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All About Optima Senior Health Insurance Policy

Buying health insurance for senior citizens is a must. An ideal policy helps the elderly secure their financial future without having to worry about exhausting their savings to cope with medical expenses. Since the risk of illnesses or diseases are more at old age, it is very important for every senior citizen to safeguard themselves with the best senior citizen health insurance policy as soon as possible. If looking for one such policy to buy, learn that Optima Senior would be a great option to go with.

What Is Optima Senior?

A simple yet reliable policy by HDFC Ergo (formerly Apollo Munich), Optima Senior is dedicated to senior citizens. It takes complete care of senior citizens and their spouse by providing a hassle free health insurance cover at an affordable premium price. A wonderful plan offering comprehensive coverage, Optima Senior is laden with multiple health benefits as well as discounts.

What Are the Prime Features of Optima Senior?

The key features of Optima Senior include:

  • Lifelong renewability
  • Policy term of 1 year or 2 years
  • Available on individual sum insured basis
  • Eligibility age starting from 61 years and above
  • Cashless treatment available across 4000 network hospitals
  • Sum insured range options Rs. 2 Lakh, Rs. 3 Lakh and Rs. 5 Lakh

What Are the Benefits Covered Under Optima Senior?

The prime features covered under Optima Senior health insurance include:

  • In-patient hospitalization
  • Pre-hospitalization up to 30 days
  • Post-hospitalization up to 60 days
  • 140-day care procedures
  • Domiciliary treatment
  • Organ donor expenses
  • E-opinion (one opinion per policy year)
  • The waiting period for certain diseases is 30 days
  • Pre-existing diseases covered after a period of 3 years
  • Accidental injuries covered (for first 30 days of the policy)
  • Emergency ambulance expenses up to Rs. 2000 per hospitalization
  • Tax benefits according to Section 80D of the Income Tax Act, 1961

Does Optima Senior Come With the Co-Payment Feature?

Yes, Optima Senior includes the co-payment feature. The co-payment options are:

  • In the case of hospitalization, co-payment of 15% and 30% are applicable as per the room type.
  • In the case of specified surgeries or illnesses, a co-payment of 30% is applicable.
  • Co-payment of 15% is applicable for daycare procedures.

Does Optima Senior Provide Discounts?

The discount benefit under Optima Senior policy includes:

  • A non-cumulative discount of 5% on renewal premium payable after every claim-free year of continuous coverage.
  • 5% discount if policyholder and spouse buy the plan
  • Additional discount of 7.5% on total premium for choosing a 2-year policy term

What Are the Exclusions Under Optima Senior?

The list of exclusions under Optima Senior includes:

  • Dental treatment
  • Cosmetic surgery procedures
  • Expenses related to pregnancy
  • Abuse of intoxicating substances
  • HIV/AIDS and related disease expenses
  • Hospitalization owing to war or an act of war
  • Items of personal comfort and convenience
  • Treatment for congenital diseases, mental disorders

Is There Any Claim Based Loading or Claim Based Underwriting in Optima Senior?

No, in the case of Optima Senior, neither renewal premium is loaded or coverage is denied in case the policyholder claims or falls sick after taking the policy.

Final Words

Optima Senior is one of the best policies for senior citizens. The vast benefit umbrella under this policy covers all health insurance benefits the elderly can think of. Optima Senior is definitely a worthwhile purchase.

Disclaimer: This article is issued in the general public interest and meant for general information purposes only. Readers are advised not to rely on the contents of the article as conclusive in nature and should research further or consult an expert in this regard.

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