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10 Things to Remember While Buying Senior Citizen Health Insurance

With the recent outbreak of Covid-19, awareness about the need for health insurance has increased among the public. But can be said that the importance of health insurance is at its place even before the incident.

Having health insurance could serve medical needs if there is any unforeseen medical emergency for any person in the family. The risk of medical emergencies may be high in the case of senior citizens.

People are searching for the best health insurance policies after the coronavirus effect. But including the parents in the family floater may cost you more comparatively.

Hence, experts in the insurance industry advise separate plans for parents if they are in the senior citizen age category. Most health insurance companies are offering senior citizen health insurance plans that match this age group.

If you are in the same boat searching for the best health insurance plan for your parents, but not sure which plan is best.

10 Things to Consider While Buying Senior Citizen Health Insurance

You are at the right place to explore the key factors to look for in health insurance to decide which health insurance plan matches your requirements.

1. Entry Age Limit and Renewability Age Limit

One of the major deciding factors to be considered before choosing a health insurance plan for senior citizens is the entry age. This varies from company to company. Some insurers provide coverage without any limit on entry age and with lifelong renewability.

Whereas, some insurers provide it to only senior citizens who are in their 60 years to 80 years age group. It is advised to select such plans with no limit and last for more years.

2. Sum Insured Limit

The whole purpose of purchasing health insurance is to address the financial need in case of a medical emergency. Compared to young people, the possibility of health issues is high in the case of elders.

So, it is important to choose the assured amount wisely to suffice your needs based on your overall health. Select a higher limit if there is a family history of critical health issues.

3. Premium Amount

The premium of health insurance is calculated based on several factors like the age of the insured, waiting period, co-pay, critical illnesses, pre-existing illnesses, sub-limits on various options, geographical area of the insured, etc.

Based on all these factors and the overall health condition of the insured persons, one has to compare and choose the best plan. Lifestyle, habits, and family history of any illnesses also can be a deciding factor of the premium amount.

4. Waiting Period

Generally, health insurance policies come with waiting periods. The waiting period is the duration through which the insured person is not eligible to get the coverage in case he or she has any illness already existing at the time of purchasing the policy.

Generally, this waiting period ranges from 2 years to 4 years varying from plan to plan and company to company. Plans with fewer waiting periods cost high. Depending on the overall health of the insured person it is advised to choose this option.

Select plans with less waiting period in the case of persons with critical issues and their age factor. The insured may have to undergo a pre-medical screening in case he has any pre-existing health conditions at the time of purchasing the policy.

5. Network Hospitals

This is one more important factor to consider for availing of the cashless facility and a hassle-free claim settlement. Insurance companies mention the list of network hospitals on their website or one can know this information by contacting the insurer’s customer care number. Prefer plans that have a wide network of hospitals.

6. Coverage of Expenses

Health insurance plans generally cover the expenses incurred in various aspects of medical bills ranging from pre-hospitalization, actual hospitalization, post-hospitalization, ambulance charges, medication bills, diagnostics bills, etc.

The insurance company mentions these details in the product brochure. To understand this you must read the product brochure. Once you read the policy document you know about your policy, what is covered, and whatnot. That helps you to avoid mistakes at the time of the claim process and for successful claim settlement.

7. Illness Coverage

As we all know the fact that the possibilities of illnesses are high as we age. A health insurance policy that covers more illnesses may be chosen to address the need in the case of senior citizens.

Health insurance companies mention the types of illnesses that are covered and not covered in their policy brochure. Some senior citizen health insurance plans would have exclusions. To understand this one needs to read the documents carefully and select those plans with minimal exclusions or no exclusions.

8. Co-Pay Limit

The co-pay is one more feature to consider when choosing the best senior citizen health insurance plan. Co-pay is the partial amount you pay out of your pocket for medical bills whereas the remaining is paid by the insurer.

For instance, if there is a co-pay of 20% in the plan, that means you would be paying 20% of bills, and the remaining 80% is fulfilled by the insurance company.

There are two views to decide on this feature. If one wants to reduce the premium amount then one may choose a plan with some co-pay. Generally plans with a co-pay option cost less.

However, it is important to realize that the partial amount shall be paid out of the insured person’s pocket at the time of the claim process. If the cost of the treatment that you are going to get is going to be expensive then the share of the bill on your end shall also be high.

9. Day-Care Treatments Allowed

Generally, health insurance is applicable only if the insured person is hospitalized for a minimum duration of 24 hours. However as the medical field is advanced, some treatments need not require the patient to stay at the hospital for 24 hours. Some examples of such treatments are cataract surgery and chemotherapy sessions.

Even though such treatments need not require a long duration of hospitalization, some such treatments usually cost high. Some health insurance plans also cover such daycare treatments. It is good to select such plans with a maximum number of day-care treatments covered as the chances of criticality are high in the case of senior citizens.

10. Claim Settlement Ratio

Last but not least remember how simple and user-friendly the claim settlement of certain health insurance companies is. The claim settlement ratio is calculated based on the total number of claims received by the insurance company versus the total number of claims settled by that company.

Insurance companies generally mention their claim settlement ratio on their websites. IRDA (Insurance Regulatory and Development Authority) releases an annual report every year in which it transparently mentions every insurance company’s CSR (Claim Settlement Ratio) details.


Apart from these points, there are other factors to consider while deciding on the best health insurance plan for your parents. Some health insurance plans offer features like No-Claim Bonus (NCB), Recharge Benefit or Restore Benefit, Daily Cash Option, OPD Coverage, etc. as features. Look for such a thing also while deciding on the best health insurance.

The insurance company from which you are buying the health insurance plan also is an important aspect. Do some market research on the reputation of the company, how it is performing, how is the customer service, how simple and hassle-free is the claim settlement process of the company, etc.

All these aspects shall be taken into consideration to decide which health insurance plan suits your needs. As a good practice read the documents carefully and ask your agent insurance advisor or customer care if you are not sure about any points mentioned in the policy document. Once you know well about your policy there is less chance of hassle at the time of emergency.

Because you know, which hospital to visit, how the claim process works, what is covered and what is not, the limits mentioned in the policy, etc. You can know all these details only if you spend some to reading the policy documents.

After all, you are going to spend your hard-earned money on the betterment of your parents. Hence spending some time learning about the plan is worth it.

Ajeet Sharma, the founder of Financegab and a well-known name in the field of financial blogging. Blogging since 2017, he has the expertise and excellent knowledge about personal finance. Financegab is all about personal finance which aims to create awareness among people about personal finance and help them to make smart, well-informed financial decisions.


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