Best Health Insurance for Senior Citizens in India
Getting the right health insurance for senior citizens in India is more important now than ever. Medical costs are rising, and most elderly people are left without financial protection. Nearly 98% of senior citizens do not have health insurance, leaving them vulnerable to expensive treatments. Only about one in five elderly individuals is covered, and even those with insurance often find it inadequate. With healthcare expenses being a leading cause of debt in urban areas, not having proper coverage can put both health and finances at risk.
The government has stepped in with initiatives like Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY), offering ₹5 lakh coverage for senior citizens aged 70 and above. But with 75% of the elderly dealing with chronic illnesses and a growing number facing multiple health conditions, private health insurance is just as crucial. Choosing the right plan can make a huge difference in getting access to good healthcare without financial stress.
In this blog, we will explore the best health insurance options for senior citizens in India, helping you find the right coverage for your needs.
Top 8 Best Health Insurance for Senior Citizens in India
| Features | Niva Bupa Senior First | ICICI Lombard Golden Shield | ManipalCigna Prime Senior | HDFC ERGO Optima Secure plan | Care Supreme | Bajaj Allianz Silver Health plan | Care Senior plan | Star Senior Citizen Red Carpet |
|---|---|---|---|---|---|---|---|---|
| Pre-existing Conditions (PED) Covered | PEDs are covered after a waiting period. | Yes, after a waiting period. | Yes, covers the cost of treating certain pre-existing conditions. | Yes. | Yes, with Instant Cover add-on for Diabetes, Hypertension, Hyperlipidemia, and Asthma. | Yes, after a waiting period | Yes, after a waiting period | Yes |
| Waiting Period for Pre-existing Conditions | A waiting period of 24 months of continuous coverage applies to pre-existing diseases. | 24 months of continuous coverage. | 24 months, with an option to reduce it to 90 days by opting for a waiting period reduction rider. | 36 months, unless specified otherwise in the policy schedule. Can be modified to 24 months or 12 months with an optional cover. | 36 months of continued coverage, but can be reduced with an add-on. | 12 months from the date of the first Silver Health policy | After 48 months of continued coverage. An optional cover is available to reduce the waiting period to 24 months | After 12 months of continuous coverage. |
| Coverage for Complications | Expenses related to the treatment of a Pre-existing Disease (PED) and its direct complications | Treatment of a pre-existing Disease (PED) and its direct complications | For donor: Complications arising during hospitalization or up to 30 days from discharge are covered up to 25% of SI, to a maximum of ₹2 Lacs, over and above the Sum Insured. | The plan covers hospitalization expenses , organ donor expenses , and AYUSH treatment. | The plan covers hospitalization and related expenses | The plan covers hospitalization expenses | The plan covers a wide range of treatments and surgeries | Pre-Existing Diseases (PED) and their complications are covered |
| Cashless Facility | 10000+ network hospitals | 10300+ Cashless Facility | 15000+ˇ Cashless | Available at 16,000+ network hospitals and healthcare service providers. | Yes, available at over 21600+ healthcare providers. | Yes, available at over 18,400+ network hospitals in India | Available at over 21600+ healthcare providers | 13500+ |
| Pre/Post Hospitalization | Expenses incurred on consultations, medicines, and diagnostic tests are covered for 60 days before admission and 180 days after discharge | Pre-hospitalisation expenses of up to 60 days & post-hospitalisation expenses of up to 180 days. | Prime Senior Classic: 30 days pre and 60 days post Prime Senior Elite: 60 days pre and 90 days post. Covered up to the Sum Insured. |
60 days pre-hospitalization and 180 days post-hospitalization coverage | 60 days pre-hospitalization and 180 days post-hospitalization coverage. | Medical Expenses Incurred during 30 days for Pre Hospitalization & 60 Days for Post Hospitalization | Pre-hospitalization: 30 days. Post-hospitalization: 60 days | Pre-hospitalization: Medical expenses incurred up to 30 days before hospitalization are covered Post-hospitalization: Medical expenses covered up to 7% of hospitalization expenses as per policy clause limits |
| Initial Waiting Period | Expenses related to the treatment of any Illness within 30 days from the first Policy commencement date shall be excluded except claims arising due to an Accident, provided the same are covered. | 30 days, though expenses related to certain illnesses within 90 days from the policy commencement date are excluded unless they were pre-existing and disclosed during underwriting; these illnesses include hypertension, diabetes, and cardiac conditions. | First 30 days from the Policy start date, for all Hospitalization due to Illnesses, except Accident. | Expenses related to the treatment of any illness within 30 days from the first policy commencement date shall be excluded except claims arising due to an accident | 30 days, except for accidental expenses. | Expenses related to the treatment of any illness within 30 days from the first Policy commencement date shall be excluded except claims arising due to an accident, provided the same are covered. | 30 days for any illness except injury; 2 years of continuous coverage | 30 days, except for accidents |
| Premium Range (Approx. Annual) | Premium starts from ₹ 13,453 /Yr | Not specified. | Prime Senior Classic: ₹18,983*/annum. Prime Senior Elite: ₹20,959*/annum. |
Premium depends on the city of residence | Not specified. | Not specified. | The premium amount depends on age, sum insured, number of insured persons, pre-existing diseases, and policy terms | INR 4,500 to INR 36,000 (excluding taxes) based on sum insured. Premium depends only on Sum Insured and does not increase with age |
| Coverage for OPD / Medication | Any expenses incurred on OPD treatment are not covered. | Out-patient consultations and pharmacy cover are available under the Care Management Plus Program. | Available as a rider with 3 flexible package options: Consultation only; Consultation and prescribed diagnostics; Consultation, prescribed diagnostics, and pharmacy (pharmacy limit is 20% of the OPD Sum Insured). | The HDFC ERGO Optima Secure health insurance plan doesn't cover outpatient department (OPD) expenses. However, the HDFC ERGO Day2Day Care plan does cover OPD expenses. | Care OPD add-on provides coverage for 4 general physician consultations and 4 specialist consultations (from a list of 14), with a maximum reimbursement of ₹500 per consultation. | Yes, the Bajaj Allianz Silver Health Plan covers out-patient department (OPD) charges and medication. This covers medical conditions that don't require hospitalization, such as dental checkups, eye tests, and fevers. | Optional OPD cover is available, providing coverage up to ₹50,000 for doctor consultations, diagnostics, and pharmacy expenses | Outpatient consultation at Network Hospitals is payable up to the limits mentioned in the policy clause. Limit of Rs.200 per consultation |
| Claim Settlement % (Overall) | 85.18% Claim Settlement Ratio | 98.53% | 90% (average of last 3 years) | 99% Claim Settlement Ratio | Not specified in the provided documents, but 48 Lakh+ insurance claims settled. | 93.30% | Not specified in the provided documents, but 48 Lakh+ insurance claims settled. | Not specified. |
| Unique Benefits | ReAssure Benefit, No sub-limits, Day-1 health checkup | Reset Benefit, Home care treatment, Vaccination incentives | Unlimited SI restoration (Elite), Annual health check-ups | 100% increase in SI after 2 years, No deductions on non-medical expenses | Cumulative Bonus Super (500% SI increase in 5 years), Unlimited Recharge | Respect Rider for emergency assistance, Family discount | Annual health check-ups, Second opinion for critical illnesses | Coverage for daycare procedures, Second opinion, Compassionate travel |
| Is Portability Available | Yes, as per IRDAI regulations | Yes, as per IRDAI regulations | Yes, as per IRDAI regulations | Yes, as per IRDAI regulations | Yes, as per IRDAI regulations | Yes, as per IRDAI regulations | Yes, as per IRDAI regulations | Yes, as per IRDAI regulations |
| Sum Insured (in ₹) | Gold: Sum insured options of Rs 5 lakh and Rs 10 lakh Platinum: Sum insured options from Rs 5 lakh to Rs 25 lakh (in multiples of Rs 5 lakh) |
Annual Sum Insured options include 5L, 10L, 15L, and 20L; and >20L. | Prime Senior Classic: ₹3 Lacs - ₹50 Lacs. Prime Senior Elite: ₹5 Lacs - ₹50 Lacs. |
5 Lakhs to 2cr, depending on the plan | 7 L, 10 L, 15 L, 25 L, 50 L & 1 Cr. | * Plan A: 50,000 to 5 lakhs * Plan B: 3 lakhs to 10 lakhs |
₹3L, ₹5L, ₹7L, ₹10L | 1,00,000 to 25,00,000 |
| Entry Age | 61 to 75 years. | Designed for individuals aged 60 and above. | Adult: 56 years (Min) to 75 years (Max). | 91 days and above | Adult: 18 to 99 years; Child: 90 days to 24 years | 46 to 80 years | Minimum: 61 years. Maximum: No upper age limit | 60 to 75 years; Lifelong renewability |
| Policy Type | Can be taken on individual or floater basis. Family combination: 1 Adult or 2 Adults (Self & Spouse). |
Maximum of 2 members can be enrolled in a single policy, covering self and spouse. | Individual/Multi-individual and family floater. | Individual and Family Floater. Individual policy can include a maximum of 6 adults and 6 children with separate sum insured individually. Family Floater can include a maximum of 4 adults and 6 children with a common sum insured | Individual (up to 6 persons) and Floater (2 adults and 2 children) | Individual and Floater options are available | Individual & Floater cover available | Available on an Individual or Floater basis |
| Policy Tenure | Information about the policy tenure is not found in the provided documents. | The sources do not contain specific details on policy tenure. | 1, 2, and 3 years (discount of 7.5% for 2 years and 10% for 3 years policy term with single premium payment mode). | 1 to 3 years | 1, 2, or 3 years | Up to 3 years | 1 year, 2 years, and 3 years A 10% discount is applicable for a 3-year policy |
1, 2, or 3 years |
| Refill / Restoration Benefit | The first paid claim triggers ReAssure, a benefit with unlimited sum insured. Maximum amount ReAssure benefit pays for any single claim is up to base sum insured. | 100% unlimited reset of Annual Sum insured in a policy year. | Prime Senior Classic: Not Available. Prime Senior Elite: Unlimited restoration of Sum Insured even for same illnesses. |
Yes. 100% of the base sum insured is restored automatically on partial or complete utilization of the sum insured. Unlimited restore add-on is also available | Unlimited Automatic Recharge of the sum insured in a policy year for related or unrelated illnesses | A cumulative bonus increases the sum insured automatically at renewal by 10% for each claim-free year, up to a maximum of 100% | Automatic recharge of sum insured is available once in a policy year | No Restoration Benefit |
| Room rent | Shared/Private room (10% co-pay for higher category) | Twin sharing (for SI <10L) / Private AC room (for SI 10L+) | Any Room up to Private AC Room | 1% SI per day (Lite plan), Private room (Select plan) | Up to SI | Private AC Room (discount for room rent limit) | 1% of SI per day | Max ₹10,000 per day |
| Co-payment | 0% to 50% (based on plan) | 50% (modifiable to 40%, 30%, 20%) | 20% (modifiable to 0%, 10%, 30%) | No co-pay | No co-pay | 10% (waivable for extra premium) | 20% for 61+ years (waivable) | 30% for all claims |
| Complementary wellness benefits | Day-1 checkups, Medicine & diagnostic test coverage | Teleconsultations, health check-ups, yoga/meditation | Unlimited teleconsultations, flexible health check-ups | Annual preventive health check-ups | Wellness Benefit discounts, unlimited e-consultations | Preventive health check-ups after claim-free years | Not specified | Annual check-ups up to ₹2,500 (individual) or ₹4,500 (floater) |
| No Claim Bonus | In case of a claim-free year, there is an increase of 10% of the expiring Base Sum Insured in a Policy Year; maximum up to 100% of Base Sum Insured In case of claim, no reduction in No Claim Bonus. | 10% cumulative bonus of the Annual Sum insured at the end of each policy year for a claim-free year. | Prime Senior Classic: 10% of Sum Insured as cumulative bonus every year maximum up to 100% (Bonus will not reduce in case of claim). Prime Senior Elite: 10% of SI for every year maximum up to 100%. |
Plus Benefit increases the base cover by 50% each year, up to 100%. Cumulative Bonus is available for 'Optima Suraksha', 'Optima Lite' and 'Optima Select' plans | Cumulative Bonus of 50% of SI per year, max up to 100% of SI. Also, Cumulative Bonus Super is available | Sum insured increases automatically at renewal by 10% if there is no claim in the expiring period, up to a maximum of 100% | A No Claim Bonus Super add-on is available to increase the sum insured amount by 50% for every claim-free year up to a maximum of 100% | A few senior citizens' health insurance policies increase the sum insured at the same premium because there are no claims in the previous policy year |
| AYUSH coverage | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes |
| ICU Charges | Covered | Covered | Covered | Covered | Covered | Covered | Covered | Covered |
| Donor Expenses | Covered | Covered | Covered | Covered | Covered | Covered | Covered | Covered |
| Domiciliary Hospitalization | Covered | Covered | Covered | Covered | Covered | Covered | Covered | Covered |
* Please read the disclaimer at the end of this page before purchasing this policy.
Our Top 5 Picks for Best Senior Citizens Health Insurance Policy
Choosing health insurance for senior citizens requires careful consideration. To help you decide, here are five health insurance policies that stand out for their coverage, benefits, and ease of claims.
ManipalCigna Prime Senior
This plan is designed for people aged 56 and above, offering coverage from ₹5 lakh to ₹50 lakh. It covers both hospital stays and outpatient care, making it a well-rounded choice for seniors.
Why It Stands Out
Unlimited sum insured restoration (Elite variant) means coverage is available even after multiple claims.
OPD coverage helps manage outpatient expenses, a feature not commonly found in senior citizen health plans.
Wellness and preventive care benefits support regular checkups and health monitoring.
High coverage options up to ₹50 lakh, which is useful for serious medical expenses.
Potential Limitations
Premium costs are on the higher side compared to budget-friendly plans.
A mandatory 20% co-payment increases out-of-pocket expenses.
The HDFC ERGO Optima Secure Plan is a good choice for those who want a policy that increases coverage over time without extra cost. The sum insured doubles within two years, making it a strong long-term option. It also covers non-medical expenses, which can reduce out-of-pocket costs during hospitalisation.
Why It Stands Out
The plan doubles the base sum insured immediately upon purchase without extra charges and increases it by 50% after one year and 100% after two years, regardless of claims made.
Unlike many senior citizen plans, this policy does not require a co-payment, reducing out-of-pocket expenses.
Covers non-medical expenses, ensuring higher claim settlements.
Access to a large hospital network with over 16,000 cashless facilities.
Potential Limitations
There is a 36-month waiting period for pre-existing conditions, which is longer compared to some other plans.
The plan does not cover outpatient department expenses, which could be a drawback for seniors requiring frequent consultations.
Care Supreme
Care Supreme is well-suited for seniors looking for a policy that adapts to their needs over time. With unlimited sum insured recharge and a high cumulative bonus, it provides increasing financial security. The plan also includes wellness benefits, making it a good choice for long-term healthcare planning.
Why It Stands Out
Ensures the sum insured is automatically recharged upon exhaustion, providing continuous coverage.
Includes benefits for outpatient consultations and wellness programs, supporting regular health maintenance.
Offers up to a 500% cumulative bonus, significantly increasing the sum insured over time.
Coverage options go up to ₹1 crore, making it a strong choice for those worried about critical illness costs.
Potential Limitations
Outpatient department coverage is not included by default and requires an additional premium.
Premium costs increase with higher coverage amounts, which may not be affordable for all.
Bajaj Allianz Silver Health Plan
For seniors needing coverage with the shortest waiting period for pre-existing conditions, this plan is worth considering. It also includes OPD benefits, making routine checkups more affordable. The Respect Rider add-on provides additional emergency assistance, which is helpful for elderly policyholders.
Why It Stands Out
Covers pre-existing diseases after just 12 months, allowing quicker access to benefits.
Includes outpatient department coverage, reducing out-of-pocket expenses for routine medical visits.
Respect Rider add-on provides emergency support, adding an extra layer of security.
Available for individuals up to 80 years of age, making it accessible for older seniors.
Potential Limitations
A 10% co-payment is applicable, requiring policyholders to share a portion of the medical costs.
Imposes limits on room rent coverage, which could lead to higher out-of-pocket expenses during hospitalisation.
Star Senior Citizen Red Carpet
For those looking for a budget-friendly health insurance plan, this one provides basic coverage at lower premium rates. It also offers OPD consultation benefits, which can help with regular medical expenses. While the sum insured options go up to ₹25 lakh, the plan does come with some cost-sharing requirements.
Why It Stands Out
Offers one of the most budget-friendly premium rates among senior citizen plans.
Provides coverage for pre-existing conditions after 12 months, offering peace of mind to those with existing health issues.
OPD consultation benefits help with routine medical expenses.
Sum insured options go up to ₹25 lakh, making it suitable for long-term care.
Potential Limitations
A mandatory 30% co-payment is required, which is higher than many other plans.
Limited wellness and preventive care benefits.
What is Senior Citizen Health Insurance?
Healthcare expenses rise with age, and medical emergencies can happen anytime. Senior Citizen Health Insurance is designed for people aged 60 and above, covering hospital bills, doctor consultations, tests, and treatments. It helps reduce the financial burden of medical care, so you or your parents don’t have to worry about sudden expenses.
Many policies cover pre-existing conditions after a waiting period. Some also offer benefits like cashless hospitalisation, free health check-ups, and home treatment coverage. Since medical costs are rising, having health insurance ensures that seniors get proper care without exhausting their savings. It’s a practical way to secure peace of mind and avoid last-minute financial stress during a health crisis.
How Regular Health Insurance Plans are Different from Senior Citizen Health Insurance Plans?
The main difference between Regular Health Insurance Plans and Senior Citizen Health Insurance Plans is who they are designed for. Regular plans cover individuals and families across all age groups, while senior citizen plans focus on those aged 60 and above, offering benefits tailored to their healthcare needs. Some other notable differences include:
| Features | Regular Health Insurance Plans | Senior Citizen Health Insurance Plans |
|---|---|---|
| Who Can Apply | Open to people of all age groups, including individuals, families, and corporate employees. | Specially designed for those aged 60 and above, keeping in mind their healthcare needs. |
| Cost of Premiums | Premiums are lower for younger applicants and gradually increase with age. | Since older individuals are at a higher risk of medical conditions, premiums are set at a higher rate. |
| Medical Tests Before Enrollment | Most plans do not require medical tests for younger applicants, though some insurers may ask for them after a certain age. | Medical tests are often necessary, especially for applicants above 45 or 55, to assess their health before issuing the policy. |
| Coverage for Pre-existing Illnesses | Health issues that existed before buying the policy are covered only after a waiting period, which differs by insurer. | These plans usually come with a shorter waiting period for pre-existing conditions, but the exact duration depends on the policy. |
| Coverage Amount (Sum Insured) | Various options are available, including lower coverage amounts suitable for young and healthy individuals. | Higher sum insured options are offered, as medical expenses tend to be higher for senior citizens. |
| Home-based Treatment (Domiciliary Hospitalisation) | Coverage depends on the policy terms. Some insurers offer it, while others don’t. | More commonly included, as older individuals may need treatment at home due to mobility issues or chronic conditions. |
| Hospitals for Cashless Treatment | Most regular plans come with a wide hospital network where policyholders can get cashless treatment. | Insurers highlight a broad hospital network with cashless facilities, ensuring that senior citizens can easily access medical care. |
| Preventive Health Check-ups | Some policies offer free health check-ups, but it is not always included. | Most plans include free health check-ups, helping in early detection of health problems. |
| Claim Process | Claim procedures vary by insurer. Some companies have faster settlements, while others may take longer. | Designed to be more straightforward, with strict timelines for claim approvals to avoid delays in medical care. |
| Age Limit for Buying the Policy | Age restrictions vary. Some plans allow entry until 65, while others may have lower limits. | Some insurers allow enrolment even after the age of 70, ensuring coverage for older individuals. |
| No-Claim Bonus (NCB) | If no claims are made in a year, the sum insured increases without raising the premium. | Similar benefit applies, allowing policyholders to get increased coverage over time. |
| Waiting Period for New Policies | Most plans have a waiting period before certain benefits start, depending on the insurer. | Waiting periods are often shorter for senior citizen benefits, considering their immediate healthcare needs. |
Why Having Health Insurance Matters for Senior Citizens?
As people get older, health problems become more common, and medical treatment can be expensive. A good health insurance plan helps seniors manage these costs without putting a financial burden on themselves or their families. Here’s why having health insurance is important:
Benefits of Senior Citizen Health Insurance
Getting a senior citizen health insurance offers you several benefits such as:
Protection from High Medical Costs
Healthcare expenses tend to increase as people get older, and treatments for illnesses like heart disease, cancer, and kidney problems can be expensive. A senior citizen health insurance policy covers a large part of these costs, making it easier to afford proper medical care. Some plans also offer critical illness add-ons, providing extra coverage for serious conditions.
Wide Range of Coverage
Most policies cover hospital stays, surgeries, doctor visits, and pre- and post-hospitalisation expenses. Some even include routine health checkups, helping in early detection of health issues. Regular checkups make it easier to manage conditions before they become serious.
Flexible Plans to Fit Your Needs
These policies can be customised based on personal requirements and budget. If you have pre-existing health conditions, you can choose an add-on that reduces the waiting period for coverage. Some plans also allow policyholders to upgrade benefits, like removing room rent limits for better hospital facilities.
Cashless Treatment at Partner Hospitals
Many insurers have tie-ups with hospitals where policyholders can receive treatment without making immediate payments. Instead of paying out of pocket and waiting for reimbursement, the insurance company settles the bill directly with the hospital. This makes hospitalisation stress-free and allows seniors to focus on recovery.
What Does Senior Citizen Health Insurance Cover?
By now, you might already know the basics of what’s covered under a senior citizen health insurance plan. But there’s a lot more to it. Here’s a closer look at what these plans usually include:
Hospitalization Expenses
Daycare Treatments
Pre and Post-Hospitalisation Costs
COVID-19 Treatment
Organ Donor Expenses
Ambulance Charges
Pre-Existing Disease Coverage
AYUSH Treatment Costs
Home Treatment (Domiciliary Hospitalisation)
What a Senior Citizen Health Insurance Plan Does Not Cover?
Before choosing a health insurance plan, it’s important to know what expenses won’t be covered. Every policy has its own set of exclusions, but here are some common ones you should be aware of.
How to Choose the Right Health Insurance for Senior Citizens in India?
Finding a good health insurance plan for senior citizens can be challenging, but the right choice can make medical care more accessible and affordable. Here are some things to consider when selecting a plan.
1
Shorter Waiting Period for Pre-Existing Diseases
Health issues are more common in old age, and many insurance plans have a waiting period before covering pre-existing conditions. Look for a plan that covers these conditions after a shorter waiting period, ideally one or two years, so that medical expenses are covered sooner.
2
Wide Network of Cashless Hospitals
Older adults may need hospitalisation more often. A plan with a large number of network hospitals allows them to get cashless treatment without worrying about payments. The insurance company directly settles the bill, reducing financial stress.
3
Free Medical Check-ups
Early detection of diseases can make treatment more effective. Some health insurance plans offer free medical check-ups, which can help in monitoring health regularly without additional expenses. Choosing a plan with this benefit ensures that necessary tests and screenings are taken care of.
4
No Claim Bonus for Increased Coverage
A no claim bonus increases the sum insured every year when no claims are made, without raising the premium. Over time, this can provide higher coverage, ensuring better financial protection for future medical needs.
5
No Co-Payment Requirement
Some senior citizen health insurance plans include a co-payment clause, where a fixed percentage of the medical bill must be paid by the insured person. This can be a financial burden. Choosing a plan without co-payment ensures that the entire hospital bill is covered by insurance.
6
Coverage for Home Treatment (Domiciliary Care)
Sometimes, medical treatment needs to be done at home due to a fragile health condition or unavailability of hospital beds. A plan that includes domiciliary hospitalisation covers these costs, allowing treatment to continue without the need for hospital admission.
7
Day Care Procedures Included
Not all medical treatments require a full-day hospital stay. Treatments like dialysis, chemotherapy, and radiation therapy are completed within a few hours. Choosing a policy that covers day care procedures ensures that these expenses are also reimbursed.
8
Lifetime Renewability
As people age, getting new health insurance becomes difficult and expensive. A plan with lifetime renewability allows senior citizens to continue their coverage without worrying about switching policies in their later years.
Disclaimer & Key Conditions
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