Health Insurance Policy for Senior Citizens
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What is Senior Citizen Health Insurance Policy?
A senior citizen health insurance policy is specifically designed for individuals aged 60 years or older, to provide coverage for illness, treatment, emergency or surgery. It provides financial coverage for medical expenses, including critical illnesses and accidental hospitalisation, annual health check-ups, and daycare procedures.
The objective of having a senior citizen plan is to reduce dependence on savings during medical emergencies. It is especially relevant for retirees or elderly parents who are more vulnerable to conditions like heart ailments, diabetes, or joint-related issues.
Why Senior Citizens Need a Health Insurance Policy?
Senior citizens need a health insurance policy to protect their savings, manage rising health risks, and ensure access to timely treatment without financial stress. Here’s why senior citizen health insurance policy is important:
Why Do Seniors Need Separate Health Insurance If They Have Government Health Schemes?
Even if seniors are covered under government health schemes, having a separate senior citizen health insurance policy offers added protection and flexibility, especially during major treatments. Here’s how a separate senior citizen health insurance policy adds real value
- Government schemes usually offer basic coverage, which may not fully cover the high medical costs seniors face, especially chronic illnesses or surgeries.
- Government coverage is limited to specific hospitals or empanelled networks, whereas private insurance usually offers a wider network of hospital choices and smoother cashless claim.
- Senior health insurance plans offer higher sum insured options, which are rarely available under government schemes.
- A separate senior health insurance plan may cover daycare procedures, domiciliary care, annual health check-ups, and AYUSH coverage, where government schemes may have limits or exclusions.
- With separate insurance, seniors won’t need to depend solely on government subsidies or burden their children during health emergencies.
What is the Ideal Coverage for Senior Citizen Health Insurance?
The ideal coverage for senior citizen health insurance should be at least ₹25 lakh or more, so that it can comfortably handle one major hospitalisation without exhausting the entire sum insured. The ideal coverage for senior citizens varies based on health conditions, financial dependency, and city of residence. Here’s a practical breakdown to help you choose the right sum insured:
Disclaimer: These are indicative ranges based on current healthcare costs and claim trends. It may vary based on individual factors such as age, medical history, lifestyle, city of residence, and rising healthcare costs. It is advisable to know your family’s specific needs and read policy terms before making a final decision.
How to Choose the Right Sum Insured for Senior Citizen Health Insurance?
Before choosing the right sum insured for senior citizen health insurance always ensure that one major medical event doesn’t exhaust their entire coverage. Here are the key factors that help you decide the right coverage:
1. Low Waiting Period for Pre-existing Conditions: Prefer 1 - 2 year waiting period in health insurance for conditions like diabetes, hypertension, or arthritis.
2. No Co-payment Clause: Avoid plans that require seniors to pay a percentage of the claim amount. Look for zero co-payment options.
3. City or Zone: If you live in polluted metro cities, toiling with traffic and bearing office stress daily, you may be at a higher risk of falling ill. Get a higher sum insured in such cases to avoid out-of-pocket expenses.
4. High Sum Insured: Ensures the policy has a high sum insured sufficient protection against major surgeries, chronic illness treatments, and long-term hospitalisation.
5. Lifetime Renewability: Ensure the policy can be renewed without age restrictions, offering coverage well into the 80s and beyond.
Most people tend to choose a health insurance plan based on how affordable the premium looks today. As age increases, medical needs become more frequent and unpredictable. A policy with a lower premium comes with lower sum insured, higher co-payment, and stricter sub-limits, which may not be visible at the time of purchase but significantly impact you during a claim.
On the other hand, a slightly higher premium will ensure that most medical expenses are covered when needed. You should consider a plan with:
* Adequate coverage (₹25 - 50 lakh+)
* Lower restrictions, exclusions and limits
* PED and critical illness coverage
* Better claim support
For senior citizens, the real cost of a policy is not the premium you pay every year, it’s the amount you pay from your pocket during a medical emergency. Always prioritise coverage, not just cost.
Tanya Marwah
Head of Marketing
Why Choose Health Insurance for Senior Citizens by Digit?
- Simple Online Processes : From the process of buying a health insurance policy to making claims is paperless, easy, quick and hassle-free! No hard copies, even for claims!
- No Age-Based or Zone-Based Co-Payment: Health insurance for senior citizen at Digit comes with no age-based or zone-based co-payment clause. This means that during health insurance claims, you need not pay anything from your savings.
- Cumulative Bonus: Up to 50% cumulative bonus for every claim-free year (with a maximum benefit of 100%). This increases your total coverage over time without increasing your premium, helping you handle larger medical expenses.
- No Room Rent Restriction: We understand that everyone has different preferences. That’s why we have no room rent restrictions. Choose any hospital room you prefer. It helps avoid hidden cost deductions that usually happen when room rent limits indirectly cap during a claim.
- Get Treated at any Network Hospital: Choose from 9000+ network hospitals in India for a cashless treatment or opt for a reimbursement. For senior citizens, this becomes especially important, as quick access to a nearby hospital during emergencies can make a critical difference.
- Add-Ons or Riders: Senior health plans include optional add-ons or riders that policyholders can customize to suit their needs. Some popular add-ons such as consumable cover, PED Waiting period modification, network hospital discount.
- Wellness Benefits: Get exclusive 12+ wellness benefits in health insurance on the Digit App in collaboration with top-rated health and wellness partners.
What’s Covered in the Senior Citizens Health Insurance Plans Offered by Digit?
Coverages
Double Wallet Plan
Infinity Wallet Plan
Worldwide Treatment Plan
Important Features
This covers for all hospitalisation expenses including due to an Illness, Accident, Critical Illness or even pandemics like Covid 19. It can be used to cover for multiple hospitalisations, as long as the total expenses are up to your sum insured.
You need to wait for a defined period from the first day of your policy to get covered for treatment related to any non-accidental illness. This is the Initial Waiting period.
Exclusive Wellness Benefits like Home Healthcare, Tele consultations, Yoga and Mindfullness and many more available on our App.
We provide a back-up Sum Insured which is 100% of your Sum Insured amount. How does Sum Insured Back Up work? Suppose your policy Sum Insured is Rs. 5 lac. You make a claim of Rs.50,000. Digit automatically triggers the wallet benefit. So you now have 4.5lac + 5 lac Sum Insured available for the year. However, one single claim, cannot be more than the base Sum Insured as in the above case, 5 lac. .
No claims in the Policy year? You get a bonus -an additional amount in your total sum-insured for staying healthy & claim free!
Different categories of rooms have different rents. Just like how hotel rooms have tarrifs. Digit plans give you the benefit of having no room rent cap, as long as it is below your Sum Insured..
Health insurance covers medical expenses only for hospitalisations exceeding 24 hours. Day care procedures refer to medical treatments undertaken in a hospital, requiring less than 24 hours due to technological advancement such as cataract, dialysis etc.
Get a world class treatment with the Worldwide Coverage! If your doctor identifies an illness during your health examination in India and you wish to get a treatment abroad, then we’re there for you.You’re covered!
We pay for your health check-up expenses upto the amount mentioned in your Plan. No restrictions on the kind of tests! Be it ECG or Thyroid Profile. Make sure you go through your policy schedule to check the claim limit.
There may be emergency life-threatening health conditions which may require immediate transportation to hospital. We absolutely understand this and reimburse for expenses incurred for your transportation to a hospital in airplane or helicopter.
Co-Payment means a cost sharing requirement under a Health Insurance Policy that provides that the Policyholder/Insured will bear a specified percentage of the admissible claims amount. It does not reduce the Sum Insured. This percentage depends on various factors like age, or sometimes also on your treatment city called zone based copayment. In our plans, there is no age based or zone based Co payment involved.
Get reimbursed for the expenses of road ambulance, in case you are hospitalised.
This cover is for all expenses before and after hospitalisation such as for diagnosis, tests and recovery.
Other Features
The disease or condition that you are already suffering with and have disclosed to us before taking the policy and has been accepted by us has a waiting period as per plan opted and mentioned in your Policy Schedule.
This is the amount of time you need to wait for, until you can make a claim for a specific illness. At Digit it is 1-3 years and starts from the day of policy activation. For the full list of exclusions, read Standard Exclusions (Excl02) of your policy wordings.
If You sustain an Accidental Bodily Injury during the Policy Period, which is the sole and direct cause of Your Death within twelve (12) months from the date of accident, then We will pay 100% of the Sum Insured as mentioned in Policy Schedule against this cover and as per plan opted.
Your organ donor gets covered in your policy. We also take care the pre and post hospitalisation expenses of the donor. Organ donating is one of the kindest deeds ever and we thought to ourselves, why not be a part of it!
Hospitals can go out of beds, or the patient’s condition may be rough to get admitted in a hospital. Don’t panic! We cover you for the medical expenses even if you get treatment at home.
Obesity may be the root cause of so many health issues. We absolutely understand this, and cover for Bariatric Surgery when it is medically necessary and advised by your doctor. However, we DONOT cover if hospitalisation for this treatment is for cosmetic reasons.
If due to a trauma, a member has to be hospitalised for a psychiatric treatment, it will be covered under this benefit, upto INR 1,00,000. However, OPD consultations are not covered under this. The waiting period for Psychiatric Illness Cover is same as Specific Illness waiting period.
Before, during & after hospitalisation, there are many other medical aids & expenditures such as walking aids, crepe bandages, belts, etc.,which need your pocket’s attention.This cover takes care of these expenses that are otherwise excluded from the policy.
What's Not Covered in Senior Citizens Health Insurance by Digit?
Add-on Options for Senior Citizens Health Insurance with Digit
Enhance your senior health insurance policy with add-ons at Digit. These add-ons are subject to underwriting approval and your eligibility at the time of purchase or renewal. Here’s a list of add-ons available that provide additional layers of protection beyond the basic coverage of your policy:
Key Benefits of Health Insurance for Senior Citizens by Digit
Your health insurance plan with Digit extends several exclusive benefits that enhance your coverage. Here are the key benefits:
* These add-ons are subject to underwriting approval and your eligibility at the time of purchase or renewal
How to Increase Your Coverage in Senior Citizen Health Insurance?
You should consider increasing your health insurance coverage as it is about ensuring your policy keeps up with rising medical needs and costs over time. Here are the most effective ways to do it:
- Get a Higher Sum Insured at Renewal: The simplest way to increase coverage is by upgrading your base cover during renewal from ₹20 - ₹25 to more, depending on age, health conditions, and medical needs. This ensures you’re better prepared for high-cost treatments like surgeries or ICU care.
- Add a Super Top-Up Plan:A smart and cost-effective way to increase coverage is by keeping your base policy and adding a super top-up of ₹30–50 lakh. This significantly boosts your overall coverage without a major increase in premium.
- Add Relevant Riders or Add-ons: If you haven’t opted for relevant riders, instead of changing the entire policy, consider add-ons like consumable cover, network hospital discounts. These don’t increase coverage directly but improve your effective claim payout.
What is the Premium Cost for Senior Citizen Health Insurance?
The premium for senior citizen health insurance is generally higher than regular health plans, as the risk of hospitalisation and medical treatment increases with age. The table represents the starting premium amounts for ₹20 lakhs sum insured (Tier 1 city) under Digit’s Infinity Wallet Plan, varying by age group.
Disclaimer: Premiums increase with age due to higher health risks and probability of claims. However, the actual premium may vary based on factors like medical history, sum insured, co-payment, and city of residence.
What is IRDAI Regulation on Senior Citizen Premium Hikes?
As per the IRDAI circular dated 30th January 2025, insurers cannot increase premiums for senior citizen health insurance plans by more than 10% in a financial year without prior approval from the regulator. If an insurer intends to raise premiums beyond this limit or withdraw a health insurance plan, they must take explicit approval from IRDAI.
This means:
- Senior citizen policies are protected from sudden, steep premium increases during policy renewal.
- Premium changes become more predictable and manageable in retirement years.
- Insurers cannot discontinue senior-focused plans abruptly without regulatory oversight.
How to Buy Senior Citizen Health Insurance Online?
Buying senior citizen health insurance online is a simple and convenient process, but it’s important to make informed decisions to ensure the policy meets healthcare needs in later years. Here’s a step-by-step process to buy senior citizen health insurance at Digit:
Enter Basic Details
Visit the Digit app or website. Enter your PIN code and mobile number, select your preferred health insurance plan and provide age details, family members covered, etc.
Choose Plan & Add Member Details
Compare & select the plan, sum insured, add-on covers and apply any available discounts to get the final premium amount. Further provide the member details for everyone you’re covering.
Make Payment & Submit KYC
Once done, proceed to make the premium payment and submit your KYC documents to complete the purchase process.
Final Review & Processing
Now, your application undergoes a brief review process. Digit may request a health declaration, lifestyle information, or medical details & reports if required. Now, based on your medical underwriting, your policy will be issued and sent to your email. You can also access it anytime through the Digit app.
What are the Documents Required to Buy Medical Insurance for Senior Citizens?
When purchasing a senior citizens health insurance policy, insurers typically require some basic documents for verification. Below is a list of optional documents that can be needed at the time of purchasing a policy:
Identity/Age Proof
Address Proof
Income Proof
Medical Reports
KYC Documents
What are the Benefits of Buying Health Insurance for Senior Citizens?
Government Health Insurance Schemes for Senior Citizens
In addition to health insurance provided by several health insurance companies, there are some government health insurance schemes for senior citizens. A few of these plans are directly under government control. However, some are provided by state-run insurers:
What to Check Before Buying Senior Citizen Health Insurance?
Buying health insurance for senior citizens requires understanding how the policy will actually perform during a claim. Here are the key things you should carefully check before finalising a plan:
- Sum Insured: Ensure the sum insured is high enough (₹20 - 50 lakh or more) to at least cover one major hospitalisations, surgeries, and ongoing treatments. Also check if the policy covers hospitalisation, medicines, diagnostics, and preventive health check-ups.
- Waiting Period: Waiting periods in health insurance for particular illnesses can differ from one insurance company to another. Seek out senior citizen health insurance with no or reduced waiting period or a minimal waiting period to cover any illness.
- Co-payment: A co-payment clause is a feature of many senior citizen health plans that requires the policyholder to pay a portion of the claim amount. The insurance company just pays the remaining fraction of the claim amount. You must, therefore, choose a plan with a low or no co-payment.
- Daycare Treatment Coverage: Because of advancements in medical technology, many treatments and surgeries can now be performed through daycare procedures. However, a senior citizen must be hospitalised for at least 24 hours to file a claim under standard health insurance coverage.
- Network of Hospitals: A cashless claim settlement is among the most effective methods of filing a claim. However, this benefit is only available if you use one of the hospitals in the insurance provider's network. As a result, consider the quantity and type of hospitals your preferred insurance company offers and choose the best one.
- No Claim Bonus: If the policyholder hasn't filed any claims in the past year, almost all insurance companies offer a no-claim bonus discount. In such a scenario, either the policy premium drops or the sum covered rises. Check with the insurance company on the bonus they provide in a no claim year.
- Domiciliary Hospitalisation: Sometimes, an elderly person's health may prevent them from being admitted to a hospital. In this situation, home treatment costs will be covered by health plans that provide domiciliary hospitalisation, provided that a qualified physician has recommended it.
- Add-on Benefits: Every health insurance plan will have add-on benefits you can customise. When searching for a senior health insurance plan, consider the available add-ons and select one that meets your needs.
- Policy Renewability: To avoid having to purchase another health plan as you age, always search for the finest health insurance plan with a lifetime renewability option. An elderly citizen shouldn't have a policy that doesn't renew, especially after 60 years.
What is the Tax Benefit on Health Insurance for Senior Citizens?
In addition to covering medical expenses, a senior citizen health insurance policy also offers tax benefits. Under Section 80D of the Income Tax Act, 1961, you can claim a deduction on premiums paid for senior citizen health insurance under the old tax regime.
If you have a mediclaim for senior citizens (your ageing parents), you can receive an income tax refund of up to ₹50,000. And, every fiscal year, you can also receive an extra ₹5,000 tax refund on payments for preventive medical examinations.
For example, Smita (28 years old) pays a premium of ₹30,000 annually under health insurance for herself. In addition, she also pays a premium of ₹40,000 annually for her parents (aged above 60 years). In such a case, the tax deduction will be
Hence, in Smita’s case, she can claim a total tax deduction for senior citizens under section 80D in a year of 65,000 after paying a premium for herself and her old-age parents. However, the maximum deductible she can claim is ₹75,000, which includes her and her old-aged parents.
Read More about Health Insurance Tips for Senior Citizens
Senior citizen health insurance is a financial safeguard that helps manage rising healthcare needs in later years. As age increases, so do the risks of hospitalisation, chronic illnesses, and high-cost treatments, making it essential to have adequate and well-structured coverage in place.
While government schemes and basic plans may provide initial support, they often fall short during major or repeated medical events. Ultimately, the goal of senior citizen health insurance is not just to pay medical bills, but to protect a lifetime of savings and ensure access to timely, stress-free healthcare when it matters the most.
FAQs about Health Insurance for Senior Citizens
Can my senior parents be included in my family floater policy or have a separate plan?
When is the right time to buy a Senior Citizen Health Insurance policy?
What makes the best Health Insurance plan for senior citizens?
Does the cost of health insurance increase with age?
How do I figure out my senior citizen health insurance premium?
What is the maximum age to buy senior citizen health insurance?
Do I need to undergo medical tests before buying senior citizen health insurance?
What is the waiting period for pre-existing diseases in senior citizen health insurance?
Can a senior citizen be denied health insurance?
Does senior citizen health insurance cover critical illnesses?
What are the documents required to buy a senior citizen health insurance plan?
The following documents may be required to buy a mediclaim policy for senior citizens:
- Aadhaar Card
- PAN Card
- Income Proof
- Address proof
- Duly filled proposal form
- Medical Reports (if any)
Do seniors who transfer their senior citizen health insurance policies receive continuity benefits?
What are some mistakes senior citizens should avoid when buying health insurance?
Here is what you need to avoid while purchasing health insurance for senior citizens:
- Choosing a very low sum insured
- Not declaring existing health and lifestyle conditions
- Not customizing the senior health insurance plan with add-ons to suit additional needs.
- Not reading the policy documents carefully
- Solely purchasing a senior health insurance plan for tax benefits only