Health Insurance Reforms in 2024: Major Updates & Development

Posted on: Dec 24, 2024 | 3 mins | Written by: HDFC ERGO Team

Health Insurance Reforms in 2024: Major Updates & Development

Health Insurance in 2024 is more important than at any other time. Even in this era of outrageous healthcare expenses, health insurance is vital for financial security against unseen medical expenses. It helps to have the right health coverage in place, whether it’s family health Insurance catering to the entire family as a single plan or covering senior citizen health Insurance suitable for older family members. With new policies that are more flexible, expansive, and have better-inclusive benefits, you can easily choose to suit your needs best. From complete packages to add-ons, 2024 is all about keeping health on top. Let's review the updates and find the perfect health Insurance plan for you and your family.

Major changes that happened in 2024

Health Insurance policies have evolved significantly in 2024, and the new plans are designed to make the schemes more inclusive, user-friendly, and beneficial to one and all. Here are some you should look into:

1. Removal of entry age limit for policies

The most important change this year is that there is no longer an entry age limit for the purchase of health Insurance. Earlier, insurers were compelled to offer plans to individuals up to 65 years of age. Under the new guidelines, however, the insurers must provide health Insurance policies for people of all age groups without any age restrictions.

How it impacts you: This is particularly advantageous to older people who might, until now, have experienced problems finding a comprehensive senior citizen health Insurance. Now, you, as well as your elderly relatives, can take any policy at any age and know the peace of mind that no unexpected medical bill will disrupt their financial security.

2. Reduced waiting period for Pre-existing Diseases

The waiting period for pre-existing diseases of any health insurance used to be four years, but now, it has been reduced to three years. This is applicable to all types of health insurance policies.

How it impacts you: It would also mean quicker access to Health Insurance coverage for the whole family, including family health Insurance and senior citizen health Insurance. This would go a long way in alleviating the burden on families suffering from chronic conditions.

3. Universal cashless claims

Earlier, cashless claims were allowed only in the network hospitals. However, this year’s new guideline says that cashless claims are acceptable in any hospital, regardless of whether they fall in the insurer's network.

How it impacts you: If you or any family member needs hospitalisation on an emergency basis in a facility that isn't part of the insurer's network, you do not need to pay first and seek reimbursement later. For family health Insurance users, this is a game-changer that ensures hassle-free care for all.

4. No more limitations on Ayush Treatments

Ayush treatments, which include Ayurveda, Yoga, Unani, Siddha, and Homoeopathy, are now without any limitations. Insurers have to have a Board-approved policy for Ayush coverage to claim up to the sum insured amount, making it at par with conventional medical treatments.

How it impacts you: For alternative or traditional treatment options, this shift guarantees that your health insurance policy is for you and that you can choose your treatments. Whether you choose it or an elderly member in the family, the expenditure is easily claimed without a hassle.

5. Shortened Moratorium period

The moratorium period, under which an insurer can challenge a claim on the grounds of non-disclosure or misrepresentation, has been reduced from eight years to five years. This applies to all health insurance policies, whether portable or migrated.

How it impacts you: If you have continuously maintained a health insurance policy for five years, then you are better protected against claim rejections. This is immensely helpful for senior citizens, making senior citizen health Insurance more reliable.

6. Faster cashless claim settlements

Settlement of cashless claims will now have to happen within three hours of discharge, and admission-related claims should be processed within an hour.

How it impacts you: This makes visits to the hospital much less stressful for you and your loved ones. With faster claim processing, you can focus on recovery instead of being worried about financial logistics. It is especially comforting for those who rely on family health Insurance to pay for medical emergencies.

7. Claims across Multiple insurers

Now, you can claim expenses for a single hospitalisation under multiple health Insurance policies. For example, assume you have one policy with ₹7 lahks and another for ₹8 lahks, and your total hospital expenses amount to ₹14 lahks. You can combine these two policies to cover the entire amount without any out-of-pocket cost.

How it impacts you: This flexibility is ideal with families that have family health Insurance and individual policies; they are guaranteed to acquire full financial coverage without their having to incur out-of-pocket expenses.

Changes that are still underway

Some interesting developments in the health insurance sector are emerging and could benefit you in the next few years. Let's look into some of the most important trends that may shape the future of health Insurance, family health Insurance, and senior citizen health Insurance.

1. Combi Plans and All-in-one Products

In response to increasing consumer demand, the insurance industry is slowly becoming more inclined towards combined health plans. These "combi plans" integrate several insurance products, such as health, life, and critical illness coverage, into one package. If you want simplicity, this is a good option that enables you to protect both your family health Insurance and other needs in one go.

2. Increased use of Artificial Intelligence

The use of AI and big data is changing the face of health Insurance delivery. Data analytics allow insurers to provide more accurate coverage based on your health risks. This will help you easily access health plans that are personalised to your needs, providing you with better coverage. In addition, AI can make claims processing simpler, faster, and more efficient.

Conclusion

The plans for health Insurance updates include making policies that are more accessible and efficient for everyone. If you have family health Insurance or tailored senior citizen health Insurance designed just for your loved ones within the family, these adjustments mean you will have better choices and fewer headaches down the line. These changes from the faster claims process to entry age elimination include all those reforms aiming at your health and financial security first. Explore the new developments, compare policies, and then choose what would suit you and your family best.

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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