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What Our Plans Cover
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In-patient hospitalisation
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Pre and post-hospitalisation withi...
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Day-care procedures including cata...
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ICU charges up to the stated cap
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Ambulance charges up to the policy...
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Domiciliary treatment where hospit...
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AYUSH treatment at a recognised in...
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Pre-policy medical check-up
Benefits, waiting periods, co-payment and other terms vary from insurer to insurer and plan to plan.
Who Can Consider This Plan?
- Indian resident, typically aged 18 to 65 at entry
- Children can usually be covered from 91 days, subject to insurer rules
- Medical tests may be required above a threshold age or sum insured
- Full and accurate disclosure of existing conditions, medication and family history
- Tobacco and alcohol use must be declared — non-disclosure is the leading cause of rejected claims
What May Not Be Covered?
- Pre-existing conditions inside the waiting period, commonly one to four years
- The stated co-payment share of every claim — this is not a deduction you can avoid
- Amounts above any procedure sub-limit, notably for cataract and joint replacement
- Treatment for conditions not disclosed in the pre-policy medical
- Cosmetic and elective procedures
Always check the policy wording before you commit.
Why Choose Wealth & Covers?
- Expert advice to choose the right plan
- Plans from leading insurance companies
- Hassle-free process and documentation
- End-to-end support, including claim assistance
- Dedicated relationship manager
Our Insurance Partners
- Star Health Insurance
- Care Health Insurance
- Niva Bupa Health Insurance
- HDFC ERGO
- ICICI Lombard
- Bajaj Allianz
We represent multiple providers to help you find the most suitable option at the best price.
- Expert Guidance Personalised advice from experienced insurance professionals.
- End-to-End Support From choosing the right plan to claim assistance, we are with you always.
- Claims Assistance Hassle-free claim support to ensure you get what you deserve.
- Transparent Process Clear information, easy documentation and a hassle-free experience.
Overview
Senior citizen health plans are written for people entering cover at or after sixty. They exist because ordinary retail plans either decline that age group or price it out, and because the pattern of claims at that age is different: more admissions, more chronic management, longer stays.
Insurers manage that risk with three levers rather than one. There is usually a co-payment, meaning you carry a fixed share of every claim. There are often sub-limits on specific procedures. And the pre-existing waiting period is the single most important number in the document, because at this age most buyers have something to declare.
Comparing these plans on premium alone is close to meaningless. Two policies at the same price can differ by a factor of two in what they actually pay on the same hospital bill.
Who should consider it
This is for a parent or an older relative who has no cover of their own, or whose only cover was an employer policy that ended at retirement. It is also for anyone who has been quoted an ordinary retail plan at sixty-five and found either a decline or a premium built on an unrealistic health declaration.
If the person still has an active retail policy from earlier years, keep it. A policy bought at forty-five and renewed continuously is almost always better than anything available to buy at sixty-eight — the waiting periods are behind you and the terms are older and kinder.
Benefits
- Entry is available at ages where ordinary retail plans decline or price out
- Pre-existing conditions are contemplated by the product rather than treated as an obstacle
- Higher Section 80D limit applies where the insured is a senior citizen
- Cashless access at network hospitals, which matters more when travel is harder
- Domiciliary and day-care cover suits the treatment patterns of this age group
- Lifelong renewability on most plans once you are inside
What is covered, and what is not
Read the right-hand column first. It is the one that decides whether a claim is paid.
Typically covered
- In-patient hospitalisation, subject to the plan's co-payment
- Pre and post-hospitalisation within the stated windows
- Day-care procedures including cataract, subject to any sub-limit
- ICU charges up to the stated cap
- Ambulance charges up to the policy limit
- Domiciliary treatment where hospitalisation was not possible
- AYUSH treatment at a recognised institution, where provided
- Pre-policy medical check-up, often at the insurer's cost or shared
Typically not covered
- Pre-existing conditions inside the waiting period, commonly one to four years
- The stated co-payment share of every claim — this is not a deduction you can avoid
- Amounts above any procedure sub-limit, notably for cataract and joint replacement
- Treatment for conditions not disclosed in the pre-policy medical
- Cosmetic and elective procedures
- Non-medical consumables
- Assisted living, attendant and nursing-at-home charges outside a covered admission
Inclusions and exclusions vary between providers and between plans from the same provider. The wording in your own policy document is what governs — we will walk you through it before you buy.
How it works with us
- 1 Tell us who is being covered Age, city, existing conditions and any cover you already hold. Two minutes, and it decides everything downstream.
- 2 We shortlist on structure, not price Room rent, co-payment, sub-limits and pre-existing waiting periods — the four things that decide what you actually get paid.
- 3 You see two or three options, with the trade-offs named Including what each one gives up. If your existing policy is already the right answer, we will tell you that.
- 4 Proposal and medicals We help you complete disclosure properly. A medical test, where required, is usually arranged at home.
- 5 Policy issued, and we stay on the file At claim time you call us, not a helpline. We prepare the file, submit it and chase the insurer until it settles.
Important considerations
The things a brochure tends to leave out. Read these before you decide.
- Co-payment is the number that decides the plan. A 30% co-pay on an ₹8 lakh admission is ₹2.4 lakh out of your own pocket, whatever the sum insured says.
- A shorter pre-existing waiting period is usually worth more than a larger sum insured at this age, because the conditions that will generate claims are already present.
- Sub-limits on cataract and joint replacement bite frequently in this age group. Read them before you read the headline cover.
- Never let an older policy lapse in order to buy a new one. Continuity of an existing contract is worth more than any feature on a new one.
- Complete the pre-policy medical honestly and keep the report. It becomes the reference point for what the insurer accepted as pre-existing.
Documents required
- Completed proposal form with full medical disclosure
- Identity proof — Aadhaar, passport, voter ID or driving licence
- Address proof
- PAN card
- Recent passport-size photograph
- Medical reports, where the insurer requires them at your age or sum insured
- Existing policy copy, if you are porting
Frequently Asked Questions
Why do these plans carry a co-payment?
It is how the insurer shares claim frequency with the policyholder at an age when admissions are more likely. It reduces the premium and it reduces what you get paid. Where a plan offers a lower co-payment for a higher premium, do the arithmetic on one realistic admission before choosing.
My parent has diabetes and hypertension. Can they still get cover?
Usually yes. These conditions are common enough that senior plans are built around them. Expect a waiting period before related claims are payable, possibly a loading on the premium, and in some cases a specific exclusion. Declare both conditions in full — this is precisely the disclosure that decides later claims.
Is a senior plan better than continuing an old retail policy?
No. A retail policy bought years earlier and renewed without a break is almost always superior, because the waiting periods are served and the terms are older. Only buy a senior plan where there is no existing cover to continue.
What is a pre-policy medical and who pays for it?
A short set of tests the insurer uses to underwrite the risk. Many insurers fund it fully or partly when the policy is issued. Its real value to you is the record it creates of what was disclosed and accepted.
Does the higher 80D limit apply automatically?
The higher limit applies where the insured person is a senior citizen, and it is available under the old tax regime. If you are paying the premium for a parent, the deduction is generally available to you as the payer, subject to the usual conditions.
Want a shortlist instead of a catalogue?
Tell us the situation and an advisor comes back with two or three options that actually fit — and names what each one gives up.