Government Health Insurance for Senior Citizens — Which one should you choose?

Health Insurance for Senior Citizens

Health insurance is a necessary choice regardless of your age group. But if you’re on the older side, then health insurance is mandatory for you.

It comes as no surprise that senior citizens are more vulnerable to health issues. They require frequent medical attention, maybe even for routine bodily functions. 

We all want to hold on to our physical fitness for as long as possible. You should, however, prepare for the possibility that you may need extra medical attention as you grow older. 

With the rise in medical expenses for even healthcare services, it has become essential to have health insurance coverage. The Indian government has introduced several health insurance schemes like Ayushman Bharat or the Pradhan Mantri Jan Arogya Yojana specifically designed for senior citizens.

Let’s find out about the benefits of government health insurance for senior citizens and whether you should pick one over a private health insurance provider.

Why is it Important to have Government Health Insurance for Senior Citizens?

Coverage for Pre-Existing Diseases:

Most private health insurance policies exclude pre-existing conditions from their coverage. This is one of the main disadvantages. However, government health insurance schemes cover pre-existing diseases, ensuring senior citizens get the required medical care.

Cashless Treatment:

Cashless treatment facilities at the approved list of hospitals ensure that you do not have to worry about arranging funds during emergencies.

No Upper Age Limit:

Private health insurance policies have upper age limits, making it difficult for senior citizens to get coverage. Government health insurance policies are a lot more inclusive. Generally, they have no upper age limit, ensuring that every senior citizen can avail of the benefits.

Affordable Premiums:

The government is not looking to make a profit from you. These health insurance policies are, therefore, very economical. They have affordable premiums, making it easier to get coverage without worrying about the financial burden.

Comprehensive Coverage:

Government health insurance schemes offer comprehensive coverage, including hospitalisation expenses, pre and post-hospitalisation expenses, ambulance charges, and more.

Tax Benefits:

Senior citizens can avail of tax benefits on the premium paid towards government health insurance schemes. Under section 80D of the Income Tax Act, senior citizens can claim a deduction of up to ₹50,000 on the premium paid towards health insurance.

Pradhan Mantri Jan Arogya Yojana — PM-JAY Health Insurance for Senior Citizens

The Pradhan Mantri Jan Arogya Yojana PM-JAY, launched in 2018, provides health insurance for senior citizens. It aims to financially protect senior citizens and their families against catastrophic health expenditures. 

Anybody who is a citizen of India and above the age of 60 can apply for Pradhan Mantri health insurance for senior citizens.

The scheme is targeted at families that fall under the socio-economically vulnerable sections of the population. This includes families with an annual income of up to ₹5 lakhs, rural households, and certain occupational categories such as manual scavengers, street vendors, and rag pickers.

The features of the Pradhan Mantri health insurance for senior citizens are as follows:

• Medical coverage of up to ₹5 lakhs per family per year.
• Cashless treatment in both government and private hospitals across India.
• Pre-existing diseases, including chronic conditions such as diabetes, hypertension, and cancer.
• No age limit for senior citizens.
• Transport allowance to cover the cost of transport to the hospital and back home.
• Wellness benefits such as free health check-ups and consultations with doctors for the early detection and prevention ofdiseases.

Government Health Insurance for Senior Citizens vs Private Health Insurance for Senior Citizens

Now, there is no real answer when it comes to the debate of government health insurance for senior citizens vs. private health insurance. There are definite pros and cons to both options.

In India, the government also offers health insurance for senior citizens through the Pradhan Mantri Jan Arogya Yojana PM-JAY. It provides coverage for hospitalisation expenses, among other benefits.

Since its inception in 2018, PM-JAY has expanded basic healthcare access to underprivileged sections of society. It is now easier to access the base medical facilities you require. 

But, you have to keep in mind that this scheme is meant for the downtrodden section of society. It is cheap and has economic benefits because the target audience cannot afford anything else. 

Please feel free to opt for private health insurance plans if you can. These plans can also offer a range of benefits, including coverage for hospitalisation expenses, pre-existing conditions, and critical illnesses. They may also provide additional benefits, such as cashless hospitalisation and wellness programs.

Of course, private health insurance plans can be more expensive than government health insurance and may not be affordable for some senior citizens. Apart from that, private health insurance plans may have exclusions or limitations on coverage, which may not be present in government health insurance plans.

Don’t be deterred though — private health care is not all that expensive, and certain insurance providers like Aditya Birla Health Insurance have a range of inclusive plans that are ideal for senior citizens. 

Take the Aditya Birla Activ Health Platinum Enhanced Insurance Plan, for instance. This plan is quite cheap — the yearly premiums start from ₹7,937. It is also very inclusive and has no maximum age limit for the eligibility criteria. It covers a range of medical conditions, including critical illnesses.