Health Insurance Plans for Senior Citizens
Senior health insurance provides financial protection for individuals aged 60 and above, covering medical expenses like hospitalization, critical illness, pre-existing conditions, and regular check-ups. These plans ensure timely access to quality healthcare without financial strain.
Recent Policy Developments
- IRDAI Guidelines (2025): Premium hikes for senior policies are now capped at 10% per year unless approved by IRDAI.
- PMJAY Expansion (2024): Free health insurance of ₹5 lakh extended to all citizens aged 70+ under AB-PMJAY.
Key Benefits
- Coverage Beyond 60: Covers seniors even when general family plans don’t.
- Cashless Treatment: Access to cashless care at partner hospitals for 24+ hour admissions.
- No Medical Screening (in most plans): Many policies waive pre-policy health tests.
- No Claim Bonus: Discounts on renewal for claim-free years (up to 100%).
- Lifetime Renewability: Continue your plan without age limit restrictions.
- Tax Benefits: Deduction of up to ₹75,000 under section 80D.
What’s Covered?
- Hospitalization costs including ICU, surgery, tests, implants, and medicines
- Pre & post-hospitalization medical expenses
- Daycare procedures like chemotherapy, dialysis
- COVID-19 related expenses
- Organ donor costs
- Ambulance charges
- Coverage for pre-existing diseases (after a waiting period)
- AYUSH (alternative treatment) in approved centers
- Domiciliary (home-based) treatment if hospital admission isn’t possible
What’s Not Covered?
- First 30 days (except accident-related treatment)
- Self-harm, suicide, or drug/alcohol abuse
- AIDS-related treatment
- Cosmetic/dental treatments not caused by an accident
- Treatments from unrecognized centers or war-related injuries
What to Check Before Buying
- Shorter waiting periods for pre-existing conditions
- Low or no co-payment clauses
- Coverage of daycare procedures and domiciliary care
- Availability of free annual checkups
- Good claim settlement track record of insurer
- Cashless hospital network near your location
- Option for lifetime renewability
How Claims Work
Cashless Process:
- Get admitted at a network hospital
- Submit pre-authorization form through hospital
- Insurer approves treatment costs
- Hospital gets paid directly by insurer
Reimbursement Process:
- Notify insurer about the hospitalization
- Collect bills and reports during discharge
- Submit claim form and documents
- Insurer verifies and reimburses eligible amount
Tax Benefits
Premiums paid for senior citizen health insurance are eligible for tax deductions:
- Up to ₹50,000 per year for individual coverage under Section 80D
- Extra ₹25,000 if the policyholder is also paying for children’s insurance
- ₹5,000 additional deduction for preventive checkups
Sample of Popular Plans
| Plan Name |
Entry Age |
Sum Insured |
Co-payment |
Pre-policy Checkup |
| Aditya Birla Activ Care |
55–80 years |
₹3L – ₹25L |
10%–20% |
Required |
| Bajaj Allianz Silver Health |
46–80 years |
₹50K – ₹10L |
10%–20% |
Required |
| HDFC ERGO Optima Senior |
61+ years |
₹2L – ₹5L |
15%–30% |
Required |
| Manipal Cigna Prime Senior |
56–75 years |
₹3L – ₹50L |
20% |
Not required |
*Plans listed are examples and may vary by insurer. Refer to official insurer websites for current info.