Senior Citizen Health Insurance
Avail upto ₹75,000 Income Tax benefits under section 80D
Ageing makes you more prone to health conditions and injuries that may not have been an issue in your younger years but now need constant medical attention. This is because older people are more prone to certain diseases and recover more slowly.
These conditions require regular treatments and medications to manage, which can quickly get very expensive. Given rising medical costs, these expenses can eat away at your retirement savings and be financially burdensome. In such times, having a senior citizen mediclaim policy helps.
What Is Senior Citizen Health Insurance?
A senior citizen plan is a type of health insurance plan specifically designed to offer financial assistance to people over the age of 61. It covers medical treatments and procedures commonly prescribed to senior citizens.
According to the IRDAI, insurance providers can not reject health insurance applications and renewals from senior citizens without valid reasons such as:
- Fraud.
- Misrepresentation.
- Moral Hazard (The intention to claim money from the insurance provider on death by committing fraud).
Why Do You Need Separate Health Insurance For Senior Citizens In India?
While you may think that the savings you have accumulated throughout your life will be enough to tide you over in your retirement years. The corpus may run out earlier than you think.
Here are some reasons why you should consider getting senior citizen health insurance.
Rising Medical Costs
Factors like rising medical costs, inflation, and medical emergencies due to unforeseen accidents or injuries can quickly deplete your savings. Investing in health insurance for senior citizens can be your way of shielding your savings.
Some of the best mediclaim policies for senior citizens will cover your hospitalisation costs and medical emergencies, so you do not have to worry about paying out of pocket for these expenses.
Critical Illness Cover
With old age, the possibility of injuries and critical illness diagnosis increases significantly. If this is the case, your policy will provide the necessary coverage for treatment
Annual Health Checkups
Physical health becomes an increasingly important factor as you age, significantly affecting your quality of life. Under most plans, senior citizens can avail free annual health checkups to undergo medical screenings regularly.
A benefit to doing this is that diseases are detected in their earlier stages, making them easier to treat, and it reduces out-of-pocket expenses.
Stress-Free Retirement
Medical expenses can be distressing for anyone to pay off, but they can be especially distressing in your retirement years as they can deplete your savings.
Having medical insurance for senior citizens can help alleviate this stress and give you peace of mind by securing your savings, as there is less risk of prematurely depleting your savings.
What Is Covered Under Tata AIG's Health Insurance For Senior Citizens In India
In-patient Treatment
This cover offers financial assistance for the hospitalisation of the senior citizen as an in-patient due to disease/illness/injury during the policy period. This also covers dental treatment under anaesthesia due to the same causes.
Pre and Post-Hospitalisation Expenses
Coverage for pre-hospitalisation expenses like consultations, investigations, and medication up to 30 days before hospitalisation and 60 days after discharge from the hospital for post-hospitalisation expenses.
This benefit is payable if you have administered claims under in-patient treatment/day care procedures under your senior citizen mediclaim policy.
Day Care Procedures
Coverage for expenses for daycare treatments due to disease/illness/injury during the policy term taken at a hospital or a daycare centre.
AYUSH Treatment
We will cover for expenses incurred for treatment as in-patient in AYUSH Hospital, subject to maximum up to 50% of the sum insured
Road Ambulance Cover
Ambulance expenses of the insured person on registered ambulances for emergencies or transportation from one hospital to another for better facilities and treatment.
This cover is payable up to ₹5,000 per hospitalisation and is admissible for claims filed under in-patient treatment and daycare procedures.
Benefits Of Buying Tata AIG's Medical Insurance For Senior Citizens
Cashless Facilities
With our senior citizen medical insurance plan, you can opt for cashless claims at network hospitals for planned and unplanned (emergency) hospitalisations. We have tied up with over 10,000+ hospitals pan-India to ensure you have access to quality healthcare services no matter where you are.
The ambulance cost also gets covered under the sum insured in your policy, so you do not have to worry about any out-of-pocket expenses being incurred after emergency hospitalisations. You simply need to notify us of any hospitalisations, and we will take care of the rest.
Use our network hospital locator to find out the addresses of the closest network hospitals in your city or region.
Easy Claims Process
At Tata AIG, we provide an easy claims process for reimbursements on health insurance for parents above 61. Our online facilities have allowed us to digitise this process, making it more accessible and faster.
To file a claim, you simply need to visit our website, fill out a claims form and upload the required documents. We also provide a claims tracking feature to promote transparency so you stay fully informed throughout the claims process.
Paperless Policies
Another benefit of digitising our processes has allowed us to go fully paperless in our transactions and application processes. So when you apply for a senior citizen mediclaim policy, the application process can be done fully online and in a matter of minutes.
Similarly, for claims processes, you only need to upload the necessary documents onto our site for us to settle your claims. You can also track your claims without needing any physical documentation.
Tax Benefits
This is one of the key benefits of health insurance. Like any other health insurance plan, our senior citizen mediclaim policy makes you eligible for health insurance tax deductions under Section 80D of the Income Tax Law.
As a senior citizen, you are eligible for deductions up to ₹50,000 if you pay the premiums yourself and an additional ₹25,000 if a family member (under 60) insured under the same plan pays the premium instead.
Cumulative bonus
On policy years where you do not make any claims, you are entitled to a Cumulative Bonus or a No-Claim Bonus. Essentially, we will increase your sum insured by 10 percentage without increasing your health insurance premium. This way, you can enjoy higher coverage without paying any extra premiums.
This benefit is applied on renewal for every claim-free year on consecutive renewals with us at Tata AIG. Under your senior citizen health insurance, you can get a maximum cumulative bonus of up to 100% of the sum insured.
Safe And Secure
We value your privacy and data. Our website is a safe place for you to input your details and complete health insurance premium payments. We promise to keep your personal and payment data 100% secure at all times.
High End Diagnostics
Covers the insured person for the diagnostic tests listed in the policy, on OPD basis, if required as part of a treatment, subject to a maximum Rs. 20,000 (over and above base sum insured) per policy year.
Benefits With Separate Limits (Over and Above the Sum Insured Amount) That Do not Affect the Cumulative Bonus
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What To Consider While Buying Health Insurance Policies For Senior Citizens
Maximum Age of Entry
While some individual health insurance plans provide coverage for people above 61, the minimum entry age for senior plans is 61 years and above.
Thus, before purchasing a senior citizen mediclaim policy, you must check the age of entry to ascertain if you are eligible to buy it.
Sum Insured
Your senior citizen health insurance plan must have an adequate sum insured. It should cover all your health-related expenses, like preventive health checkups, medications, and hospitalisations, and medical emergencies.
When deciding your sum insured amount, always make sure you account for all your medical expenses and for medical emergencies to ensure adequate coverage.
Enhancement of Sum Insured
Your senior citizen mediclaim policy must be flexible enough to provide coverage enhancement. This can be available through:
- Enhancing the sum insured amount on policy renewal,
- By an increase in the sum insured through a cumulative bonus, or both.
Waiting Period
Several covers in your senior citizen health insurance plan have specific waiting periods attached. You must read the policy wordings carefully to know when you can get coverage for each cover.
Policy Inclusions and Exclusions
This is the most important part of any medical insurance policy. When comparing your senior citizen mediclaim policy with other senior citizen health policies, always make sure to check the policy inclusions and exclusions to know what is covered under the plan.
Policy Renewability
Not all senior health insurance plans have lifetime renewability. This feature, in particular, can save you a lot of money as it is more cost-effective to renew your plan than it is to purchase a new senior citizen mediclaim policy every year.
How To File A Claim For Your Tata AIG Senior Citizen Mediclaim Policy?
If you file a reimbursement claim, we must be informed as soon as possible. This is because there are chances of the claim getting rejected if the treatment or procedure is not pre-approved by us. To avoid this, ensure that you check the policy terms and coverage carefully.
Lastly, after getting discharged from the hospital, you must pay their bills and raise a claim through our website. You must present all the necessary documents and submit your claim.
- Visit the Tata AIG official website.
- Click on 'Claims' on the top tab.
- Click 'Initiate Claim' and choose your product; in this case, it will be 'Health.'
- Log in to the site using your registered details.
- Fill out the claims form and upload the required documents.
- After submitting your claim, an insurance agent will contact you to guide you through the process.
How To File A Claim For Your Tata AIG Senior Citizen Mediclaim Policy?
Reimbursement Claims
If you file a reimbursement claim, we must be informed as soon as possible. This is because there are chances of the claim getting rejected if the treatment or procedure is not pre-approved by us. To avoid this, ensure that you check the policy terms and coverage carefully.
Lastly, after getting discharged from the hospital, you must pay their bills and raise a claim through our website. You must present all the necessary documents and submit your claim.
- Visit the Tata AIG official website.
- Click on 'Claims' on the top tab.
- Click 'Initiate Claim' and choose your product; in this case, it will be 'Health.'
- Log in to the site using your registered details.
- Fill out the claims form and upload the required documents.
- After submitting your claim, an insurance agent will contact you to guide you through the process.
Cashless Claims
This facility can be claimed only in cases of treatment and hospitalisation at network hospitals and applies to planned and emergency hospitalisations. For a global cover, the cashless facility would be available for in-patient and daycare hospitalisations only and approved on a case-by-case basis.
To process your cashless claim under medical insurance for senior citizens, we must be informed:
- At least 48 hours before planned treatments, procedures and consultations.
- Within 24 hours after the hospitalisation or treatment for emergency medical procedures.
Notify the TPA/us 48 hours before any planned hospitalisations/treatments. For emergency hospitalisations, we must be notified 24 hours after the treatment/hospitalisation.
Upon notification, we will check your coverage and eligibility and send an authorisation letter to the provider.
You have to provide the ID card issued to you along with any other information or documentation that is requested by the TPA/us to the network hospital.
If approved, we will directly settle the bill with the network hospital.
In case of a rejection of the cashless claim, you can still apply for a reimbursement claim, as a rejection of cashless claims in no way indicates rejection of the claim itself.
FAQs
Why Is Health Insurance Important for Senior Citizens?
I am 65 years old. Am I eligible for Senior Citizen Health Insurance?
What Does a Pre-existing Condition Mean In Health Insurance?
What Are The Various Covers Available Under Tata AIG's Elder Care?
Does the Tata AIG Senior Citizen Health Insurance Plan Cover AYUSH Treatments?
What Are the Factors That Determine the Premium of a Senior Citizen Health Insurance Policy?
Can I Get Tax Benefits for the Health Insurance Premiums Paid Towards my Parents' Senior Citizen Health Insurance Plans?
How Can I Check the Premium for Tata AIG's Senior Citizen Health Insurance Policy?
Are the Premiums For Health Insurance Policies for Senior Citizens Higher Than Those For The Health Insurance Plans For People Below The Age of 60 Years?
How Can I File a Claim for My Tata AIG Senior Citizen Health Insurance Plan?
What documents do I need for a reimbursement claim under my senior health insurance plan?
How Can I Buy a Senior Citizen Health Insurance Plan from TATA AIG?
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Understanding Health Insurance Terms
- Co-Pay If you’d like to lower your health insurance premium, you can opt for co-payment. You can promise to pay a certain percentage of each claim you make against your medical insurance policy, and your insurance provider will take care of the rest. If you’d like your insurance provider to settle the full claim, you can opt-out of co-payment.
- Deductible This is a fixed amount that the insured individual has to pay towards their medical treatments before they can file a claim with their insurance provider. The deductible is a fixed amount and not a percentage of the total claim amount. Let’s assume that your deductible is INR 5,000. In a policy year, you undergo treatment worth INR 50,000. You have to pay INR 5,000 before you can make a claim for the balance amount of INR 45,000.
- Pre-Existing Disease If the individual purchasing insurance already suffers from any disease, it is called a pre-existing diseases. The individual can purchase their medical insurance policy, but the pre-existing disease will only be covered after a given waiting period.
- Sum Insured Your sum insured refers to the maximum amount that your insurance provider will pay in a given policy year. It basically reflects the total value of your policy. You can choose your sum insured when you purchase your health insurance policy. But, you should remember that the amount you choose will directly impact your premium.
- Waiting Period The waiting period is a specific amount of time during which insured individuals cannot make certain claims against their health insurance policies. There are different waiting periods defined for different issues. The first is the initial waiting period. This is the time you must wait before making a non-accidental claim after purchasing the health insurance policy. The second is a waiting period for pre-existing illnesses. This can range from anywhere between 2 to 5 years. The third waiting period is for specific illnesses. Some health issues such as hernia or ENT disorders will only be covered after a few years of cover. Generally, the waiting period for these issues is 2 years. The final waiting period is for maternity cover. Most health insurance policies will cover maternity expenses only after a few years.
