All you need to know about mediclaim for senior citizens


21 Jul 2023

Read about about mediclaim for senior citizens what is covered in it. For more information, check out the health insurance plans from Kotak General Insurance.

With increasing costs of healthcare and medical treatments, it has become extremely important to have adequate health insurance, especially for senior citizens. As your age increases, immunity becomes weaker and health conditions start developing resulting in an increased need for regular check-ups and medical care. A mediclaim policy for senior citizens is designed to provide coverage for medical expenses incurred by older individuals. These policies have a higher age limit for eligibility and offer health coverage to senior citizens.

Such plans protect your savings from inevitable and unexpected medical expenses. In this article, we will discuss in detail all that you need to know about a mediclaim policy for senior citizens.

What is covered in a senior citizen mediclaim policy?

It is important to understand the terms and conditions of a senior citizen mediclaim before buying so that you get the coverage that you need. Common medical expenses that are covered under mediclaim for senior citizens are;

1. In-patient hospitalisation expenses -

It includes nursing costs, room and ICU charges, fees for doctors, consultants, surgeons, specialists, and other medical practitioners, cost of medicines and medical supplies related to the treatment.

2. Cashless hospitalisation -

Senior citizen mediclaim plans offer cashless hospitalisation in network hospitals. In a cashless hospitalisation, you do not need to pay the hospitalisation bills out of your own pocket; the same would be paid directly by the insurer. The other type of claim, i.e. reimbursement claims, especially in non-network hospitals, is also allowed in mediclaim for senior citizens.

3. Pre-existing diseases -

Pre-existing diseases such as diabetes, and hypertension are quite common in old age. Hence, coverage for these diseases is provided as per the policy terms and conditions. Do check the waiting period for pre-existing diseases while opting for a mediclaim for senior citizens.

What to consider while buying a senior citizen mediclaim policy?

Here are some important points to consider before you select a mediclaim for senior citizens.

1. Limitations -

Senior citizen mediclaim plans often have limitations like limited sum insured and no riders available. There could be limitations on hospitalisation expenses such as room rent sub-limit, doctor’s fee sub-limit, etc. in a mediclaim for senior citizens.

2. Waiting period for pre-existing diseases -

Normally senior citizen mediclaim policies have a low waiting period for pre-existing diseases because there is an increased need for hospitalisation in old age. So always remember that the lower the waiting period the better the plan.

3. Co-payment -

It is the percentage of the claim amount that the policyholder has to bear himself. Most mediclaim policies for senior citizens come with a co-payment clause and as the waiting period is reduced, the co-payment goes up.

4. Exclusions -

Do check what is not covered in the policy and select a policy with fewer exclusions.

5. Premium -

Since mediclaim is a basic health insurance plan without additional benefits like coverage for critical illnesses, it comes with a low premium. A mediclaim policy for senior citizens is a low premium policy with basic coverage.

However, if you want comprehensive coverage with additional benefits, it is best to opt for a comprehensive health insurance plan for senior citizens which can be customised with enhanced coverage. The premium could be higher than a mediclaim policy, but the increase in coverage could be worth the price!


Select a mediclaim policy considering the above-mentioned factors. Remember that senior citizen health insurance is the best and most necessary investment that everyone should make for a financially secure future. At Kotak General Insurance, you can choose the most comprehensive coverage as per your requirements.

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Team Kotak GIC

The content of this blog has been created and carefully reviewed by the esteemed team at Kotak General Insurance, with the sole purpose of providing valuable guidance and sharing insights on the importance of general insurance. Our objective is to assist users in making informed decisions when purchasing or renewing insurance policies for their cars, bikes, and health. Our expertly curated information aims to empower our readers with the knowledge they need to protect their valuable assets and financial interests.