National Senior Citizen Mediclaim Policy

When compared to younger people, older people are more susceptible to certain illnesses and health issues. The cost and duration of treatment for health issues associated with getting older are both high. You won’t have to worry about covering the cost of medical care associated with health issues as you age if you purchase a Senior Citizen Mediclaim Policy.

A type of health insurance called senior citizen health insurance pays for medical costs incurred by people over 60. It provides elderly patients with preventive health checkup services as well as cashless hospitalization at the insurance company’s network hospitals. Pre-existing conditions, hospital costs, critical illnesses, pre-hospitalization, and post-hospitalization costs, and coronavirus treatment are all covered.

7 Advantages of having New India Senior Citizen Mediclaim Policy

For elderly people, a senior citizen’s medical insurance policy has many advantages. Here are some of the main advantages of purchasing a senior citizen medical insurance policy in India:

1. Medical Insurance for Seniors –

 Senior citizen health insurance plans provide health coverage to those over 60 because traditional family health insurance policies typically only cover those under 65.

2. Pre-medical Screening-

Contrary to regular plans, most health plans don’t demand that seniors undergo any kind of medical examination before purchasing the policy.

3. Coverage of Hospitalization Costs 

The costs of pre-hospitalization, post-hospitalization, and in-patient hospitalization are all covered by these plans for seniors.

4. Cashless Treatment-

Seniors who are admitted for a minimum of 24 hours may receive medical care at network hospitals of the insurance provider without paying any cash.

5. No-Claim Bonus

 Senior citizens who have never filed a claim are given a No Claim Bonus, which entitles them to a discount on their renewal premium. Depending on the plan, it might be between 20% and 100%.

6. Renewability for Lifetime-

There is typically a lifetime renewability option available with senior health insurance.

7. Tax-Benefits-

According to Section 80D of the IT Act, senior citizen health insurance policies offer tax exemption benefits on the paid premiums every fiscal year.

Features & Benefits of New India Senior Citizens

Seniors should have health insurance because they may experience serious health problems as they get older. Your parents being admitted to the hospital in an emergency can be upsetting financially and emotionally. You can manage the financial effects of a hospital stay with the assistance of parent health insurance. The following are a few of the additional crucial justifications for purchasing a senior health insurance plan:

  • Be Prepared for Rising Healthcare Costs 

Senior citizens must purchase a senior citizen health insurance policy in order to access the best healthcare services because the cost of hospitalization and medical care is increasing due to medical inflation.

  • Coverage for Serious Illness 

Critical illnesses like cancer, kidney disease, and heart conditions are more likely to be diagnosed as people age. You can include coverage for critical illnesses in your basic plan or as an add-on with a senior health insurance policy.

  • Facilities for yearly health examinations

 Under the majority of senior citizen health plans, seniors can receive yearly, free health examinations. This facility can lessen out-of-pocket costs because they must regularly undergo medical screening. Some plans, however, might provide this option every two or three years of being claim-free.

  • Mindfulness – 

Elderly people may experience distress when having to pay hospital bills, particularly in light of the rising costs of both minor and major illnesses’ treatments. Senior citizens can feel more at ease in these circumstances thanks to health insurance.

The premium for the New India Senior Citizen Mediclaim Plan (Rs.)

The different senior health insurance plans available are listed in the table below:

Plans for Seniors’ Health InsuranceEntry AgeAmount Insured(Rs)
Aditya Birla Activ Care Plan55-80 yearsStandard: 3 lakh to 10 lake classic: 3 lakh to 10 lake premier: 5 lakh to 25 lakh
Bajaj Allianz Silver Health Plan46-70 years50,000 to 5 lakh
Bharti AXA Smart Health Insurance Plan18-65 yearsBasic: 50,000 to 5 lakh premium: 1 lakh to 5 lakhOptimum: 1 lakh to 5 lakh
Care Senior Health Plan61 years onwards3 lakh to 10 lakh
Cholamandalam Flexi Health Supreme Plan18-75 yearsBasic: 3 lakh to 25 lakh plus: 5 lakh to 25 lake premiere: 30 lakh to 5 crore
Digit Health Care Pus Plan18 years onwardsUp to 3 crore
Edelweiss Health Insurance Plan18 years onwardsSilver: 1 lakh to 5 lakh gold: 5 lakh to 20 lakhPlatinum: 15 lakh to 1 crore
Future Generali Health Suraksha Plan18-70 yearsGold: 1 lakh to 5 lakhPlatinum: 6 lakh to 10 lake topaz: 1 lakh to 5 lake ruby: 6 lakh to 10 lakh
IFFCO Tokio Individual Medishield Plan18 -65 years50,000 to 50 lakh
Kotak Mahindra Health Care Plan18 -65 yearsExcel: 2 lakh to 4 lakh premium: 5 lakh to 25 lakh
Liberty Health Connect Plan 18 -65 yearsE-Connect: 3 lakh to 7.5 lakh basic: 2 lakh to 10 lakh liter: 3 lakh to 15 lakhSupreme: 2 lakh to 15 lakh
ManipalCigna ProHealth Insurance Plan18 years onwardsProtect: 2.5 lakh to 50 lakh plus: 4.5 lakh to 50 lakhPreferred: 15 lakh to 50 lake premier: 1 crore accumulated: 5.5 lakh to 50 lakh
Niva Bupa (Formerly known as Max Bupa) Heartbeat Plan18 years onwardsGold: 5 lakh to 50 lakhPlatinum: 15 lakh to 1 crore
National Senior Citizen Mediclaim Policy18 years onwards1 lakh to 10 lakh
New India Senior Citizen Mediclaim Policy60-80 years1 lakh to 1.5 lakh
Oriental HOPE Insurance Plan60 years onwards1 lakh to 5 lakh
Raheja QuBE Health Insurance Plan18-65 yearsBasic: 1 lakh to 50 lakhComprehensive: 3 lakh to 50 lakes super Saver: 1 lakh to 50 lakhAla Carte: 1 lakh to 50 lakh
Reliance Health Gain Plan18-65 years3 lakh to 18 lakh
Royal Sundaram Lifeline Health Insurance Plan18 years onwardsClassic: 2 lakh to 4 lakhSupreme: 5 lakh to 50 lakh litre: 25 lakh to 1.5 crore
SBI Arogya Premier Plan18-65 years10 lakh to 30 lakh
Star Senior Citizen Red Carpet Insurance Plan60-75 years1 lakh to 25 lakh
Tata AIG MediCare Plan18 years onwards3 lakh to 20 lakh
United India Senior Citizen Health Insurance Plan61-80 years1 lakh to 3 lakh

Applicable Discounts

  • Offers a cumulative bonus of 5% up to 30% for each year a claim is not made (renewal).

  • The premium will be discounted by 10% for families when adding a spouse to the policy. Additionally, if a voluntary deductible of Rs. 10,000 is chosen, the premium will be reduced by another 10%.

  • For senior citizens who already have a health plan, migration to a Senior Citizen Mediclaim is possible.

  • Four claim-free years’ worth of payment toward the cost of a health check.

  • Benefit from income taxes for the premium paid in accordance with Section 80D of the Income Tax Act.

9 Unique Aspects of the Senior Citizen Mediclaim Plan from New India Assurance

1. Daycare services

Many surgeries and treatments can now be performed in a day care setting thanks to advancements in medical technology. But for a senior to file a claim under a standard health insurance plan, they must stay in the hospital for at least 24 hours. As a result, it is preferable to pick a senior citizen insurance plan that offers extensive coverage for daycare procedures like dialysis, chemotherapy, radiotherapy, etc.

2. Cashless Hospitals

There are many hospitals in every health insurance company’s extensive network where you can use their cashless hospitalization services. Before purchasing a plan, you must look over your insurance provider’s list of network hospitals.

3. The success of insurance claims for medical care

When choosing a senior health insurance policy, claim settlement rates and the length of time it takes the insurance company to resolve a claim should also be taken into account.

 Your chances of having your claim settled quickly are increased if an insurance company has a low claim settlement time and a high claim settlement ratio.

4. The No Claim Bonus

If a policyholder does not file any claims during the previous year, almost all insurance companies offer a no claim bonus discount. Either the policy premium or the sum insured amount decreases in such a situation.

5. Free medical and health checkup service

The best senior health insurance plans enable policyholders to receive a medical exam for free once a year. This is typically offered following the conclusion of a specific number of policy years or every two to three years without a claim.

6. Co-payment

Many senior citizen health plans have a co-payment provision that requires the policyholder to pay a portion of the claim amount. The insurance provider only covers the remaining sum of the claim. You must choose a plan with a low to no co-payment as a result.

7. Policy Renewal

So that you won’t need to purchase another health plan as you get older, always look for the best health insurance plan that offers a lifetime renewability option. A senior citizen should not have a policy that stops renewing, especially after 60 years.

8. Pre-existing Diseases Waiting Time

Pre-existing conditions that require expensive treatment are more common in the elderly. As a result, you should select a senior health insurance plan with a short waiting period for pre-existing conditions.

9. Residential Hospitalization

An elderly person’s health may prevent them from being admitted to a hospital in some circumstances. In this situation, health plans with domiciliary hospitalization coverage will cover the costs of in-home medical care as long as a licensed physician has recommended it.

How Do I File a Claim for the Senior Citizen Mediclaim Plan by New India Assurance?

If a policyholder receives emergency medical treatment or is admitted to the hospital, senior citizen health insurance plans require them to submit a health insurance claim. A claim can be made to receive cashless treatment at a network hospital or to be reimbursed for costs incurred at a hospital that is not on the network. The steps for submitting a cashless claim and a reimbursement are listed below:

  1. Procedure for Filing a Senior Citizen Health Insurance Reimbursement Claim:

The procedures for filing a reimbursement claim under a senior health insurance plan are as follows:

  • Notify the insurance provider right away in the case of hospitalization.

  • Gather all medical records before leaving the hospital.

  • Sign and complete the claim form.

  • Send the claim form and all necessary supporting documentation, such as doctor’s prescriptions, pathological reports, chemist bills, and certificates of hospital admission and discharge, to the TPA or the insurer.

2. Cashless Claims Process for Senior Citizens’ Health Insurance:

If you receive medical care at a network hospital, you may be eligible for a cashless claim under a senior health insurance plan. Look at the following procedures:

  • Visit a hospital in the insurance company’s network while you’re there.

  • To obtain pre-authorization, complete the hospital’s available form and turn it into the hospital’s administrators.

  • To start the process of cashless hospitalization for the insured elderly person, the hospital will send the TPA a pre-authorization request, which must be approved by the insurance company or the claims team.

  • Once approved, they will receive treatment and be released.

  • The insurance provider will deal directly with the hospital to resolve the claim.

Tax Benefits of Senior Citizen mediclaime policy

A senior citizen health insurance plan not only guarantees coverage for medical costs but also enables you to take advantage of the section 80D tax exemption.

  • If you have a senior citizen medical insurance policy for your elderly parents, you may be eligible for a tax credit of up to Rs 50,000.

  • On payments made for preventive health checkups each fiscal year, you are also eligible for an additional tax credit of Rs. 5,000.

  • If the elderly person receives critical disease treatment, you may also be eligible for a rebate of up to Rs 1 lakh.

New India Assurance Senior Citizen Mediclaim Plan inclusion

The following list includes some of the typical coverage included in senior health insurance plans:

  • HospitalizationExpenses: 

Under this plan, hospitalization costs such as room and board, physician and nursing fees, the cost of medications and supplies, ICU fees, the cost of surgical supplies, and operating room fees are all covered.

 The cost of orthopedic implants, prosthetic devices, artificial limbs, and diagnostic tests that the senior citizen will need while in the hospital is also covered.

  • Treatments for Daycare- 

The majority of plans cover particular daycare procedures like chemotherapy, dialysis, and other procedures that don’t require more than 24 hours of hospitalization.

  • Pre- and post-hospitalization costs 

A senior citizen mediclaim policy also covers medical expenses incurred both before and after discharge from the hospital.

  • Cover for COVID-19 

A coronavirus treatment up to the predetermined limit is also covered by the policy.

  • Cost of organ donation 

The costs incurred by organ donors during transplants are typically covered by medical insurance policies.

  • The cost of an ambulance

 It pays ambulance costs up to the predetermined amount to take the insured to the closest hospital.

  • Diseases that already exist 

After a set waiting period, any pre-existing illnesses of the insured senior are also covered.

  • Cost of AYUSHTreatment 

Some senior citizen medical insurance policies also provide coverage for AYUSH treatment received in a facility or institute that has government recognition.

  • Hospitalization Coverage at Home- 

The elderly patient’s insurance company will cover the cost of a home hospitalization if the doctor recommends it for them.

The New India Assurance Senior Citizen Mediclaim Plan’s exclusions

The following medical costs are excluded from coverage by senior health insurance plans:

  • Existing illnesses or injuries

  • Cost of self-inflicted injuries or cost of suicide

  • Costs associated with drug or alcohol abuse and the treatment it requires

  • Conditions identified within 30 days of policy purchase (aside from accidental injuries)

  • Costs associated with alternative medicine treatments

  • The cost of medical care for injuries sustained as a result of civil war or military action by an outside force.

  • Cosmetic procedures

  • The price of getting new lenses or glasses unless they are necessary because of an accident.

  • The cost of AIDS treatment

  • It should be noted that each plan has a different list of exclusions.

FAQs – Senior Citizens’ Health Insurance

Q1. What are the benefits of purchasing senior health insurance?

Ans – The likelihood and severity of various illnesses also increase with age. As a result, older patients end up paying more for healthcare. However, elderly people frequently do not have a consistent source of income outside of their pension. With their limited income, it might be challenging to cover the cost of expensive medical care. Because of this, it is crucial that you purchase senior health insurance at this time.

Q2. What should I be on the lookout for in a senior citizen medical insurance policy?

Ans – Pre-policy medical exams are typically required, there is usually a limited amount of coverage, and there is typically a long list of exclusions.

Prior to purchasing a plan, you must thoroughly examine these factors. When purchasing the policy, you should also keep an eye out for details like the entry/exit age, maximum renewal age, co-payment, domiciliary treatment, etc.

Q3. What paperwork is needed to purchase a senior citizen medical insurance policy?

Ans – A senior citizen’s medical insurance policy purchase requires the following paperwork:

proof of age
Proof of identity
Proof of address
income evidence
filled out proposal form properly
health test results from before insurance, if any

Q4. Do I need to undergo medical testing before acquiring a senior health plan?

Ans – Yes, you might have to undergo a medical examination before purchasing the majority of senior citizen health plans.

Aged people are a bigger risk for the insurance company because they are more prone to serious illnesses and medical conditions. Therefore, the majority of insurance companies require the elderly applicant to undergo a medical examination in order to determine their health status and charge a premium accordingly.

Q5. Does every health insurance provider provide cashless hospitalization?

Ans – A cashless hospitalization option is available to customers of all Indian health insurance companies at the hospitals in their network.

Q6. Do seniors who switch their senior citizen health insurance plans receive continuity benefits?

Ans – Yes You are permitted to transfer your continuity benefits, such as the No Claim Bonus or cumulative bonus and waiting periods, to your new policy when you port your senior health insurance policy from one insurance provider to another. To ensure continuity benefits, you must, however, port to a plan with comparable coverage. Prior to purchasing any insurance, be sure to speak with the company to learn more about the terms and conditions of insurance portability.