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Health Insurance for Senior Citizens

About Care for Senior Citizen Health Insurance

Healthcare cost in India is increasing at 20 % every year. Therefore, the need for adequate health cover has attained the importance in not just during the working life of an individual, but even after retirement. A health insurance for senior citizen is a health insurance policy that offers medical coverage to individual above 61 years. Some of the unique benefits of senior citizen medical insurance include cashless hospitalization, no pre-policy medical check-up, pre-existing diseases cover, annual health check-up, and day care expenses.

Introducing Care for Senior Citizens

Don’t let age stop you from enjoying life to the fullest. Presenting Care for Senior Citizens, a comprehensive health insurance plan. Let age be just a number and nothing more than that. It’s finally time for you to relax and enjoy the most peaceful years of your life. However, this is an alarming age that requires more caution of health. Post-retirement life comes with a bounty of expectations - for the shackles of the daily grind are gone and one can finally dedicate their time to the things they love! Our parents and elderly relatives can get the best out of this phase if they are in good health and they are reassured by their health insurance plans. This is why we have specially curated mediclaim for senior citizen individuals who are aged above 61 years of age. This health insurance plan for senior citizens includes an annual check-up, tax savings, floater and individual cover, and of course, a servicing team that empathizes and guides you at every step.

Key Features of Care for Senior Citizen Health Insurance

A medical uncertainty can knock your door anytime and with Care for Senior Citizen you can protect your parents or elderly loved ones with the best health care facilities without worrying about finances.

  • Individual or floater cover
  • Cover pre and post hospitalization expenses
  • No pre-policy medical check-up
  • Annual health check-up for all insured person
  • Automatic recharge of Sum Insured
  • Lifelong renewability
  • Under section 80 D, tax benefits up to INR 50000/-

Factors to consider while buying Mediclaim policies for Senior Citizen

Below are the important points that should be taken into consideration while you are planning to buy senior citizen health insurance plan:

  • Affordable- Due to growing age and limited income, it is advisable to buy affordable senior citizen health plan through which one can afford medical expenses without overburdening their children financially. Care for Senior Citizen is an ideal and affordable plan that helps elderly people to stay healthy without worrying about additional medical expense.
  • Convenience and Ease of Purchase- you or your elderly parents do not need to go anywhere and can buy policy online with few clicks. Read the features, benefits, coverage, claim process, policy T & C on the website or download the brochure to get every detail about the plan. With us, the process of getting insurance for senior citizens is quick and easy.
  • Coverage - It is recommended to opt for a plan that offers maximum coverage with minimum limitations. Care for Senior Citizen is ideal for senior citizens as it offers comprehensive coverage for pre and post hospitalization, day care treatments, annual health check-up, second opinion, AYUSH treatments and many more benefits.

Why do you need Cover for Senior Citizens?

  • Cost of medical treatment in India is always on the rise. Health insurance for Senior Citizen can ensure that an unfortunate ailment at old age does not impact your finances and assist you to beat medical inflation.
  • Day Care Costs which arises for special procedures
  • Ambulance coverage reduces the impact of miscellaneous costs that are incurred
  • Senior Citizen Health Insurance Plan includes annual health check-ups to keep track of your health
  • Coverage for alternative treatment takes into account the latest practices wherein treatments combine multiple disciplines
  • Pre-existing diseases are covered subject to terms and conditions of the policy

Tax Benefits of Care for Senior Citizens Health Insurance Plan

This Senior Citizen Health Plan not only provides assurance of multiple health benefits but also entitles you to avail tax exemption under section 80D of the Income Tax Act, 1961.You are eligible for an income tax rebate up to Rs. 50,000 if you hold a mediclaim policy for senior citizens for your elderly parents. Additionally you can avail additional rebate of Rs 5,000 for preventive health check-up done apart from Annual check-up covered in policy.*

Things to keep in mind while buying Senior Citizen Health Plan

Purchasing a health insurance plan for the senior citizen is always a wise decision to opt for and avoid uncertainties of medical costs due to sudden illness. Unique Annual health check-up feature helps you to monitor health yearly.

Let’s consider the factors which one should keep in mind while buying senior citizen health insurance.

  • Co-payment - Copay is the fixed percentage of the claim amount that an insured has to pay from his own pocket for every covered services claim. We offer only 20% co-payment clause on every claim under senior citizen plan, rest will be paid by us.
  • Expenses covered: It covers a wide spectrum of medical expenses including in-patient hospitalization, pre and post hospitalization, day care treatments, ICU charges, daily allowance and many more.
  • Waiting Period for Pre-Existing Conditions: It is the time period that must elapse before coverage can begin. It depends on the insured’s medical history and other related factors; in case of pre-existing ailments, the waiting period is 4 years.
  • Sub-limits: It is the limit placed by the insurance company on the health insurance claim. It is usually applicable to services such as room rent, ambulance charges, and certain medical procedures.
  • Additional Features: While choosing health insurance plans for parents . you should also check additional features. We offer additional features such as coverage to alternative treatments, annual health check-up, second opinion etc.
  • No Claim Bonus: Care for Senior citizen health insurance offers 10% increase in Sum Insured for every claim-free year. Up to 150% increase in sum insured with No Claim Bonus & No Claim Bonus Super(optional Super)

Claim Settlement Process of Care for Senior Citizens

In the case of emergency, intimate our customer support team within 24 hours of hospitalization. If it is a planned hospitalization, then you have to inform us 48 hours before hospitalization. Below are the simple steps to file the claim:

Cashless Hospitalization Claim Process :
  • Submit the pre-authorization form and submit it to the hospital insurance desk.
  • An approval letter will be sent from the side of our claim management team
  • If required, a query might be raised from the side of our claim management team.
  • After the approval, your bills will be directly paid to the hospital.

Reimbursement Claim Process :
  • Submit the Health Insurance claim reimbursement form and attach all the required documents along with the form
  • Our claim management team may raise a query if required
  • An Approval letter will be sent by the claim management team
  • Submit a medical certificate issued by the hospital/doctor
  • Duly submit the claim form to us
  • Submit the discharge form issued by the hospital/doctor
  • We will communicate in case of any rejection.

Exclusions under Care for Senior Citizen Health Insurance Policy

Exclusions are the diseases that are not covered under the policy. Read the common exclusions for a senior citizen mediclaim policy:

  • Self-Inflicted Injury: Expenses attributable to self-inflicted injury such as suicide, attempted suicide, etc.
  • Injuries Due to Consumption of Alcohol: Expenses arising out of or attributable to alcohol or drug use/misuse/abuse.
  • Transmitted Diseases: Medical expenses incurred for the treatment of AIDS and other transmitted diseases.
  • Pregnancy Treatment: Treatment arising from or traceable to pregnancy and childbirth, miscarriage, abortion, and its consequences.
  • Infertility Treatment: Tests and treatment relating to infertility and in vitro fertilization cannot be claimed.
  • Permanent Exclusions: War, riot, strike, and nuclear weapons induced hospitalization are considered as permanent exclusions.
  • Cosmetic Surgery: Plastic surgery, cosmetic treatment, and implants are also not covered under an insurance policy.
Plan Name Care 8 Care 9

Sum Insured (SI) – on annual basis (in Rs.)

3 Lacs 5 Lacs \ 7 Lacs \ 10 Lacs

Age of Proposer

18 years or above 18 years or above

Entry Age – Minimum

Individual: 61 years and above
Floater: 2 Adult (Self, Spouse, Father, Mother)
Individual: 61 years and above
Floater: 2 Adult (Self, Spouse, Father, Mother)

Entry Age – Maximum

Lifelong Lifelong

Exit Age

Lifelong Lifelong

Cover Type

Individual : Maximum up to 6 Persons
Floater : 2A (Self, Spouse, Father, Mother)
Individual : Maximum up to 6 Persons
Floater : 2A (Self, Spouse, Father, Mother)

Pre-policy Issuance Medical Check up

Yes, as per Annexure – 1 Yes, as per Annexure – 1

Hospitalization Expenses

- In-Patient Care

up to SI up to SI

- Day Care Treatment

up to SI up to SI

Pre-Hospitalization Medical Expenses and Post-Hospitalization Medical Expenses

Pre-Hospitalization for 30 days & Post-Hospitalization for 60 days; Maximum up to SI Pre-Hospitalization for 30 days & Post-Hospitalization for 60 days; Maximum up to SI

Daily Allowance

Rs. 500 per day; Max. 5 days per hospitalization covered

Ambulance Cover

Up to Rs 1,500 per hospitalization Up to Rs 2,000 per hospitalization

Organ Donor Cover

Upto Rs.50,000 Upto Rs.1 Lac

Domiciliary Hospitalization

Up to 10% of SI if domiciliary hospitalization exceeds 3 days Up to 10% of SI if domiciliary hospitalization exceeds 3 days

Automatic Recharge

Up to SI (Once in a Policy Year) Up to SI (Once in a Policy Year)

Second Opinion

Once per Major Illness / Injury per policy year Once per Major Illness / Injury per policy year

Alternative Treatments

Up to Rs 15,000 Up to Rs 20,000

No Claims Bonus (NCB)

10% increase in SI per Policy Year in case of claim-free year; Max up to 50% of SI (10% decrease in SI per Policy Year in case a claim has been paid; Such decrease is only in SI accrued as NCB) 10% increase in SI per Policy Year in case of claim-free year; Max up to 50% of SI (10% decrease in SI per Policy Year in case a claim has been paid; Such decrease is only in SI accrued as NCB)

Annual Health Check-up

Annual Annual
OPTIONAL COVERS

No Claims Bonus Super (NCBS)

50% increase in SI per Policy Year in case of claim-free year; Max up to 100% of SI (50% decrease in SI per Policy Year in case a claim has been paid; Such decrease is only in SI accrued as NCBS) 50% increase in SI per Policy Year in case of claim-free year; Max up to 100% of SI (50% decrease in SI per Policy Year in case a claim has been paid; Such decrease is only in SI accrued as NCBS)

Smart Select

For listed Hospitals : Up to SI; Other Hospitals : Up to SI with an additional co-payment of 20% per claim For listed Hospitals : Up to SI; Other Hospitals : Up to SI with an additional co-payment of 20% per claim

OPD Care (Please refer to point 4 of the Notes below)

5K 10K
Wait Periods, Sub-Limits and Co-Payment

Initial Wait Period

30 Days 30 Days

Named ailments

24 months 24 months

Pre-existing Diseases

48 months 48 months

Room Rent / Room Category

Up to 1% of SI per day Single Private Room (Max. Up to 1% of SI per day)

ICU Charges

Up to 2% of SI per day Up to 2% of SI per day

Treatment of Cataract

Up to Rs. 20,000 per eye Up to Rs. 30,000 per eye

Treatment of Total Knee Replacement

Up to Rs. 80,000 per knee Up to Rs. 1 Lac per knee

Treatment for each and every Ailment / Procedure mentioned below:-
i. Surgery for treatment of all types of Hernia
ii. Hysterectomy
iii. Surgeries for Benign Prostate Hypertrophy (BPH)
iv. Surgical treatment of stones of renal system

Up to Rs. 50,000 Up to Rs. 65,000

Treatment for each and every Ailment / Procedure mentioned below:-
i. Treatment of Cerebrovascular disorders
ii. Treatments / Surgeries for Cancer
iii. Treatment of other renal complications and Disorders
iv. Treatment for breakage of bones

Up to Rs. 2 Lacs Up to Rs. 2.5 Lacs

Co-payment (Please refer to Notes 1, 2, 3 for further details)

20% per claim, where age of Insured / eldest member is 61 years or above (Optional for existing Insured Person on attaining 61 years of Age) 20% per claim, where age of Insured / eldest member is 61 years or above (Optional for existing Insured Person on attaining 61 years of Age)

Tenure

1 Year / 2 Years / 3 Years 1 Year / 2 Years / 3 Years

Note:-

  1. The Co-payment proportion (if applicable) shall be borne by the Insured Person on each Claim which will be applicable on Benefits namely Hospitalization Expenses, Pre Hospitalization Medical Expenses and Post Hospitalization Medical Expenses, Ambulance Cover, Organ Donor Cover, Domiciliary Hospitalization, Alternative Treatments, Care Anywhere, Global Coverage (excluding U.S.A.), Vaccination Cover, Global Coverage Total, Extension of Global Coverage, Maternity cover, Air Ambulance Cover and Additional Sum Insured for Accidental Hospitalization.
  2. At the time of issue of the first Policy with the Company, if Age of Insured Person or eldest Insured Person (in case of Floater) is 61 Years or above, such Insured Person or all Insured Persons (in case of Floater) shall bear a mandatory Co-payment of 20% per Claim (over & above any other co-payment, if any) and the Company’s liability shall be restricted to the payment of the balance amount subject to the available Total Sum Insured.
  3. On attaining 61 years of Age by an existing Insured Person or eldest Insured Person (in case of Floater), the Company provides an option to Insured Person / Policyholder, only on subsequent renewal, to choose for co-payment option of 20% per claim (over & above any other co-payment, if any) which applies to such Insured Person or all Insured Persons (in case of Floater) and thereby get a discount of 20% in Premium to be paid. The Company’s liability shall be restricted to the payment of the balance amount subject to the available Total Sum Insured
  4. Coverage for Optional Cover ‘OPD Care’ is provided for entire Policy year and is available to all the Insured members in a Floater Policy type along with Individual Policy type. All the valid OPD claim expenses incurred by the Insured Person in a policy year will be payable / reimbursed by the Company. However, claim can be filed with the Company, only twice during that Policy year, as and when that Insured Person may deem fit.

Annexure – I

Sr. No. Insured Events % of coverage amount of the Insured Person under this Optional Cover
1 Total and irrecoverable loss of sight of both eyes, or of the actual loss by physical separation of two entire hands or two entire feet, or one entire hand and one entire foot, or the total and irrecoverable loss of sight of one eye and loss by physical separation of one entire hand or one entire foot 100%
2 Total and irrecoverable loss of (a) use of two hands or two feet, or (b) one hand and one foot, or (c) sight of one eye and use of one hand or one foot 100%
3 Total and irrecoverable loss of sight of one eye, or of the actual loss by physical separation of one entire hand or one entire foot 50%
4 Total and irrecoverable loss of use of a hand or a foot without physical separation 50%
5 Paraplegia or Quadriplegia or Hemiplegia 100%

Note: For the purpose of Sr. No. I to IV above, physical separation of a hand or foot shall mean separation of the hand at or above the wrist, and of the foot at or above the ankle.

For the purpose of this Benefit only:
(i) “Hemiplegia” means complete and irrecoverable paralysis of the arm, leg, and trunk on the same side of the body
(ii) “Paraplegia” means complete and irrecoverable paralysis of the whole of the lower half of the body (below waist) including both the legs
(iii) “Quadriplegia” means complete and irrecoverable paralysis of all four limbs.

Annexure II - Basis of treatment of Optional Covers

Optional Covers Pay-out Basis Individual / Floater SUM INSURED AND IMPACT ON BASIC / MEDICAL SUM INUSRED
1.No Claims Bonus Super Indemnity Individual / Floater 50% increase in Basic / Medical SI per Policy Year in case of claim-free year; Max up to 100% of SI.
2.Smart Select Indemnity Individual / Floater Coverage up to Basic / Medical SI applicable in listed hospitals (coverage to non-listed hospitals with a co-payment)
3.OPD Care Indemnity Individual / Floater Separate SI- claim doesn’t impact the Basic / Medical SI

About Religare Health Insurance

Religare Health Insurance is a leading player in the health insurance segment in India. We are committed to providing senior citizens a comfortable life by delivering customised health insurance plans keeping in view the possibilities of age-related illnesses and likely expenditures. We are committed to delivering impeccable services by providing health insurance & specific geographic travel insurance while guaranteeing the benefits of hassle-free claims procedures.

Call:1800-102-4488|1800-102-6655

Disclaimer: Information above is just for reference. For more details on risk factors, terms and conditions please read sales brochure carefully before concluding a sale.

UIN: IRDAI/HLT/RHI/P-H/V.II/253/16-17. UAN2: 18032484.

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