Buying Health Insurance? Seniors Should Know This.

As healthcare costs rise and life expectancy increases, securing the right health insurance becomes critical, especially for senior citizens. Insurers offer plans specifically designed for individuals aged 60 years and

above, addressing unique age-related healthcare needs such as chronic illnesses, pre-existing conditions, and frequent hospital visits.

Tailored for aging needs

Senior citizen health insurance differs from regular plans by offering coverage that accounts for the medical risks of aging.

“These plans typically provide comprehensive coverage for age-related illnesses, higher hospitalisation costs, and critical illness treatments,” said Ashish Yadav, Head of Products and Operations at ManipalCigna Health Insurance.

He added that such plans often include annual check-ups, easier terms for pre-existing diseases, and dedicated support.

Gaurav Dubey, CEO & Founder of Livlong 365, explained that their structure is often more nuanced.

“One of the biggest challenges for seniors is navigating pre-existing disease clauses. We address this by creating structured PED summaries that help reduce policy rejections and ensure suitable coverage," he said.

However, not all experts agree on the distinction.

Hari

Radhakrishnan, expert at the Insurance Brokers Association of India (IBAI), pointed out, “There is no difference between health insurance for senior citizens and regular health insurance. Regular plans can continue lifelong. But insurers do market specific products for seniors who start after 60.”

The earlier, the better

Timing is crucial when purchasing health insurance. Experts recommend buying a plan well before retirement.

“Purchasing early ensures lower premiums and wider coverage, including for

pre-existing conditions after waiting periods,” Yadav said.

Radhakrishnan added, “Ideally, one should buy before age 60. Medical conditions diagnosed later can limit both coverage options and affordability.”

Individual plans vs family floaters

Senior citizens are often better served by individual health insurance policies rather than family floater plans.

“Since seniors are more likely to make frequent or higher claims, having a dedicated individual policy ensures their coverage is protected,” said Yadav.

Radhakrishnan added that in a floater plan, a single major claim by any family member can exhaust the sum insured, potentially leaving the senior citizen underinsured — unless the plan offers a sum insured restore facility.

Managing premium costs

Premiums rise with age, reflecting the increased likelihood of claims. To make premiums more manageable, co-payments or higher deductibles can help.

“Opting for a voluntary co-payment or higher deductible reduces the premium cost,” said Yadav.

He

also recommended smart choices like avoiding unnecessary add-ons, choosing essential room categories, and using family discounts.

Radhakrishnan noted that top-up plans can be a useful strategy. “One can finance deductibles through a medical fund. Often, premiums are high because deductibles are low and hospitalisation frequency is high.”

Watch out for exclusions

Understanding exclusions is crucial for making informed decisions. Common exclusions include cosmetic treatments, dental care, self-inflicted injuries,

and treatments during waiting periods for pre-existing diseases.

“There are no exclusions specific to senior citizens,” said Radhakrishnan. “As per IRDAI, standard exclusions apply to all products, although insurers may limit coverage based on individual health conditions.”

Dubey emphasised the importance of carefully reviewing clauses on surgeries, waiting periods, and disease-specific sub-limits. “These fine-print limitations are especially critical for senior health plans.”

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