures Covered | 1859 |
| Cashless Treatment | Available at empanelled hospitals |
| Other facilities | Preventive healthcare, dental care, and pharmacy services |
3. Rashtriya Swasthya Bima Yojana
The Rashtriya Swasthya Bima Yojana, or RSBY, is a GOI-run health insurance program covering the nation’s BPL (Below Poverty Line) families. The Prime Minister's insurance scheme for senior citizens provides cashless coverage of up to ₹30,000 per family per year. Beneficiaries are issued smart cards, which they can use to get inpatient treatments at any empanelled private or public hospital.
The RSBY scheme aims to safeguard BPL families from the economic burden of healthcare expenses, enabling their social mobility. The scheme covers up to five family members with a registration/renewal fee of ₹30/year. All hospitalisation expenses are covered, including surgery, treatment, lodging, and consultations, plus pre-and post-hospitalisation, maternity expenses, etc. The scheme offers zero waiting periods and pre-existing disease (PED) coverage with very few exclusions.
Key Highlights of RSBY
| Name of the Scheme | Rashtriya Swastha Bima Yojana |
|---|---|
| Scheme Launched on | 1st April 2008 |
| Who Is Eligible? | BPL families (up to 5 members) and unorganised sector workers |
| Coverage Amount | Up to ₹30,000 per year per family |
| What’s Covered? | All expenses incurred at a licensed hospital |
| Pre-and Post-Hospitalisation Cover | 1-day limit for pre-hospitalisation and 5-day limit for post-hospitalisation expenses |
| Waiting Period and PEDs | No waiting period, all PEDs covered |
| Other Coverage | Maternity care, newborn baby care, dental treatments, transportation expenses, etc. |
4. National Programme for Health Care of the Elderly
The National Programme of Health Care of the Elderly, or NPHCE, is a national healthcare scheme for senior citizens, aged parents and people with disabilities. The health scheme for senior citizens aims to provide affordable, easily accessible and long-term medical care to the elderly. It provides preventive, curative and rehabilitative services through a variety of government schemes and primary/tertiary care centres.
The NPHCE provides funds to states and union territories that provide a variety of services via district hospitals, medical colleges, community centres, and wellness centres. It provides free preventive and promotive care via trained healthcare workers, free medical examinations, medications and support services to the elderly. The scheme also funds various medical research efforts throughout the country.
Key Highlights of NPHCE
| Name of the Scheme | National Programme of Health Care of the Elderly |
|---|---|
| Scheme Launched in | 2010-11 |
| Who Is Eligible? | Elderly patients, bedridden patients, and disabled persons |
| Coverage Amount | Non-applicable, funds directed towards states, UTs and healthcare facilities |
| What’s Covered? | Preventive and promotive care, home-based care, establishment of geriatric services wards, medical rehabilitation, therapeutic interventions, information and communication programmes |
5. Rashtriya Vayoshri Yojana
The Rashtriya Vayoshri Yojana, or RVY, is a fully Central Government-funded scheme that provides assisted living devices to senior citizens. The Prime Minister's Scheme for senior citizens is meant for senior citizens in BPL families with a maximum monthly income of ₹15,000. The devices are provided by the ALIMCO (Artificial Limbs Manufacturing Corporation), a PSU agency under the Ministry of Social Justice and Empowerment.
Some of the devices offered include walking sticks, walkers, elbow crutches, tripods/quadpods, wheelchairs, hearing aids, prescription glasses, artificial dentures and hearing aids. Any eligible senior citizen suffering from age-related disability or infirmity can get these devices for free at an authorised camp. Senior citizens above the age of 80 can get it delivered to their homes. To date, the scheme has distributed over 35.26 lakh devices to 6.73 lakh beneficiaries.
Key Highlights of RVY
| Name of the Scheme | Rashtriya Voyoshri Yojana |
|---|---|
| Scheme Launched on | 1st April 2017 |
| Who Is Eligible? | Senior citizens with disabilities from BPL families and with less than ₹15,000 monthly income |
| What’s Covered? | Free assisted living devices |
| How to Get It? | Walk-in or home delivery from a state-authorised camp |
| Documents Required | Aadhaar card, ration card, and income certificate |
| Beneficiaries Identification | Identified by state and district authorities through assessment camps |
Benefits of Senior Citizen Health Insurance Schemes
The primary benefit of senior citizen insurance schemes is that they reduce the financial burden senior citizens face when receiving medical treatment. However, that isn't the only benefit these schemes offer. Here are some prime benefits of senior citizen health insurance schemes -
Covers Multiple Healthcare Expenses
Policyholders can enjoy comprehensive coverage from senior citizen health insurance schemes by the Government of India. They can get coverage for:
Pre and post-hospitalisation expenses
Treatment of injury from accidents or illness-specific treatment during inpatient hospitalisation
Cashless treatments at network hospitals listed under the plans
Treatment for pre-existing illnesses after a waiting period
Daycare treatments and the cost of special equipment
Cost of ambulance and hospital room rent
Free medical checkups once a year (In the case of some insurers)
Domiciliary expenses
AYUSH Treatments
Organ donor expenses (within a specific limit)
Tax Deduction Of Paid Premiums
Senior citizens paying premiums for government mediclaim are eligible to opt for tax deductions up to ₹50,000 under Section 80D of the Income Tax Act.
Tax deductions and exemptions also happen to be a prime reason many people opt for health insurance plans, whether backed by government or private insurers. So even if you aren't suffering from serious chronic conditions, buying a health insurance plan may still be a good idea.
Free Look Periods
Senior citizen health insurance schemes by the Government of India offer a free look period of 15 to 30 days to their policyholders. This way, they get to look through the terms and conditions of the plan and decide whether to terminate or proceed with the medical insurance plan they have chosen.
Annual Health Checkups
As stated, overall health maintenance is essential for senior citizens. So most government senior citizen health insurance schemes (SCHIS) offer free annual health checkups in their packages. So by purchasing a plan, policyholders can get access to cashless checkups every year at one of the network hospitals listed under their plans.
Coverage For Special Equipment
Most daycare treatment procedures, like dialysis, chemotherapy, etc., involve the use of specialised equipment, which can incur additional treatment costs. However, a government scheme or health card for senior citizens covers such additional expenses. This eases many of the financial burdens caused by the regular use of these daycare treatments.
Conclusion
The above-listed senior citizen insurance schemes offer free or subsidised healthcare services, helping the elderly in times of distress. Since the Ayushman Bharat Yojana was expanded to all senior citizens, anyone aged 70 or above can get free healthcare of up to ₹5 lakh in a year. This ensures that the nation’s elderly can get a basic level of medical care.
Some limitations of these government healthcare schemes are that they exclude some senior citizens and often don’t offer enough coverage for expensive treatments. Fortunately, there are many good options for a specialised health policy for senior citizens.
Whether you want to cover yourself or your elderly parents, the TATA AIG Senior Citizen Health Insurance plan will meet all healthcare needs. It offers easy claim settlement, attractive bonuses and a premium amount as low as ₹15 per day. Explore our senior citizen plans now!
Disclaimer / TnC
Your policy is subjected to terms and conditions & inclusions and exclusions mentioned in your policy wording. Please go through the documents carefully.
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