With the increasing cost of healthcare, proper health insurance is crucial for any family. If you have elderly parents, getting health insurance is even more necessary. As people age, they tend to fall ill more, have more diseases, and visit doctors and hospitals more frequently. If your parents are currently covered under a health policy, it may not be enough.

In this post, you will learn how to choose the right health insurance for your senior parents. But before that, let’s discuss what health insurance is for senior citizens.

Health Insurance for Seniors

This is a contract between the policyholder and the insurer that is meant for people who are 60 years of age or older.

The policyholder has to pay a premium to the insurance provider. The insurer pays for the medical expenses, such as hospitalization, daycare, and pre- and post-hospitalization; however, the premium charges for a senior health insurance policy are much higher than those for a younger individual.

So, what are the factors you should consider when buying health insurance for senior citizens? Find them below:

6 Factors to Consider Before Buying Senior Citizen Health Insurance

1. Coverage for In-Patient Hospitalization

The insurer provides in-patient hospitalization coverage for the medical expenses incurred by the policyholder when they get admitted to the hospital for days or months. It should cover all hospital expenditures, such as medicine, nurses’ expenses, and doctor and specialist fees. Certain senior citizen health insurance policies in the marketplace have sub-limits for certain expenditures.

For instance, some plans cover in-patient hospitalization but with sub-limits on doctor fees. As a senior citizen, you may need to stay longer in a hospital. You should look for a senior citizen medical plan that offers maximum in-patient hospitalization coverage.

2. Restrictions on Post-Hospitalization Expenses

All costs incurred by the policyholder after being released from the hospital that are directly related to the illness or injury for which they were admitted will be reimbursed. The post-hospitalization eligibility period is usually 60 to 90 days. The post-hospitalization period has shrunk several health insurance plans for senior citizens.

Some plans say the post-hospitalization coverage would be approximately 7 to 10 percent of the claimed amount. So, you should check the terms and conditions before buying a policy.

3. Restrictions on the Number of Day-Care Hospitalizations

Some procedures, such as chemotherapy, dialysis, and cataract surgery, take less than a day to get completed at a hospital. Even though many health insurance plans for senior citizens don’t cover day-care facilities, some plans limit that number.

The number of day-care facilities can be as low as 8 or 10 for some plans. Ensure you are aware of the number of day-care facilities included in a policy before buying a health plan.

4. Pre-existing Illness Terms and Conditions

Your senior parents may have one or more pre-existing illnesses. So, check the terms and conditions related to pre-existing illnesses when looking for a policy.

You should know if health insurance covers some pre-existing illnesses, their waiting periods, and co-payment clauses.

5. Waiting Period, Co-payment, Exclusion, and Sub-limits

Don’t forget to read the insurance policy wording to learn the waiting period, co-payment, exclusions, and sub-limits. See below for more on what they are:

Waiting Period

It is a type of hibernation period during which no claims will be allowed. This clause applies if you have a pre-existing illness. The waiting period is usually 2–4 years for a health insurance policy. However, many insurance providers have reduced the waiting period to 1 year for the medical insurance of senior citizens, since there is a greater need for quick hospitalization among the senior population.

Co-payment Clause

A co-payment requires you to pay a share of the claim from your bank balance. You should consider two things when choosing health insurance for senior citizens. Check if the insurance policy for senior citizens comes with a co-payment clause. Another thing you need to check is if the co-payment clause is related to the plan’s waiting period.

There is no such thing as a free lunch. The amount of the co-payment goes up if the waiting period shortens. Read the policies about the waiting period and co-payment clause. For senior citizen medical insurance, the policyholder’s co-payment percentage ranges between 10% and 30%.


Numerous medical insurance plans for senior citizens have exclusions. A health insurance plan may not cover healthcare for certain medical conditions. Read the policy’s fine print to learn about the excluded diseases.

Buy a health insurance policy for senior citizens that has no or minimal exclusions.


A sub-limit is an amount that a policyholder can claim for a specific expense or procedure. Many senior citizen Mediclaim policies have certain sub-limits. For instance, cataract surgery may have a certain limit per eye, as may kidney dialysis and knee-cap surgery.

Go through the policy points to learn about the treatments or procedures having sub-limits and the terms and conditions for all of them.

6. Premium Charges vs Benefits Included

The premium amount is much higher than the policies for younger individuals for senior citizen health insurance. Don’t choose the policy that is offered to you at the lowest premium when comparing health insurance for senior citizens.

Buy the insurance policy that offers maximum benefits for a lower premium charge. Plus, some insurers have started offering monthly premium payments, which give you relief from big payments all at once.

Consider these factors and search accordingly to buy the right health insurance for your senior parents. You can also consider other important factors, such as room rent allowance, enhanced sum insured, and OPD expenses, when buying a health insurance policy. Once you consider the five points above, you can choose a policy depending on the other benefits offered.
Health insurance is the best gift you can offer your parents. So, make sure you select the best one for your needs. DeverCare helps you to get the best health insurance through our expert brokers. Contact us today for more information and quality insurance services.

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