Senior Citizen Health Insurance in India

As a person’s age advances, the likelihood of experiencing minor or major health issues also rises. Without appropriate health insurance, this individual's retirement savings could face significant strain due to potential hospitalisations.

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Including a suitable health insurance policy for senior citizens becomes a necessary component of one's financial objectives. With a health insurance plan, you can get advantages such as extensive insurance coverage, cashless hospital admission, coverage for pre-existing conditions, and complimentary annual medical tests. These benefits collectively have the potential to result in substantial cost savings.

NRIs too, should buy NRI senior citizens health insurance plans for their ageing parents. Given the increasing availability of job opportunities that require onsite presence, individuals are relocating far from their families to pursue their careers.

Although this move abroad might appear appealing without apparent reservations, several factors warrant consideration before finalising such a move, with parental care standing out as a paramount concern.

The above plans and premiums are for AED 1,000,000 Sum insured for 1 Adult of 30 Years for Dubai city.
The above plans and premiums are for AED 1,000,000 Sum insured for 1 Adult of 30 Years for Dubai city.

An essential stride in ensuring your family’s well-being involves getting health insurance, and this holds true even for NRIs. In the forthcoming discussion, we will explore the feasibility of NRIs purchasing health insurance plans for their parents residing in India along with other crucial factors that merit attention.

However, prior to delving into these intricacies, it's beneficial to grasp some fundamental aspects of health insurance for senior citizens in India.

Features of Senior Citizen Health Insurance in India

Discussed below are the salient features of senior citizen health insurance plans in India -

  • Coverage for Pre-existing Conditions - As individuals age, they often begin to experience various health issues. These medical conditions that exist prior to obtaining an insurance policy are referred to as pre-existing diseases. Due to the higher likelihood of older individuals being diagnosed with certain ailments, it becomes crucial to secure a plan that includes coverage for these pre-existing conditions. With that said, keep in mind that these conditions not only affect the policy's premium but also impose a waiting period before the insurance coverage becomes effective.
  • Lower Co-payment Provisions - The clause involving co-payment refers to a predetermined percentage of expenses that the policyholder is required to contribute when filing an insurance claim. Opting for a policy with lower co-payment helps minimise the amount of money that one needs to pay out of their own pocket. This choice assists in preserving the policyholder's hard-earned savings.
  • Accumulated Bonus - The accumulated bonus is a useful feature that enhances the coverage of an insurance plan in instances where no claims have been filed. Since claims might not be made during every policy duration, the accumulated bonus helps in increasing the sum insured for the subsequent policy term. Having a senior citizen health insurance plan that offers an accumulated bonus feature serves to augment the assured sum of the policy whenever a claim is not raised.
  • Coverage for Pre and Post-Hospitalisation Expenses - While hospitalisation coverage is a standard component of senior citizen insurance plans, coverage for treatments before and after hospitalisation is equally important. Medical treatments following a surgical procedure hold significance. Similarly, the expenses incurred for medical examinations preceding these treatments can be substantial. For these reasons, incorporating coverage for pre-hospitalisation and post-hospitalisation treatments can prove to be advantageous.
  • Extended Entry Age - Health insurance designed for senior citizens is specifically designed to provide medical coverage to the elderly population. Consequently, these plans come with a higher entry age limit, which can extend up to 70 years. Owing to this elevated entry age limit, individuals can usually purchase this type of policy after they retire from active employment.
  • Preventive Health Check-ups - Given that age-related health concerns tend to arise as one gets older, early detection becomes essential. The inclusion of preventive check-up features in senior citizens' coverage assists in identifying such health issues promptly. 

With that said, it’s worth noting that the outcomes of these preventive health check-ups frequently influence the insurance premium rates

Benefits of Senior Citizen Health Insurance in India

Listed below are the salient benefits of health insurance for senior citizens in India -

  • Coverage for Elderly Individuals: Individuals aged 60 and above can receive health coverage through senior citizen health insurance schemes, as typical family health insurance plans tend to offer coverage only up to 65 years of age.
  • Exemption from Pre-medical Screening: Unlike standard plans, senior citizen health insurance plans usually don’t mandate elderly individuals to undergo medical screenings before procuring the policy.
  • Inclusive of Hospitalisation Expenses: These policies provide comprehensive coverage to senior citizens, encompassing a wide array of medical expenses such as pre-hospitalisation, post-hospitalisation, and in-patient hospitalisation costs.
  • Cashless Treatment: Senior citizens are eligible for cashless medical treatment at the insurance company's network hospitals, provided their hospital stay exceeds 24 hours.
  • Benefit of No Claim Bonus: These policies offer a no-claim bonus to senior citizens, granting them a renewal premium discount or increase in the policy’s limit for each year without any claims. 

Option for Lifetime Renewability: Most health plans designed for senior citizens include the option for lifelong renewability.

Inclusions for Senior Citizen Health Insurance in India

Here are some of the common coverage features provided under senior citizen health insurance plans -

  • Hospitalisation Costs Coverage - This type of health insurance includes the coverage of expenses related to hospitalisation. These expenses encompass various aspects such as charges for hospital rooms, fees for medical practitioners and nurses, expenses for medications and prescribed drugs, charges for utilising the ICU, costs associated with surgical instruments, and fees for using the operation theatre. These plans also extend their coverage to include expenses for artificial limbs, orthopaedic implants, prosthetic devices, diagnostic tests, and other necessary medical services that are incurred during the hospital stay of the senior citizen.
  • Daycare Procedures Coverage - A majority of plans also provide coverage for specific medical procedures that fall under the category of daycare treatments. These treatments are characterised by hospitalisations of less than 24 hours, examples of which include chemotherapy, dialysis, and similar procedures.
  • Pre and Post-hospitalisation Expenses - Medical costs before getting hospitalised and after getting discharged are also included under a senior citizen health insurance policy.
  • COVID-19 Cover - The policy also pays for the cost of treatment for COVID-19 up to the specified limit.
  • Organ Donor Expenses - Most health insurance plans cover the donor expenses incurred during organ transplants. 
  • Ambulance Fees - These policies include the expenses associated with transferring the insured individual to the nearest hospital via ambulance, up to the designated cap.
  • Pre-existing Medical Conditions - Senior citizen health insurance also provides coverage for pre-existing medical conditions of the senior citizen policyholder after a predetermined waiting duration.
  • Cost of AYUSH Treatment - Certain senior citizen health insurance plans in India extend their coverage to AYUSH (Ayurveda, Yoga and Naturopathy, Unani, Siddha, and Homeopathy) treatments received at hospitals or institutions recognised by the government.
  • Domiciliary Hospitalisation Cover - If the doctor suggests home treatment for the elderly person, the latter’s insurance provider can pay for domiciliary hospitalisation expenses as well.

Exclusions for Senior Citizen Health Insurance in India

Listed below are the standard exclusions for senior citizen health insurance plans in India -

  • Pre-existing medical conditions prior to the waiting period
  • Medical expenses incurred due to self-harm or suicide attempt
  • Medical expenses for accident and harm due to the influence of alcohol or drugs
  • Non-allopathic treatments (unless specified in the policy)
  • Aesthetic and cosmetic surgeries
  • Injuries due to act of war or a civil war
  • Diseases diagnosed within 30 days of purchasing senior citizen health insurance in India
  • Dental and optical treatments

Things to Consider When Buying Health Insurance for NRI Parents in India

Here are the things you should consider when buying parents' health insurance plans - 

  • Daycare Treatments - With the progression of medical technology, numerous medical treatments and surgeries can now be conducted through daycare procedures. However, under a standard health insurance policy, senior citizens must be hospitalised for at least 24 hours to initiate a claim. For this reason, selecting a senior citizen plan that encompasses various daycare procedures such as dialysis, chemotherapy, and radiotherapy would be a more advantageous choice.
  • Cashless Hospitals - Within the scope of each health insurance provider lies an extensive network of hospitals, affording individuals the convenience of cashless hospitalisation services. It is prudent to review the roster of network hospitals associated with one's chosen insurance company before finalising a plan purchase. This ensures awareness regarding the inclusion of reputable local hospitals in the network. 
  • Efficiency and Settlement of Health Insurance Claims - When getting a senior citizen health policy, one should also evaluate the insurance company's claim settlement ratio and the duration taken for claim settlement. A higher claim settlement ratio coupled with a shorter settlement timeframe signifies an increased likelihood of swift claim resolution.
  • No-Claim Bonus - Nearly all insurance providers extend a discount as a no-claim bonus if policyholders refrain from filing claims in the preceding year. In such instances, the policy premium may decrease or the insured sum might see an increase.
  • Free Medical Health Check-up Facility - Premier health insurance plans for senior citizens extend the privilege of annual complimentary medical check-ups to policyholders. This provision typically becomes accessible after the fulfilment of specific policy terms or after every 2 or 3 claim-free years.
  • Co-payment - Numerous senior citizen health plans incorporate a co-payment stipulation. This condition requires policyholders to contribute a portion of the claim amount — the insurance company covers only the residual segment of the claim sum. Opting for a plan featuring minimal to zero copayment is advisable.
  • Policy Renewability - It is advisable to seek out a top-tier health insurance plan that presents the option of lifelong renewability. This ensures that there is no need to procure another health plan during the twilight years. A policy that terminates renewal, particularly post 60 years of age, is ill-suited for senior citizens.
  • Pre-Existing Diseases Waiting Period - Considering that elderly individuals are more prone to harbouring pre-existing health conditions, the treatment of which could deplete their savings, it is judicious to select a senior citizen health insurance plan that incorporates a limited waiting period for pre-existing ailments.
  • Domiciliary Hospitalisation - Circumstances may arise wherein an elderly individual's health condition precludes hospitalisation. In such scenarios, health plans inclusive of domiciliary hospitalisation coverage will finance home-based treatment expenses, as long as a qualified medical practitioner has recommended such an approach.

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Can NRIs Buy Health Insurance Plans for Parents Living in India?

A major concern of Non-Resident Indians (NRI), residing or working abroad, is the well-being of their parents situated in India. In this case, even the slightest health ailment can lead to distress when one is separated by miles from their parents.

Comprehensive health insurance coverage can play a pivotal role in safeguarding both the family's health and financial stability. However, a query immediately arises -

Can an NRI purchase health insurance for their parents residing in India?

The answer is affirmative – the process of procuring health insurance for the parents of NRIs is as uncomplicated and straightforward as it is for Indian residents!

By obtaining health insurance for their parents, NRIs can ensure that their family receives timely and excellent medical treatment during situations of medical emergencies. For NRIs aiming to secure health insurance for their parents in India, the option to purchase a policy online is available as well. 

It is essential to be aware of certain crucial details before finalising the purchase of health insurance for parents in India -

  • The premium of the health insurance policy can be settled either in Indian Rupees (INR) or in a foreign currency.
  • The payment of the premium can be facilitated through an NRE/NRO account held with an Indian bank. In this case, NRIs have the flexibility to make use of direct remittances as well as payments via cheque or draft.
  • Claim settlements are solely conducted in Indian currency.
  • While the majority of health insurance policies in India extend coverage exclusively within the country, those seeking coverage beyond India's borders should opt for a plan that encompasses international coverage.

Benefits of Purchasing Health Insurance Plans for NRI Parents 

Health insurance plans play a crucial role for individuals residing independently in India. They serve to safeguard not just their financial well-being but also ensure access to excellent medical treatment from affiliated hospitals in times of necessity.

Check out the key benefits of NRI parents health insurance plans -

  • Fighting Inflation - The heightened life expectancy witnessed in recent decades also requires consideration on the healthcare side. Skyrocketing medical costs have become a significant concern, particularly in the elderly phase of life, when numerous instances requiring costly medical interventions are likely to occur. During such circumstances, possessing a health insurance policy can provide a safety net for one's savings.
  • Saving pension for future - If one's parents are pensioners, it is advisable to safeguard the pension funds for their personal expenditures. Given the inevitability of medical emergencies that can deplete a substantial portion of savings, it is a prudent choice to possess health insurance coverage.
  • Enabling self-reliance in parents during unforeseen circumstances - A considerable segment of the Indian population lacks access to pension benefits. In such scenarios, elderly parents often rely heavily on their earning children or their lifelong savings. Health insurance can play a pivotal role in shielding savings from the financial impact of medical crises in such cases. Moreover, the availability of cashless insurance empowers parents to effortlessly access healthcare even in the absence of their children.
  • Creating a financial net of savings -  Settling medical bills can be an arduous task, exerting a significant strain on savings earmarked for planned endeavours. Moreover, these health-related emergencies can arise even when one doesn’t anticipate them. By securing a health insurance policy, one can navigate such difficult situations and ensure that their financial plans and moments of happiness remain unaffected.

Factors to Consider When Purchasing NRI Senior Citizen Health Insurance in India

Detailed below are some factors to consider before buying NRI senior citizen health insurance -

  • Age Limitation - The individual should examine the age restrictions relevant to the various policies being compared. Some policies impose an upper age limit of 65 years while others may have no such restrictions. It is advisable to choose a policy that is relevant to the age of one's parents and provides the option of lifelong renewal, ensuring continuous medical coverage throughout their lives.
  • Coverage - The extent of coverage, denoted as the insured sum, must be evaluated. Alongside a higher insured sum, it's essential to review the deductible and copayment requirements that the policyholder must fulfil during the claims process. The medical conditions of the parents and their anticipated future medical expenditures should also be taken into account before settling on an appropriate insured sum. Ultimately, it is recommended to select a coverage amount that adequately addresses one’s medical necessities.
  • Waiting Period - The waiting period for pre-existing conditions or specific illnesses within a health insurance policy should be checked. Opting for a policy with the shortest waiting periods is advisable, as this minimises the waiting time for parents to make a claim if the need arises.
  • Policy Inclusions and Exclusions - The policy's inclusive and exclusive features must also be examined. Certain inclusions like coverage for outpatient procedures, daycare treatments, free annual health checkups, and AYUSH treatments should be integrated into the health insurance coverage for one's parents.
  • Cashless Facility - The list of network hospitals offering cashless services should also be reviewed. Selecting a plan with network hospitals situated close to the parents' place of residence ensures convenient access to medical services without much travelling or the need for upfront payment.
  • Sub-Limits - Opting for a plan with minimal or no sub-limits is preferable. Sub-limits denote a cap on the insurer's liability for expenses such as room-rent limits.
  • Efficient Claim Settlement - The efficiency of claim settlement holds significant importance. It is recommended to choose an insurance provider with a reputable history of promptly and seamlessly settling claims.

A swift and uncomplicated claim settlement procedure can greatly impact the ease of managing medical expenses when the need arises.

Here are some quick questions related to NRI senior citizens health insurance.

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Frequently Asked Questions

Q1. Can NRIs purchase health insurance plans for their families in India?

Ans: Yes, non-resident Indians (NRIs) have the option to purchase health insurance intended for their families residing in India. This coverage encompasses their marital partner and children who rely on them as well as parents who are financially dependent on them.

Q2. Can NRIs file a health insurance claim for parents?

Ans: NRIs can claim health insurance for their parents in India. The necessary procedure involves notifying the Indian insurance provider regarding the hospitalisation and furnishing the mandatory paperwork.

In instances of cashless treatment, the insurance company will directly settle the medical expenses with the affiliated hospital. Alternatively, if reimbursement claims are applicable, the insurance company will compensate the insured individuals for their incurred expenses after proper verification.

Q3. Do all health insurance plans in India cover the medical expenses for NRIs?

Ans: Health insurance companies provide coverage for medical expenses incurred in India for Non-Resident Indians. Nevertheless, in recent times, a couple of insurance providers have initiated coverage for medical costs in foreign countries as well, subject to specific terms and conditions.

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