Senior Citizen Health Insurance Plans & Policies | Niva Bupa (2023)

Myth 1: My parents don’t need health insurance as they are healthy

Everyone needs health insurance, especially ageing parents. While they may be healthy now, the situation could change in a few years. Thus, having a health insurance plan for contingency is a wise move. Additionally, most health insurance plans have a waiting period. So, it best to buy a health insurance plan as early as possible to serve the waiting period and mitigate the risks.

Myth 2: There are very high waiting periods in senior citizens health insurance policies

Senior First has a waiting period of only two years for pre-existing conditions and for specific diseases/procedures such as cataract, hernia, joint replacement etc. However for other conditions, the hospitalization coverage starts after initial waiting period of 30 days. For hospitalization due to accident, the policy provides coverage from day 1.

Myth 3: My work/corporate insurance cover is enough

This is a prevalent misconception. Many youngsters feel that the mediclaim policy provided by their employer is comprehensive, but in most cases it is not. Additionally, the insurance benefit ceases if you lose your job or quit. Hence, it is prudent to have separate health insurance for yourself and your parents.

Myth 4: Insurance for senior citizen is expensive

Health insurance is a safety net to safeguard your finances and ensure the best possible care if a health emergency arises. With medical costs skyrocketing, it is highly essential to have health insurance. While the cost of health insurance for senior citizens is slightly higher, it is not expensive. With some financial planning, it can easily be taken care of, and in the long run, it will only help you save money.

Furthermore, Senior First gives you the freedom to choose co-payment or deductible options to make the premium more affordable as per your needs.

Myth 5: Senior citizens cannot get health insurance if they have a pre-existing condition

Many people refrain from buying health insurance if they have a pre-existing condition such as diabetes, hypertension, etc., as they believe that they will be denied a health cover. This is not true. For instance, Niva Bupa’s Senior First health insurance plan covers pre-existing conditions up to a certain level with a waiting period of two years.

With advancing age, health-related issues are inevitable. Hence, it is important to select the appropriate health insurance plan that specifically caters to the needs of senior citizens. Here are some key factors to consider when choosing a health policy for those above 60:

Sum insured:Senior citizens could have multiple health issues and may also have to account for frequent hospitalisation or surgeries. Thus, you need a comprehensive health plan with a relatively high sum insured to cover the high medical expenses. Niva Bupa’s Senior First Platinum Health Insurance Plan provides coverage up to Rs 25 lakh.

Affordable premium:The premium cost for senior citizens will depend on their age, Sum Insured, co-pay / deductible options chosen etc. With Niva Bupa’s Senior First Health Insurance Plan, you can choose co-payment percentage of 20%, 30%, 40% or 50%. And while making a claim, you will have to pay the chosen percentage of the total admissible claim. For instance, if the sum insured is Rs 5 lakh with 20% co-pay, and the admissible claim is Rs 2 lakh, then you will have to pay 20% of the amount, i.e Rs 40,000. Rest will be paid by Niva Bupa.

Alternatively, you can choose Deductible (1/5^th of Sum Insured) which will make your policy free from co-payment. For instance, you can choose 1 lakh deductible with 5 lakh Sum Insured. In case of claim(s), first 1 Lac will be borne by you in a policy year and rest over and above we will pay.

Wider coverage:Keeping in mind the varied needs of senior citizens, one should opt for a plan that covers a diverse range of expenses such as domiciliary treatment, health check-up, day-care treatment, pre-and post-hospitalisation, emergency ambulance, AYUSH treatments, organ transplant, ambulance charges etc.

Hassle-free claims:When making health-related claims, time is of the essence. Niva Bupa’s Senior First Health Insurance Plan offers a quick and easy cashless claim process at 7000+ hospitals. Cashless claims are processed within 30 minutes by our in-house team of doctors. And with the insta-reimbursement feature, you can file for claim online without any tedious paperwork. Focus on your health and well-being, and let Niva Bupa take care of the rest.

Today, there are many health insurance plans available from different providers. They differ in terms of premium, coverage, riders, waiting period, etc. Hence, it is crucial to buy the right health insurance that caters to your specific needs so that if the need comes to raise a claim, you get optimum care and financial support.

Here are a few things you should keep in mind when buying health insurance for senior citizens:

Compare different plans:Do your research and compare the various plans available. If the insured has any existing health conditions, ensure the plan has coverage for specific needs such as dialysis, radiotherapy, etc. Also, consider the sub-limit on room, co-pay, and other non-payable items so that you don’t have to shell out a large amount from your pocket.

Choose the right sum insured: Hospitalisation expenses can add up real fast. Consider medical inflation, health vulnerabilities and choose a plan with a high sum assured so that the insured receives comprehensive coverage.

Buy separate policies: Ideally, do not include senior citizens in a family floater plan as the premium is based on the eldest insured member. Additionally, there is a possibility that the sum assured meant for the entire family can be utilised by just one member (senior citizen), considering health vulnerability that comes with older age, and this might leave the others without coverage. It is hence best to buy individual health insurance policies for senior citizens.

Check the waiting period: Most policies come with a waiting period, i.e., the time a policyholder has to wait before the benefits kick in. Choose a plan with a lower waiting period so that the coverage starts sooner, and the insurance can be used whenever the senior citizen needs it.

Check for cashless claims: Besides offering comprehensive coverage, a plan must allow for cashless claims at network hospitals. All Niva Bupa Health Insurance Plans, including Senior First ensures 30 minutes cashless claims processing at 7000+ network hospitals. You can also access cashless tele-consultation and OPD with our network doctors.

Check for inclusions and exclusions: Every health insurance plan has several features and services that may or may not be included in the scope of coverage. So, before you sign up for a health policy, make sure you thoroughly read up on the inclusions and exclusions. Ensure coverage for daycare expenses, domiciliary treatment, organ transplant, pre-hospitalisation and post hospitalisation, AYUSH treatments, ambulance charges and modern treatments are included. Click here to check the inclusions and exclusions of Niva Bupa Senior First Plan.

Health insurance plans for senior citizens are specifically designed to cater to the needs of the elderly and may offer different benefits, features and, terms and conditions from other regular health insurance plans. Here are a few you should know about.

Entry age:Entry age for most standard individual or family floater health insurance plans is restricted till age 65 years. However, plans such as Niva Bupa’s Senior First Health Insurance Plan is specially designed for senior citizens and allows for higher entry age for policyholders, going up to 75 years.

Sum insured:Those in the higher age bracket can find it difficult to get higher coverage with regular plans due to age-related risk. A specialised product such as Niva Bupa Senior First Health Insurance accounts for the insurable risk and offers a customisable cover starting from Rs 5 lakh, going up to Rs 25 lakh.

Co-payment: A senior citizen plan usually relies on a co-payment option where the policyholder bears a certain portion of the medical expense. This reduces the risk from the insurer and makes the premiums affordable.

ReAssure benefit:A Reassure benefit is when the original sum insured is exhausted, an additional ReAssure Sum Insured comes to rescue. This benefit may or may not apply to standard health plans.

But given that senior citizens may suffer from chronic issues, Niva Bupa’s Senior First Health offers ReAssure benefit (applicable even for same illness) in the same year.

There are many other benefits of choosing a customised insurance, such as Niva Bupa’s Senior First over a regular health insurance plan. Please refer to the brochure for more information.

All our indemnity plans covers expenses incurred during the treatment for Coronavirus as per the terms and conditions of the Senior Citizen Family Floater plan.