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Government Health Insurance Programs for Senior Citizens

Government Health Insurance Programs for Senior Citizens

​​Health risks for senior citizens are higher compared to other age gro​​ups, which is why their biggest concern is to protect themselves from the financial burden caused by medical treatments. 

However, not all senior citizens can afford regular insurance coverage for their healthcare, especially those who do not have a regular source of income or sufficient financial support. 

Health insurance for senior citizens by the government allows the elderly members of our society to avail of healthcare services without incurring financial losses.

What is Generally Covered Under a Government Insurance Scheme for Senior Citizens?

The government of India has introduced a number of health insurance schemes to provide financial assistance to senior citizens to avail treatments according to their specific health-related issues. 

A govt health insurance for senior citizens typically provides the following coverage:

  • Daycare Treatments - Any daycare treatment, such as cataract surgery or dialysis, with less than 24 hours of hospitalisation, is covered under such a scheme. 

  • Hospitalisation Expenses - Coverage of costs related to hospitalisation, including room rent, treatments, doctor’s fees, etc.

  • Ambulance Charges - The cost of providing senior citizens with emergency ambulance service is also covered under a government health insurance scheme. 

Health Insurance for Senior Citizens by Government - Factors to Consider Before Investing

These are some important points worth considering before investing in a govt medical insurance for senior citizens.

  • Pre-existing Health Conditions - Check for any pre-existing medical conditions before you apply for such an insurance policy. Knowing which insurance policy offers the least waiting period can help you avail of the associated benefits mo​re quickly.

  • Coverage Provided - Due to the fact that senior citizens are more likely to develop life-threatening ailments, it is best to find out what illness types are covered under each government insurance scheme. Generally, dental surgeries and treatment of hereditary conditions are not covered under these schemes..

  • The Amount that is Insured - The health policy that you choose should be based on the insured amount that is mutually agreed upon. Pre-assess your needs and invest in a policy that comes with a low premium and offers customisable features.

  • Network Hospitals - Opt for an insurance policy that covers a large number of hospitals in and around your vicinity. This will help you receive immediate and convenient medical care during an emergency situation. 

Additionally, you should consider opting for critical illness insurance coverage if your senior family member is suffering from a critical health issue that is likely to require immediate medical care.

​Top 5 Government Health Programs for Senior Citizens

The following are five prominent senior citizen mediclaim policies the government offers to its residents.

1.Ayushman Bharat Scheme for Senior Citizens

This scheme is available to all the residents of India who are above 70 years of age. Under this scheme, the government will provide insurance coverage of up to ₹5 lakhs to all senior members of the society for them to avail proper healthcare facilities without being troubled by financial restraints. Hospitals across the country will be open to senior citizens under this scheme for cashless treatment options. 

  • Eligibility - The applicant must be a retired permanent citizen of India above the age of 70.

  • ​Benefits - The benefits under Ayushman Bharat Scheme for Senior Citizens include:

  1. The insured person can avail of cashless healthcare options in hospitals all over the country.

  2. This scheme can be used anywhere across the country.

  3. This policy allows applicants to avail of quality treatment without any additional financial burdens. 

  4. Healthcare benefits up to ₹5 lakhs are available for applicants.

  5. This scheme additionally covers expenses such as supplies, drugs, physician’s fees, diagnostic services, room charges, ICU and OT charges, surgeon charges, etc.

  • Enrollment Process - The applicant has to visit the homepage of this scheme's official website. Next, click on “Apply Online”.  After filling out all the necessary details on the page, the applicant has to click on “Submit” to complete the application process.

2.Varistha Mediclaim Policy

This government initiative is offered by the National Health Insurance Company. Medical insurance coverage is applicable to citizens between 60 and 80 years of age. While this policy period lasts a year, policyholders can renew it till the age of 90. 

  • Eligibility - The applicant must be between 60-80 years of age. 

  • Benefits - The benefits under the Varistha Mediclaim Policy include:

  1. This policy covers the cost of pharmaceuticals, medications, oxygen, diagnostic fees, blood, etc.

  2. Sum insured for hospitalisation costs is ₹1 lakh, and the sum insured for critical illness treatment cost is ₹2 lakhs.

  3. This policy additionally covers eight serious ailments. 

  4. Coverage of up to ₹1000 is available for emergency ambulance services.

  5. This policy covers the expenses of up to 30 days of pre-hospitalisation and up to 60 days of post-hospitalisation. 

  6. Coverage is provided for the fees charged by specialists, doctors, consultants and other such professionals. 

  7. Coverage is available for treating conditions like cancer, stroke, etc., without hospital admission.

  8. Cashless and reimbursement treatment facilities are available under this scheme. 

  • Enrollment Process - The proposal form for applying for this scheme can be obtained through the office or agent. After filling out the application form with necessary details, it has to be submitted back to the office or agent for approval.

3.Rashtriya Vayoshri Yojana

This government scheme aims to enhance the living conditions of senior citizens belonging to the BPL category only. Under this scheme, assisted-living devices and physical aid are provided to those senior citizens who are in need of them but cannot afford to pay for such medical expenditures. 

The scheme falls under the Artificial Limbs Manufacturing Corporation or ALIMCO (Public Sector Undertaking). Any senior citizen in need of assisted living aids or physical devices who belongs to the BPL category can avail of them for free under this scheme. 

  • Eligibility - Any citizen above 60 years, holding a valid BPL card and suffering from age-related disability such as hearing impairment, locomotor disability, loss of teeth or low vision can avail of required devices to restore bodily functions to normalcy, under this scheme.

  • Benefits - The benefits of the Rashtriya Vayoshri Yojana include:

  1. The distribution of devices as per the applicant's medical requirement is completely free of cost.

  2. More than one assisted device, in accordance with the medical requirements,  will be provided to an applicant who is suffering from multiple disabilities. 

  3. Free maintenance of assisted living devices and aids will be provided by ALIMCO for 1 year. 

  4. Camps will be organised to provide these devices to those in need. 

  5. Identification of BPL beneficiaries will be made by the respective state or UT governments, thirty percent of which shall be women.  

  • Enrollment Process - To enrol for this scheme online, you have to download the “ALIMCO Mitra” app on your Android phone and opt for “New Registration”. To complete the registration process, you have to fill in the required details, which will include ID proof, a valid BPL Card and a certificate from a registered medical officer confirming the disability of the applicant, among other details. Once the form is filled out, you have to submit it to finalise your registration. 

4.National Senior Citizen Mediclaim Policy

This senior citizen medical insurance the government provides is meant for citizens between 60 and 80 years of age. This policy by National Insurance Company features an insured amount of up to ₹10 lakhs. Additionally, you can include your spouse by opting for the family floater plan under this scheme.

  • Eligibility - Applicants must be aged between 60-80 years of age.

  • Benefits - The benefits of opting for the National Senior Citizen Mediclaim Policy include:

  1. You can avail yourself of tax deductions on premiums under the Income Tax Act (Section 80D).

  2. The waiting period for pre-existing health conditions is only 24 months.

  3. Coverage for HIV and mental illness is also provided under this policy.

  4. Coverage costs include surgeon’s fees, doctor’s fees, accommodation charges, injection and transfusion fees, etc.

  5. Costs associated with organ donors and ambulance fees are also included.

  6. Ayurveda and homoeopathy treatment expenses are covered under this scheme. 

  • Enrollment Process - The applicant has to obtain the proposal form from either the office or an agent. After filling out the form with the required documents and details, the complete application form has to be submitted back to the office or agent for processing.

5.New India Assurance Senior Citizen Mediclaim Policy

This policy caters to senior citizens belonging to the 60-80 years age group. It has been specifically designed to cover the expenses of senior citizens when they avail medical assistance.

  • Eligibility - The applicant must be 60-80 years old.

  • Benefits - The benefits of the New India Assurance Senior Citizen Mediclaim Policy include:

  1. The sum insured can range between ₹1 lakh - ₹1.5  lakhs. 

  2. Pre-existing conditions are covered once the waiting period of 18 months is over.

  3. Coverage is provided for 30 days pre-hospitalisation and 60 days post-hospitalisation.

  4. A discount of 10% is available on premium if your spouse is also covered.

  • Enrollment Process - You can either procure the proposal form from an agent or online. After filling out the form with the necessary details and documents, you have to submit it to the agent or the office to be approved for insurance coverage.

Affordable Medical Care for Senior Citizens by Reliance General Insurance

Reliance General health insurance plans for senior citizens cater specifically to their medical requirements, so that they can receive high-quality medical care without stressing about money. 

We offer you a substantial sum insured for access to the best medical treatment, along with several beneficial add-ons like air ambulance option, lifetime policy renewability, No-Claim Bonus on policy renewal and medical equipment cover, etc. 

Get more information about our sr citizen health insurance plans, and protect your ageing loved ones with the best possible coverage for medical care. 

Conclusion

With Government schemes available at such affordable rates, there should be no reason for your senior family members to be deprived of quality healthcare to help with their medical issues. 

However, if you are looking for an insurance policy with a larger sum insured and holistic coverage, opt for our health insurance plans for senior citizens, which provide several exclusive features, such as lifetime renewability, tax benefits and access to quality healthcare at the best hospitals across the country. 

Frequently Asked Questions

What is the right age to invest in a senior health insurance policy?
According to experts, you should apply for this insurance policy as soon as you reach the age of 60.

Can a government health insurance policy for senior citizens be renewed?
Yes, most government health insurance plans for the elderly can be renewed up to the maximum age limit under the policy, provided there is no evidence found for misrepresentation, fraud, etc.