NRIs are usually worried about their parents’ health and financial well-being and they are constantly looking for the best Health Insurance for Senior Citizens in India. Most of the seniors in India don’t have health insurance, making them vulnerable to financial risk. Without health insurance, many elderly simply choose to not avail of health treatments thereby ruining their quality of life.

(Please note: This article is written by a senior advisor at Niva Bupa Health Insurance and will provide 1-to-1 free consultation about Health Insurance for Senior Citizens in India. Contact +91-9930607322)

Senior citizens should obtain a health insurance plan because they may have significant medical demands. Compared to younger people, seniors are more vulnerable to certain diseases and health issues. Health issues associated with age usually require expensive and continuous therapy.

An exclusive plan from Niva Bupa Health Insurance that offers many advantages is available to senior citizens. Niva Bupa’s Senior First could be the plan that’s right for your parents as they won’t have to worry about covering the costs of medical care associated with health issues.

The Insurance Advisor provides service to the senior citizens taking the Niva Bupa’s Senior First health insurance policy so that you and your parents can be sure of support during hospitalisation and claims-processing.

Plan Type	Niva Bupa Senior First Health Insurance Plan
Type of Policy	Health Insurance Plan
Plan Unique Identification No.	MAXHLIP21575V012021

The Niva Bupa Senior First is a Health Insurance for Senior Citizens in India, made to provide seniors over the age of 60 with complete medical coverage. Included in the policy’s features are complete coverage of all day care services, restoration of the insured amount for multiple claims within a year, substantial coverage of cutting-edge hospitalisation procedures, and reimbursement of land and air ambulance charges. Along with choosing an annual deductible option for lower premium costs, the policyholder also has the option to totally or partially waive the co-payment provision. Furthermore, there are no exceptions for widespread medical disorders like cataracts and joint replacements.

Health Insurance for Senior Citizens in India – Niva Bupa’s Senior First

Index of Content

Highlights
Key Features
Optional Features
Variants
Eligibility Criteria
Claim Process

Highlights of the Health Insurance for Senior Citizens in India

The health insurance plan comes in two variants – Gold and Platinum.
Age of entry is from 61 to 75 years.
The sum insured / cover amount ranges between INR 5 lakh to INR 25 lakh.
Only 2 years waiting period for existing health ailments.
Zero co-pay is available.
Covers expenses 60 days prior to hospitalisation and 180 days post hospital discharge.
Completely cashless coverage for hospital admission costs at 8500+ network hospitals pan-India.
The treatment of organ donors’ medical expenses is also covered.
Daycare expenses for ENT, dental, and other services.
Under the gold plan the insured gets access to shared room while the platinum plan gives access to single private room.
Obtain coverage for AYUSH medical expenses.
Insurance coverage for modern medical procedures, such as a few robotic surgeries (INR 1 lakh per claim).
Coverage for a road ambulance of INR 2,000 and an air ambulance of INR 2,50,000.
A 10% bonus of the remaining sum insured is given to the insured in the event of a claim-free year. This functions as a reward for the insured not using his or her health insurance.
Offer the platinum plan’s reassurance benefit, which reinstates the sum insured after the first claim is made to ensure that the insured never runs out of coverage. Regardless of the quantity of claims resolved, this reinstatement is unrestricted within a policy year.
With this policy, the insured has the choice to pay an additional premium and reduce the co-payment from 50% to 0%, 20%, 30%, or 40%.
The insured might also choose for a yearly deductible to get co-payment-free medical coverage. Deductible refers to the situation in which the insured pays the agreed-upon sum for hospital admission, and the insurance company pays the difference if the total cost exceeds the agreed-upon sum.

Key Features of the Health Insurance for Senior Citizens in India

ReAssure benefit: The insured person may submit multiple claims for the treatment of any ailments throughout the course of the year. After each claim, the sum insured will be reinstated back to the maximum base sum insured. This unique Reassure feature is available in the Platinum variant only.
For example:
- Mr. Patil has a Niva Bupa Senior Citizen health insurance policy with a base sum insured of Rs. 15 lakhs. Due to certain health reasons, he gets admitted and makes his first claim of Rs. 8 lakhs. After the claim, the base sum insured that remains is Rs. 2 lakhs.
- Now suppose, in the same year Mr. Patil had to be admitted in the hospital again for same or different ailment. He’s treatment expenses are Rs. 13 lakhs and he makes a claim of that amount. In such a case, the total claim of Rs. 12 lakhs (2 lakh from the base sum insured and 10 lakhs from the ReAssure benefit) is paid to Mr. Patil. The balance of 1 lakh will have to be borne by him.
- Imagine, in the same year Mr. Patil makes a third claim of Rs. 5 lakhs. In this scenario, the base sum insured was completely exhausted but it was triggered up to the limit of base sum insured i.e. Rs. 10 lakhs. So, the third claim will be completely covered under the policy.
Direct Claim Settlement: In case of hospitalization, the insured person or his/her relatives can settle the claim directly with Niva Bupa. A third-party authority will not be involved in claim settlement thus maintaining transparency.
No Claim Bonus: With Niva Bupa Senior Citizen Health Insurance plan, an additional 10% of the cover amount / sum insured is added as a no-claim bonus for each year without a claim (maximum of 100% of the base sum insured).
No Room-rent capping: The rent on the hospital room is not subject to any sub-limits under Niva Bupa Senior Citizen health insurance. This will ensure the best experience of getting healthcare.
In-patient care: Senior citizens will receive cashless coverage for their medical costs at selected all network hospitals in India.
Organ transplant: Along with the insured person having an organ transplant surgery, the medical costs associated with an organ donor’s inpatient care are also covered.
Day care treatment: Senior citizens gets covered for daycare treatment. Day care treatments are defined as medical and/or surgical procedures performed in a hospital or daycare clinic in less than 24 hours, often while the patient is under general anaesthesia.
Hospital accommodation: There is no room rent cap with this Senior Citizen Health Insurance Plan for any of the options you select. Be it a single private room under the Platinum plan of Niva Bupa Senior First or a shared room under the Gold plan.
Domiciliary Hospitalization: The medical expenses involved with the therapy will be compensated even if the insured senior gets treatment at home on the advice of a doctor due to a scarcity of hospital beds.
Pre & Post hospitalization cover: The insured person’s both pre- and post-hospitalization costs are covered by Niva Bupa’s Senior Citizen health insurance plan. The medical costs associated with the hospitalisation are covered for a period of 60 days prior to admission and a period of 180 days following discharge.
Waiting period for pre-existing diseases: The insured senior citizen with a specific pre-existing conditions will have to wait only two years (instead of three years) under the Senior First plan. After the two years waiting time is over, they can submit claim for the pre-existing conditions.
Co-payment clause (Zero Co-payment available): Every senior citizen plan always involves a co-payment clause. Co-payment denotes a cost-sharing contract between the insurance company and the insured senior citizen. But under the Niva Bupa Senior Citizen health insurance plan, the co-pay percentage is up to the insured senior citizen to decide. The co-payment amount can be set by the insured at 40%, 30%, 20%, or even 0%. For example; Mr. Patil, aged 69 years has a Senior First Policy, the Niva Bupa Senior Citizen health insurance plan with 5 Lakhs cover. In accordance with the co-payment agreement, he consents to a 0% co-payment or cost-sharing. In this scenario, suppose the patient’s final hospital cost totals roughly Rs. 5 lakhs, the 0% co-payment condition requires Mr. Patil to pay nothing out of his own pocket.

Optional Features of the Health Insurance for Senior Citizens in India

Safeguard: Gain access to additional special advantages, includes –
- a yearly increase in coverage depending on the rate of inflation without affecting the premium
- coverage for non-payable products and
- no impact on no-claims bonuses if the treatment cost is up to INR 50,000.

Variants of Niva Bupa Senior First Plan

Depending on their specific needs, senior citizens can choose from any of the Niva Bupa Senior Citizen plan variations. Each plan is self-sufficient and has features that are largely the same. Check the two varients provided by the Niva Bupa Senior Citizen Health Insurance Plan:

Variants	Gold	Platinum
Base sum insured	5 lakhs/10 Lakhs	5/10/15/20/25 Lakhs
Room Category	Shared room	Single Private Room
Ambulance coverage	Road ambulance: up to Rs. 2,000 per hospitalization Air ambulance: up to Rs. 2,50,000 per hospitalization
ReAssure Feature	NA	Can reinstate the base sum insured value unlimited times
Health Check-up	NA	Up to Rs. 500 for every 1 Lakh. In an Individual plan, the maximum cost covered is up to Rs. 5,000. In a Family Floater plan, maximum cost covered is up to Rs.10,000.
Co-Payment Clause	Co-payment clause is mandatory under Senior Citizen plan
Modern Treatments	Covered up to Sum Insured with a sub-limit of Rs. 1 Lac for every claim on a few robotic surgeries.
AYUSH Treatments	Covered up to Sum Insured
Pre-issuance medical test	Not Mandatory

Eligibility Criteria in Niva Bupa Senior Citizen Health Insurance Plan

In order to avail the Niva Bupa Senior Citizen Health Insurance Plans, there are a few criteria that need to be looked upon. These criteria have a key role when it comes to purchasing Health Insurance for Senior Citizens in India.

Categories	Eligibility
Minimum entry age	61 years
Maximum age for entry	75 years
Person’s covered	Individual and family floater (2 adults)
Co-payment category	Depending on the cost-sharing option chosen

Claim Process in Niva Bupa Senior Citizen Health Plan

The policyholder or his relatives can follow the below-mentioned procedure to claim for the hospitalization expenses. One can avail the cashless claim benefits at network hospitals or apply for a reimbursement claim.

Know about Cashless Claim Process:

When you choose to be hospitalized at network hospitals, you can go cashless.
You will be given a health card, which is required to be presented at the time of admission in hospitals. Also, the personal identification number such as passport, pan card or voter’s id.
Post this, the hospital will send a pre-authorization request to Niva Bupa
Next Niva Bupa will confirm the details and offer confirmation on the claim made for hospitalization.
The claim will be settled directly with the hospital after all the process is completed.

Know about Reimbursement Claim Process:

In case you are admitted to a hospital, it is mandatory to inform the Niva Bupa helpline within 48 hours.
You will be required to clear the hospitalization bill on your own
Post that, all the medical bills, reports, documentation, and discharge summary is to be duly collected from the hospital.
Then, all these documents are to be submitted along with the claim form filled and proof of identity and age proof to Niva Bupa for scrutinizing
Following the review of the claim, the policyholder will be authorized to either receive the reimbursement claim amount or would be denied, depending upon the plan’s terms and conditions.

Best Health Insurance for Senior Citizens in India