5 Senior Citizen Health Insurance Scheme by Government of India 2023

A primary necessity for most senior citizens is overall health maintenance. This is because many age-related health issues and illnesses come with ageing. Pairing that with expensive healthcare treatments and rising medical inflation rates, people may worry about the financial stress it can bring them in their later years.

This is where government mediclaim for senior citizens comes in. A senior citizen health insurance scheme or SCHIS is a government-backed mediclaim scheme meant to cover the healthcare expenses of those over 60. These government plans are often more affordable than health insurance plans from private insurance companies.

Before looking at the various government senior citizen schemes, let us first look at the conditions under which they are presented. The Insurance Regulatory and Development Authority (IRDAI) has laid down specific rules regarding senior citizen health insurance schemes by the Government of India.

• The senior citizen must be at least 65 years of age.

• If the insurance application is accepted, the insurer should pay 50% of the pre-insurance medical check-up cost.

• Applicants can change their third-party administrators (licensed intermediaries between policyholders and insurance companies) if they wish.

• Insurers must provide valid reasons for application rejections for senior citizens. They can not reject applicants unless they are found guilty of fraud or other misdemeanours relating to their insurance policy.

- Pradhan Mantri Suraksha Bima Yojana (PMSBY)

Pradhan Mantri health insurance for senior citizens is one of the two components of the Ayushman Bharat scheme introduced by the Indian government. It has no age cap and provides health coverage for Indian citizens working in the public and private sectors.

This scheme offers the most comprehensive health card for senior citizens and is made to cater especially to the underprivileged. It offers a health cover of ₹5 Lakhs per family member annually with an annual premium of ₹30.

- National Senior Citizen Mediclaim Policy

This government mediclaim for senior citizens offers a sum insured of ₹10 lakhs and can be purchased by senior citizens between the ages of 60 - 80 years. This plan also offers coverage to spouses/partners based on a family floater plan. A unique feature of this plan is that it also offers coverage for mental illness.

- National Varishtha Mediclaim Policy

This is a senior citizen health insurance scheme or SCHIS that provides medical coverage for senior citizens between the ages of 60 - 80 years. The policy period lasts a year but can be renewed to 90 years. It includes limited coverage for organ transplants and coverage of ₹1 lakh for hospitalisation and ₹2 lakhs for critical illnesses.

- Central Government Health Scheme (CGHS)

A central government health insurance for senior citizens provides medical insurance plans for current and former central government employees. People eligible to opt for this scheme include railroad workers, supreme and high court judges, Delhi police personnel, members of parliament, Indian freedom fighters, etc.

Policyholders of this scheme are offered a wide range of benefits which provide coverage for hospital expenses, AYUSH treatments, home treatments, consultation fees, etc.

- New India Assurance Senior Citizens Mediclaim Policy

This scheme is designed for senior citizens between the ages of 60 to 80 years. Policyholders can opt for a sum insured of ₹1 lakh or ₹1.5 lakhs and can get a discount of 10% on their premiums if their spouse is insured under the same plan. This plan offers coverage for pre and post-hospitalisation in addition to ambulance fees.

The primary benefit of these 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,

**- 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 in-patient hospitalisation.

• Cashless treatments at network hospitals listed under the plans.

• Treatment for pre-existing illnesses after a waiting period.

• Daycare treatments and cost of special equipment.

• Cost of ambulance and hospital room rent.

• Free medical check-ups 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 for senior citizens are eligible to opt for tax deductions up to ₹50,000 under Section 80D under 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 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 Check-ups

As stated, overall health maintenance is essential for senior citizens. So most government senior citizen health insurance schemes (SCHIS) offer free annual health check-ups in their packages. So by purchasing a plan, policyholders can get access to cashless check-ups 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.

These plans are a great initiative introduced by the Indian government for senior citizens. The senior citizen health insurance scheme by the government of India not only provides financial coverage in times of distress but also eases a lot of stress and gives senior citizens peace of mind as it shields their savings from being prematurely depleted.

Similar to the plans mentioned above, medical insurance plans from Tata AIG offer similar benefits for health insurance. A prime one is the tax deductions under Section 80D of the Income Tax Act.