Health insurance rules revised: Individuals above 65 yrs can buy health cover, waiting period relaxed

Aligning with its objective of “Insurance for all by 2047”, the Insurance Regulatory and Development Authority of India (IRDAI) has recently made a significant change concerning health insurance policies in India. Now, health insurance policies will be available to all regardless of age factor. 

“Previously, insurers were mandated to provide health insurance coverage only until the age of 65. However, the latest announcement states that health insurance policies will now cover individuals of any age,” says Rakesh Goyal, Director  Probusinsurance.com.

Dr. S. Prakash - MD / CEO, Galaxy Health & Allied Insurance Company on the move said, “The regulators' initiative to make health insurance products accessible for all age groups is commendable. Elderly individuals, who often suffer from non-communicable diseases (NCDs) and face risks of organ damage, particularly in the heart, kidneys, eyes, and brain, will greatly benefit.  Degenerative bone and joint diseases are prevalent among the elderly, and having insurance coverage will enable them to receive necessary treatment and reduce morbidity.”

The move will boost the longevity for the country’s citizens.

Also, the regulatory authority has announced a reduction in the waiting period for pre-existing conditions from four to three years, which is a beneficial adjustment for policyholders.

What does the new ruling on health insurance mean for senior citizens?

Goyal goes on to explain that this revision implies that those above the age of 65, who were previously ineligible for enrollment in health insurance plans, can now obtain coverage. Consequently, insurance firms may be obliged to accept requests from individuals beyond the age of 65, as the age limit barrier has been removed.

As a result of this alteration, insurance companies might be prompted to introduce specialized plans tailored specifically for seniors. Furthermore, the impact on premiums for this demographic could be favorable, as the elimination of age restrictions may lead to more competitive pricing, he adds.

Nonetheless what needs to be noted is that insurers reserve the right to decline health insurance coverage if they perceive it to be excessively risky.

On the pricing front, Goyal commented that although pricing may initially experience fluctuations due to the expanded age bracket, it is anticipated to stabilize over time. Moreover, the surge in demand from a broader demographic might prompt adjustments in pricing strategies.

Pointers to take note of when buying health insurance for senior citizens/ elderly

Verify waiting period for pre existing diseases (PED).

Ensure if the plan offers a 0 copay option or not. 

Opt for a comprehensive plan covering various medical needs.

Confirm the plan provides lifetime renewability.

Check the network of hospitals covered by the insurance.

Review the claim settlement ratio of the insurers for reliability.

Examine all inclusions and exclusions of the policy for clarity.