ManipalCigna rolls out senior citizens' health plan without sub-limits, co-pay

Private health insurer Manipal Cigna has announced the launch of a dedicated cover for senior citizens, Prime Senior, with two variants.

According to the company, the product does not feature room rent sub-limits, co-pay and pre-existing disease waiting period clauses.

“The new plan is designed after considering the various problems that people face in the golden years of their life. They may have suffered from medical complications earlier or may have an income problem as most of them are living on their retirement funds,” said Prasun Sikdar, MD and CEO, ManipalCigna Health Insurance.

The sum assured offered under the product ranges from Rs 3 lakh to Rs 50 lakh. Cumulative bonus - 10 percent for every claim-free year under Classic and guaranteed 10 percent under Elite plan for every completed year - can go up to 100 percent of the sum insured.

Read: Your guide to picking the right health insurance policy 

The company will not insist on pre-policy issuance medical check-up for senior citizens buying this policy. It will rely on their health declaration instead, which makes it imperative for senior citizen applicants to fill up their proposal forms and answer questions carefully and in detail.

It provides the option of unlimited restoration of sum insured (in-built in case of Elite variant), reduction in pre-existing disease waiting period to 90 days and coverage of non-medical items and outpatient department (OPD) expenses.

Doing away with the proportionate deduction clause will allow policyholders to choose rooms where rent is higher than their eligibility. “Due to the clause, the entire bill gets inflation as doctor’s fees and even cost of injections, for instance, go up,” said Sikdar. Here, they will need to pay the difference in room rent.

The OPD cover will take care of non-hospitalisation expenses such as doctor’s consultation fees on a cashless basis, provided the advice is sought from doctors in ManipalCigna’s cashless network.

Also read: All about buying health insurance cover for senior citizens

Non-medical expenses that form part of the hospitalisation bill are not reimbursed by the insurance companies. “These constitute 15-20 percent of the hospitalisation bill that have to be met out of pocket,” said Sikdar. Under Prime Senior, policyholders can buy an optional cover to take care of such expenses.

Under the Classic variant, a senior citizen aged 60 buying a cover of Rs 10 lakh will be charged an annual premium of Rs 18,000 plus taxes. A 75-year-old Mumbai resident buying a Rs 10-lakh cover will have to shell out a premium of Rs 44,000 a year.

While senior citizens need health insurance the most, many are unable to procure one. This is either because of prohibitive premiums or denial of coverage due to health conditions. They have to settle for policies that do not meet all their requirements due to a plethora of restrictions.

The last three months have seen the launch of two senior citizen-focussed health insurance plans so far. Bajaj Allianz General Insurance had launched a senior citizen-focussed optional rider benefit in December. In a recent interview to Moneycontrol, another standalone health insurer – Niva Bupa – indicated that the company will focus on this category in the months to come.

Sikdar said ManipalCigna clocked a 36 percent growth in premiums in the nine months of this financial year (April-December 2023). “We believe we will grow faster than the industry’s growth of 25-30 percent next financial year as well,” he said.