IRDAI Removes Health Insurance Age Limits in India

Posted on: Jul 2, 2024 | 3 mins | Written by: HDFC ERGO Team

IRDAI Removes Health Insurance Age Limits in India

In today’s times, when health conditions and medical expenses are increasing exponentially, it is important to plan your savings and investments wisely to prevent financial setbacks. The same is particularly important for senior citizens who are prone to age-related health issues and have limited income or retirement funds.

Keeping the importance of health insurance in mind, especially for the elderly population, IRDAI or the Insurance Regulatory and Development Authority of India, has removed the age restriction on health insurance products. After this amendment, senior citizens who are over 65 years of age can also buy health insurance to cover their medical expenses. Moreover, this insurance product will also be available for students and children. Let’s talk about this new-age health insurance provision in detail.

What is the new age insurance provision, and how will it help?

Effective from April 1, 2024, the new age health insurance provision implemented by the IRDAI states the following: “Insurers shall ensure that they offer health insurance products to cater to all age groups. Insurers may design products specifically for senior citizens, students, children, maternity, and any other groups, as specified by the competent authority”.

The new-age health insurance policy can help in the following ways —

1. Equal access to healthcare:

The removal of the age cap from health insurance policies will help people, particularly senior citizens, access healthcare at any age. They can buy senior citizens’ health insurance policies even after they are 65 and secure their well-being and finances.

2. Comprehensive healthcare benefits:

After the latest amendment, one can take a comprehensive health plan at any age. This health insurance policy offers wide coverage to policyholders and makes things easier during medical emergencies. They can opt for quality and timely treatment without worrying about exhausting their savings or retirement funds. Senior citizens or anyone advised by the doctor can also avail of domiciliary care and many other healthcare benefits.

Other major changes made by IRDAI

In addition to removing the age cap from health insurance, the IRDAI has also made the following changes in health insurance —

1. Reduced waiting period for pre-existing conditions:

The IRDAI has reduced the maximum waiting period for pre-existing conditions from 4 years to 3 years. Therefore, if you pay policy premiums for 3 years continuously and serve the waiting period, the insurance provider cannot reject your claims for pre-existing conditions.

2. Reduced waiting period for specified diseases:

As per the new rules, the IRDAI has also reduced the waiting period for specified diseases from 4 years to 3 years. These diseases include osteoporosis, dementia, Parkinson’s disease, cardiac ailments, etc.

3. Health insurance for severe medical conditions:

The new rules also state that insurers must issue health insurance policies to people with severe medical conditions, such as cancer, heart disease, kidney ailments, and more. This simply means that insurance providers cannot deny coverage to people with severe health issues.

4. No sub-limits on AYUSH treatments:

Keeping the importance of AYUSH treatments in mind, IRDAI has also removed sub-limits on these alternative systems of medicine, i.e., Ayurveda, Yoga, Unani, Siddha and Homeopathy. Therefore, if you opt for any of these treatments, you can claim reimbursement up to the sum insured by your health insurance policy.

5. Customised plans for senior citizens, students, and other specified groups:

The IRDAI has also asked insurance companies to customise healthcare policies for senior citizens, students, children, expectant mothers, and other such groups. This will help policyholders opt for plans that best match their healthcare requirements.

6. Reduced moratorium period:

This is the period when insurance companies do not cover certain pre-existing conditions. As per the latest rules, the IRDAI has reduced the moratorium period in health insurance from 8 years to 5 years. Therefore, if you pay policy premiums continuously for 5 years, your insurance provider cannot reject your claim based on misinterpretation or non-disclosure of pre-existing conditions.

7. No indemnity-based policies:

The insurance regulator has advised insurance companies to stop issuing indemnity-based plans altogether. Insurers must offer only benefit-based policies to prospective policyholders. Under this plan, if a policyholder is diagnosed with a covered disease, the insurance company will pay them a fixed amount as stated in the policy’s terms and conditions.

8. Multiple claims:

Policyholders with benefit-based policies can file health insurance claims with several insurers. This will ensure better financial security during medical emergencies and expensive procedures.

Conclusion

To sum up, the IRDAI’s new rules for health insurance plans will benefit policyholders, especially senior citizens and people with pre-existing conditions, specified diseases and severe medical conditions. These amendments will remove health insurance age limits in India, making health insurance accessible to more people. Moreover, the IRDAI has also stated that if policyholders find annual premium payment a burden, they can pay policy premiums in easy instalments, such as quarterly or half-yearly.

Disclaimer: The above information is for illustrative purposes only. For more details, please refer to the policy wordings and prospectus before concluding the sales.

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