Benefits under Senior Citizens Health Insurance plans include:

Some of the key benefits under the Senior Citizen Mediclaim insurance plan include:

• Cashless Treatment – The insurance company will process all claims across all hospitals in their network on a cashless basis, subject to the claim being admissible under the policy
  
  • Entry age restriction – Most policies have an entry restriction above 60/65 years of age. However all plans have a lifetime renewal facility
• Pre-Hospitalization coverage : You may incur some expenses before you are hospitalized, like doctors fees, pharmacy-related expenses, or diagnostic tests. All such costs will be covered by the insurer for up to 30-60 days before your hospitalization
• Post-Hospitalization coverage : After you get home from the hospital, there are still many expenses to be taken care of, like consultation fees, diagnostic tests, pharmacy-related costs among other things. The insurer will cover such expenses related to your hospitalization up to 60/90 days (as per plan) after your discharge.
• In-patient Hospitalization : The insurer pays for room charges, intensive care unit charges, doctor’s fee, diagnostic tests, medications, blood, oxygen, operation theater charges, etc. if you get admitted to a hospital for in-patient care, for more than 24 consecutive hours.
• Day Care Treatment (Hospitalization less than 24 Hours) : Treatments such as operations on the eyes (cataract), ligament tear, chemotherapy, Haemodialysis etc require you to stay hospitalized for less than 24 hours.
• Cumulative Bonus( No Claim Bonus) : You shall get guaranteed cumulative bonus (Normally upto 50-100% of Base Sum Insured. No claim bonus increases the sum insured for every claim-free year (or more as per the plan).The Sum Insured increases by 5/10% each year.
• AYUSH Cover : Some insurance plans allow the insured to avail treatment of your choice and hence support alternate treatments including Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy.
• Ambulance Cover : Medical emergencies can happen anytime. So, the insuer cover expenses incurred for transportation by an ambulance service provider to the hospital for treatment and back home after the treatment. The coverage limit shall depend upon the plan taken by you
• Domiciliary Treatment : Sometimes it is not possible to move the patient to a hospital because of their condition or lack of accommodation at the hospital. In such cases, the patient can be treated at home. This is called domiciliary hospitalisation. Medical expenses for such cases will be covered if the treatment continues for a defined period as per the policy coverages.
• Pre-existing Coverage / Disease : A pre-existing disease is any condition, ailment or injury or related condition(s), for which the insured person had signs or symptoms, and /or were diagnosed, and / or received medical advice / treatment within a defined period prior to 1st health insurance policy is issued under which the insured person was covered. Plans offer different waiting periods for Pre existing conditions from 24 months to 48 months.
• Out Patient Treatment (OPD Expenses) : Outpatient treatment refers to any diagnostics, consultations or treatment where a hospital admission is not required. It will often begin from an initial investigation following a referral from your family physician and can be for a consultation involving blood tests, x-rays, MRI scans and so on. Some insurance plans offer coverage upto a defined limit for OPD expenses.
• Health Check-up : This consists of measures taken for disease prevention, as opposed to disease treatment“. Health, disease, and disability are dynamic processes which begin before individuals realize they are affected. Disease prevention relies on anticipatory actions that can be categorized as primary, secondary, and tertiary prevention. Under section 80D, there is a defined limit of ₹5,000 per year for the insured, his/her immediate family and parents.