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Comprehensive mediclaim insurance for parents

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There are a few important aspects to be kept in mind while choosing a health insurance plan for your parents. The basic factors to be considered are :
  • Right Sum Insured - The sum insured should be arrived at based on their affordability, family history and the financial status they currently are in.
  • Strong Insurance Partner – opt for an insurance partner whose policy is transparent and clear on the terms and condition, as well as their claim settlement capabilities and their claims settlement ratio. One must also ensure the insurance company has a strong cashless network across India.
  • Evaluate the Exclusions and Waiting Periods under the Plan – one should end up understanding what is covered and after what period of waiting they can make a claim while also understanding what is not covered under the policy. Waiting periods vary from 24/36/48 months depending on the insurance company / illness.
  • Day Care Procedures / Pre & Post Hospitalisation – these are also a few important features that must be present in the proposed plan. Day Care procedures are those surgeries and medical interventions that don’t require hospitalisation.
  • Truthfully Declare existing medical conditions –it is recommended that the individual makes a transparent declaration for their parents/themselves so that they do not face an issues at the time of a claim.
  • Co-Payments - Most senior citizen health plans come with a co-payment ranging from 10% to 30% depending on the treatment availed by the insured. Choose a plan with lesser co-pay %. Higher co pay could also mean a lower premium.
  • Lifetime renewal - While IRDA mandates that all health insurance policies come with a lifetime renewal clause, there could be a few which come with some pre conditions. Opt for a plan that offers lifetime renewability option without any strings attached.
  • Pre Policy Health Check Up - Almost all plans insist on the senior citizen / insured going through a medical check up before granting coverage. Some of them also offer a waiver of this check up.

EIndia General insurance Partners

Check out plans for your parents with comprehensive coverages which are available on Eindiainsurance

There are many insurance companies offering specific health insurance plans for parents with attractive benefits. It Is important while finalizing on a Senior Citizen plan, that the following criteria be kept in mind – Benefits / Coverages of the plan, Waiting Period for Pre Existing Conditions and other illnesses, Co Payment for Inpatient treatment, Pre Policy Medical check ups, Lifetime Renewal conditions, Additional Coverages apart from the basic covers. Some of the popular and better performing individual plans ones are tabled below:

Insurance Company Number of Retail + Group Lives Insured (as per IRDA) in 2017-18 Sum Insured Range Unique Features of this plan
Apollo Munich Optima Restore

Apollo Munich		 34,30,454 ₹ 3 lacs - ₹ 50 lacs
  • The sublimits for patient room and medical expenses is Nil
  • The New Restore Benefit- Instant addition of 100% basic sum insured to your cover, on your first claim.
  • Multiplier Benefit- Multiplier Benefit Double your sum insured in two consecutive claim free years.
Star Health Family Health Optima Insurance Plan (Individual & Family)

Star Health		 90,40,280 ₹ 3 lacs - ₹ 25 lacs
  • No third Party Administrator, direct in-house claim settlement + Network of more than 9600+ hospitals across India.
  • Additional Sum Insured upto 25% of Sum Insured – Max 5 Lac for Two Wheeler Road Accidents.
  • Automatic Restoration of SI - 3 times at 100% each time, during the policy period + Auto Recharge Option.
HDFC Ergo M: health Suraksha

Hdfc-Logo		 23,83,045 ₹ 3 lacs - ₹ 50 lacs
  • 586 Day Care procedures covered.
  • Sum Insured Rebound - Get additional sum insured equivalent to the admissible claim amount upto a maximum of the basic sum insured.
  • No Room Rent Capping.
Bajaj Allianz Health Guard

Bajaj Allianz		 33,82,347 ₹ 1.50 lacs - ₹ 50 lacs
  • Sum Insured Reinstatement - In case sum insured along with the cumulative bonus (if any) has been completely exhausted during the policy year, it will be reinstated.
  • In-house claim settlement team that ensures a quick, smooth and easy claim settlement process.
  • Organ Donor Cover - Expenses towards organ donor’s treatment for harvesting of the donated organ are covered under this policy.
Tata AIG Medicare Premier

Tata AIG		 8,24,843 ₹ 5 lacs - ₹ 50 lacs
  • No room rent restrictions in
  • Global Cover: Insured can be covered for Medical Expenses incurred outside India, upto the sum insured provided that the diagnosis was made in India and the insured travels abroad for treatment.
  • Consumables Benefit available.
New India Mediclaim Premier

india		 1,54,61,902 ₹ 1 lacs - ₹ 100 lacs
  • No Zonewise Premium rating – rating only based on age and sum insured + No Loading for Adverse Claims Experience.
  • Lifelong Renewal subject to there not being a break in the renewal of the policy.
  • Pre Acceptance Medical Check up only for insureds beyond 50 years of age.
  • No Loading for Diabetes & Hypertension.
Religare Health Religare Care

Religare Health		 26,17,865 ₹ 4 lacs - ₹ 40 lacs
  • Annual Health Check up every year if it is a claim free year.
  • Up to 150% No Claim Bonus with NCB Super.
  • Unique Unlimited Automatic recharge.
  • Care anywhere – Global Cover for 12 Critical Illnesses.
Max Bupa Health Premia

Max-Bupa		 14,44,887 ₹ 10 lacs - ₹ 300 lacs
  • Sum Insured upto ₹300 lacs.
  • Indemnification of alternate treatments like Ayurveda, Unani, Siddha and Homeopathy (AYUSH).
  • Medical treatment abroad for 9 selected diseases (platinum plan only).
SBI General Arogya Premier

SBI General		 51,88,252 ₹ 0.50 lacs - ₹ 30 lacs
  • No pre-policy medical test up to the age of 55 years for people with no medical history.
  • Automatic Reinstatement of Sum Insured + Cumulative Bonus of 10% of SI for each claim free year maximum up to 50%.
  • Indemnification of alternate treatments like Ayurveda, Unani, Siddha and Homeopathy (AYUSH).
Royal Sundaram Lifeline

Royal Sundaram		 10,81,248 ₹ 2 lacs - ₹ 150 lacs
  • Provides coverage for International Treatment for 11 specified illnesses upto Sum Insured along with return airfare upto Rs.3lacs.
  • Provides coverage for International Treatment for 11 specified illnesses upto Sum Insured along with return airfare upto Rs.3lacs.
  • OPD Treatment covering the expenses incurred on doctor’s consultation, medicines, diagnostic tests, etc.
Reliance General HealthGain

Reliance General		 25,34,491 ₹ 3 lacs - ₹ 18 lacs
  • Double Sum Insured in each Policy Period – Reinstatement of SI
  • 5% discount if the proposer is a Woman, also if there is a girl child to be covered under the Family Plan
When one is trying to buy health insurance policies for their parents, depending on their parent’s age they can opt for a Individual Mediclaim or go for a Senior Citizen plan. Senior Citizen plans normally start from the insured age of 61 and do not have a cap on the entry age at all for most insurance plans.

The plans listed below all come with Lifelong renewability and have comprehensive coverages and are available on Eindiainsurance

Insurance Company + Name Eligibility Criteria / Age Sum Insured / Premium Options Waiting Period for Pre-existing Diseases Medical Check-up
Religare Health – Care Senior

Religare		 Individual: 61 years and above
Floater: 2 Adult (Self, Spouse, Father, Mother)
Entry Age Maximum : Lifelong
Lifelong Renewal 		3, 5, 7, 10 lacs 24 / 48 months depending on the ailments No Pre Policy Medical Check up
Star Health - Senior Citizen Red Carpet Health Insurance Plan

Star Health		 Any person between 60 and 75 years of age at the time of entry can take this insurance policy. 1,2, 3, 4, 5, 7.5, 10, 15, 20, 25 lacs 12 months No pre-acceptance medical test required
However if following medical records of the person proposed for insurance are submitted, a discount of 10% of is allowed. - Stress Thallium Report - BP Report - Sugar (blood & urine) (Fasting / Postprandial) - Blood urea & creatinine
Bajaj Allianz - Silver Health Plan for Senior Citizens

Bajaj		 This policy covers members up to from 46 to 70 years of age Renewal age upto 75 years 50, 000 - 5 lacs 12 months Pre Policy Medical Check up required for this plan
Apollo Munich Health Insurance - Optima Senior

Apollo Munich		 Any person whose age is 61 years and above.
No Maximum Entry Age.
Lifelong Renewal
 2, 3, 5 lacs 24 / 36 months depending on the treatment required Insured will be called for a medical check-up on the basis of your age, health declaration and cover opted for.
New India - Senior Citizen Mediclaim Policy

Tata AIG		 60 - 80 years (renewable up to 90 years of age Lifelong Renewal Two Options of 1, 1.50 lacs 18 months / 48 months for certain ailments Persons opting for a policy for the first time have to undergo prescribed Pre Health check up from an empanelled doctor.
HDFC Ergo – Silver / Gold Plan

india		 Any person whose age is 61 years and above. No Maximum Entry Age. Lifelong Renewal 3, 4, 5, 7.5, 10, 15 lacs 48 months Persons opting for a policy for the first time have to undergo a detailed prescribed Pre Health check up from an empanelled doctor in HDFC Ergo Network
Tata AIG - MediSenior Health Insurance

Religare Health		 Insureds of the age 61 and above
No Maximum Entry Age.
Lifelong Renewal
 1, 3, 5 lacs 24 / 48 months PPC Required and to be done at Tata AIG Authorised centres.
50% reimbursement of cost after proposal acceptance

Comprehensive mediclaim insurance for parents

While one is purchasing a Health Insurance policy for parents, there are a Few Factors to keep in mind while going through this process. They include:
  • Coverage : Keep in mind their medical requirements, health concerns, age, pre-existing medical conditions, issues that might affect your health insurance premium. Check importantly for sub-limits and co-payment clauses. Select a plan that offers maximum coverage and minimum restrictions. Almost all plans cover Inpatient hospitalisation, including Ambulance charges, Pre & Post hospitalisation expenses etc
  • Waiting Periods : This is the period/duration when the insured person has to wait before a defined illnesses is covered under the policy. During this period no claim will be payable for that illness. This period varies from 24/36/48 months depending on the insurance company / illness. In some cases, the health insurance company offers coverage on payment of additional premium. Opt for a shorted waiting period plan.
  • Claims Processing Capability : The Claim settlement ratio and Incurred claims ratio of the prospective insurance company are key factors to consider while choosing on one’s insurance partner. They should also evaluate the average turn around time (TAT) for settling a claim, lower the claims TAT, better for the insured to take on board as the insurance partner.
  • Co-Payments : Co-pay is the % of the claims expense that the policyholder will need to pay against each claim. Most senior citizen health plans come with a co-payment ranging from 10% to 30% depending on the treatment availed by the insured. Choose a plan with lesser co-pay %. Higher co pay could also mean a lower premium, in case the insured would prefer to bear a lower premium cost.
  • Lifetime renewal : While IRDAI mandates that all health insurance policies come with a lifetime renewal clause, there could be a few which come with some pre conditions. Opt for a plan that offers lifetime renewability option without any strings attached. This is particularly important for a Senior Citizen while buying their policy.
  • Pre-Hospitalisation/Post-Hospitalisation : These are hospitalisation expenses which are related to the ailment/disease for which the insured was hospitalised and which incurred before and after hospitalisation. In the case of senior citizens, the possibility of undergoing many pre hospitalisation tests as well as post hospitalisation recovery expenses could be relatively higher/longer and hence having an ideal plan with the longer pre & post hospitalisation coverage is ideal.
  • Pre Policy Health Check Up : Almost all plans insist on the senior citizen / insured going through a medical check up before granting coverage. Some of them also offer a waiver of this check up.
  • Cashless Treatment : Policyholders can go for cashless treatment at any of the hospitals which are part of the insurance company’s hospital network. and even ask for reimbursement of all medical-related expenses post the actual hospitalization. Hence it is important for the individual to review the number of hospitals in the network of the insurance company before making a final decision.
  • Individual Mediclaim insurance for Parents : If the family has floater plan coverage, it is recommended that the parents who are senior citizens have an individual plan covering them. This is better for two reasons - 1) if the senior citizens is included in the family group, then the premium for the group will be calculated based on the age of the senior citizen and hence the premium cost will increase and 2) since the propensity of a claim is higher with a senior citizen, having a separate plan means a separate sum insured, rather than utilising the sum insured of the entire family plan.
  • Free-look & Grace Period under Parents Mediclaim insurance : A free look period is a time within which a policyholder can cancel the policy and seek a complete refund. It is usually 15 days that allows the insured to review the policy terms and conditions and then decide whether to continue the coverage under the plan.. If the insured is not satisfied and wishes to cancel it, then he is eligible to get a full refund. Similarly all plans offer a Grace period of 30 days for payment of renewal/instalment premium, that is useful for a senior citizen.
  • Number of Day-care Procedures : Given that the individuals buying a senior citizen plan are only seniors, opting for an insurance partner who offers coverage for a higher number of day care procedures will be beneficial to the insured. Day care procedures are those which are completed in less than 24 hours and the do not require the insured to be an inpatient at the hospital, this will make to process comfortable for the senior citizen.
  • Income Tax Benefits for Parents Mediclaim insurance: Another factor to consider in a senior citizen health insurance plan is that all premiums paid by the policyholder will be liable to get tax benefits ranging from ₹25,000 up to ₹75,000 under Section 80D of the Income Tax Act, 1961

Benefits under Parents Health Insurance plans include

Some of the key benefits under the Parents medical 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 theatre 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 up to 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 insurer 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.

Parents Mediclaim insurance - FAQ’s

One needs to carry the following documents - Pre-policy medical check-up documents, Duly-filled proposal form, Supporting documents for any pre-existing condition, Age & Address proof.

This health policy entitles the proposer to avail tax exemption under section 80D of the Income Tax Act, 1961. You are eligible for an income tax rebate of ₹30,000 if you hold a mediclaim policy for senior citizens for your elderly parents. You can also avail am additional rebate of Rs. ₹5,000 for preventive health check-ups annually. As a parent who is a senior citizen who is the proposer, this rebate is as high as ₹50,000 per year.

As a person advances in age, the frequency and severity of illness (propensity of falling ill) increases as well. Most individuals in this age group have no regular source of income apart from the pension/investment income/savings. That is the reason, getting a health insurance at this point of time becomes all the more critical.

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