Lok Sabha Question No. 1367 (UNSTARRED), answered on 2023-12-11
Subject: Health Insurance Schemes
Ministry: FINANCE
Asked by: Vijayakumar (alias) Vijay Vasanth, Sunil Dattatray Tatkare

## GOVERNMENT OF INDIA MINISTRY OF FINANCE DEPARTMENT OF FINANCIAL SERVICES

## LOK SABHA UNSTARRED QUESTION NO. 1367

ANSWERED ON MONDAY, DECEMBER 11, 2023/AGRAHAYANA 20, 1945 (SAKA)

## HEALTH INSURANCE SCHEMES

## 1367. SHRI VIJAYAKUMAR (ALIAS) VIJAY VASANTH: SHRI SUNIL DATTATRAY TATKARE

Will the Minister of FINANCE be pleased to state:

- (a) the details of the health insurance schemes exclusively for senior citizens in the country;
- (b) whether the health insurance coverage among senior citizens is very low in the country, if so, the details thereof and the reasons therefor along with the corrective steps taken in this regard;
- (c) the percentage of senior citizens covered under health insurance schemes of public and private sector companies in the country, State/UT-wise; and
- (d) the  other  steps  taken/being  taken  by  the  Government  to  ensure  health  insurance coverage to each senior citizen in the country?

## ANSWER

## THE MINISTER OF STATE IN THE MINISTRY OF FINANCE (DR. BHAGWAT KARAD)

(a): General Insurance Companies including Standalone Health Insurance companies, offer different insurance products for various segments as per the policy terms and conditions.  The Illustrative list containing details of health insurance products exclusively offered to senior citizens by insurers registered with Insurance Regulatory and Development Authority of India (IRDAI), is at Annexure-I.

(b)  and  (c): The State /Union Territory wise data showing percentage of senior citizens covered as against total number of lives covered in respect of health insurance schemes, as furnished by IRDAI for FY 2022-23 is at Annexure -II.

(d): Health  Insurance  benefits  to senior  citizens  are  also  extended  through Ayushman Bharat - Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) and various State sponsored health insurance schemes. AB-PMJAY is flagship health assurance scheme of Government of  India  which  is  implemented  in  partnership  with  the  States/UTs.  The  scheme  provides health coverage of up to Rs. 5 lakh per family per year for secondary and tertiary care hospitalization to 12 crore beneficiary families comprising of 55 crore individuals.  Under ABPMJAY, for senior citizens, approximately 6.14 crore Ayushman Cards have been issued and more than 1 Crore hospital admissions have been authorized.

In addition to this, the sector regulator IRDAI has mandated to the insurers, that the premium charged for health insurance products offered by Insurers to senior citizens shall be fair, justified, transparent and duly disclosed upfront.  It has further stipulated that Insurers and TPAs, shall establish a separate channel to address the health insurance related claims and grievances  of  senior  citizens.  Insurers  are  also  encouraged  to  design  health  insurance policies for various groups, such as, specific age or gender or different age groups.

*****

## Annexure-I referred to in reply to part (a) of the Lok Sabha Unstarred Question No. 1367

## for 11.12.2023

| Illustrative list of Commercial Health insurance Products available exclusively for Senior Citizens   | Illustrative list of Commercial Health insurance Products available exclusively for Senior Citizens   | Illustrative list of Commercial Health insurance Products available exclusively for Senior Citizens   | Illustrative list of Commercial Health insurance Products available exclusively for Senior Citizens   |
|-------------------------------------------------------------------------------------------------------|-------------------------------------------------------------------------------------------------------|-------------------------------------------------------------------------------------------------------|-------------------------------------------------------------------------------------------------------|
| S. No                                                                                                 | Insurer                                                                                               | Name of the Product                                                                                   | Line of Business (Health Indemnity/ Health Benefit based/ PA / Domestic Travel/ Overseas Travel)      |
| 1                                                                                                     | Star Health & Allied Insurance Co. Ltd.                                                               | Senior Citizens Red Carpet Health Insurance Policy                                                    | Health Indemnity                                                                                      |
| 2                                                                                                     | Universal Sompo General Insurance Co. Ltd.                                                            | Senior Citizen Health Insurance Policy                                                                | Health Indemnity                                                                                      |
| 3                                                                                                     | Universal Sompo General Insurance Co. Ltd.                                                            | CSC - Senior Citizen Health Insurance Policy                                                          | Health Indemnity                                                                                      |
| 4                                                                                                     | Universal Sompo General Insurance Co. Ltd.                                                            | PoS - Senior Citizen Health Insurance Policy                                                          | Health Indemnity                                                                                      |
| 5                                                                                                     | New India Assurance Co Ltd                                                                            | Senior Citizen Mediclaim Policy- Entry age (60-80 Y)                                                  | Health Indemnity                                                                                      |
| 6                                                                                                     | New India Assurance Co Ltd                                                                            | New India Sixty Plus Mediclaim Policy Entry age (60-80 Y)                                             | Health Indemnity                                                                                      |
| 7                                                                                                     | New India Assurance Co Ltd                                                                            | OneHealth Senior                                                                                      | Health Indemnity                                                                                      |
| 8                                                                                                     | Magma HDI General Insurance Co Ltd                                                                    | OneHealth Senior                                                                                      | Health Indemnity                                                                                      |
| 9                                                                                                     | Tata AIA Life Insurance Co Ltd                                                                        | Tata AIA Life Insurance Smart Health Shield Plan                                                      | Benefit based                                                                                         |
| 10                                                                                                    | ICICI LOMBARD General Insurance Co. Ltd.                                                              | Golden Shield                                                                                         | Health Indemnity                                                                                      |
| 11                                                                                                    | National Insurance Co. Ltd.                                                                           | National Senior Citizen Mediclaim Policy                                                              | Health Indemnity                                                                                      |
| 12                                                                                                    | Niva Bupa Health Insurance Co. Ltd                                                                    | Senior First                                                                                          | Health Indemnity                                                                                      |
| 13                                                                                                    | Future Generali India Insurance Company Limited                                                       | Future Varishta Bima                                                                                  | Health Indemnity                                                                                      |
| 14                                                                                                    | Bajaj Allianz Allianz General Insurance Co. Ltd                                                       | Silver Health                                                                                         | Health Indemnity                                                                                      |
| 15                                                                                                    | HDFC ERGO General Insurance Co. Ltd.                                                                  | Optima Senior                                                                                         | Health Indemnity                                                                                      |

Source: IRDAI

## Annexure-II referred to in reply to part (b) and (c) of the Lok Sabha Unstarred Question No. 1367 for 11.12.2023

| Name of the State/UT      | Total Number of Lives covered (Retail)   | Sr Citizen Lives covered   | %Of Sr. Citizen   |
|---------------------------|------------------------------------------|----------------------------|-------------------|
| Andaman & Nicobar Islands | 8,278                                    | 228                        | 2.75%             |
| Andhra Pradesh            | 28,25,376                                | 1,17,016                   | 4.14%             |
| Arunachal Pradesh         | 17,861                                   | 284                        | 1.59%             |
| Assam                     | 10,21,071                                | 30,015                     | 2.94%             |
| Bihar                     | 59,17,754                                | 63,325                     | 1.07%             |
| Chandigarh                | 4,79,608                                 | 34,867                     | 7.27%             |
| Chhattisgarh              | 7,03,103                                 | 30,219                     | 4.30%             |
| Dadra & Nagar Haveli      | 77,909                                   | 2,920                      | 3.75%             |
| Daman & Diu               | 31,604                                   | 707                        | 2.24%             |
| Delhi                     | 96,99,674                                | 6,89,795                   | 7.11%             |
| Goa                       | 2,17,377                                 | 14,640                     | 6.73%             |
| Gujarat                   | 75,40,313                                | 4,26,119                   | 5.65%             |
| Haryana                   | 85,40,317                                | 3,76,524                   | 4.41%             |
| Himachal Pradesh          | 2,76,351                                 | 20,545                     | 7.43%             |
| Jammu & Kashmir           | 1,61,023                                 | 9,365                      | 5.82%             |
| Jharkhand                 | 11,74,733                                | 51,556                     | 4.39%             |
| Karnataka                 | 1,83,43,043                              | 13,59,898                  | 7.41%             |
| Kerala                    | 54,60,481                                | 4,50,603                   | 8.25%             |
| Ladakh                    | 1,298                                    | 40                         | 3.08%             |
| Lakshadweep               | 552                                      | 14                         | 2.54%             |
| Madhya Pradesh            | 36,01,474                                | 1,17,163                   | 3.25%             |
| Maharashtra               | 4,64,79,752                              | 37,44,924                  | 8.06%             |
| Manipur                   | 45,779                                   | 661                        | 1.44%             |
| Meghalaya                 | 27,325                                   | 672                        | 2.46%             |
| Mizoram                   | 6,332                                    | 106                        | 1.67%             |
| Nagaland                  | 12,118                                   | 368                        | 3.04%             |
| Odisha                    | 25,94,746                                | 1,03,257                   | 3.98%             |
| Puducherry                | 1,56,951                                 | 8,875                      | 5.65%             |
| Punjab                    | 27,65,134                                | 1,06,332                   | 3.85%             |
| Rajasthan                 | 31,25,163                                | 96,607                     | 3.09%             |
| Sikkim                    | 69,234                                   | 5,006                      | 7.23%             |
| Tamil Nadu                | 1,58,04,666                              | 10,99,747                  | 6.96%             |
| Telangana                 | 95,41,120                                | 6,46,671                   | 6.78%             |
| Tripura                   | 88,308                                   | 2,753                      | 3.12%             |
| Uttar Pradesh             | 90,30,641                                | 3,84,087                   | 4.25%             |
| Uttarakhand               | 8,23,115                                 | 33,481                     | 4.07%             |
| West Bengal               | 69,48,277                                | 4,92,900                   | 7.09%             |
| Others                    | 1,65,12,291                              | 5,30,446                   | 3.21%             |
| Grand Total               | 18,01,30,152                             | 1,10,52,736                | 6.14%             |

Source: IRDAI