The Insurance Regulatory and Development Authority of India (IRDAI) has recently enacted significant revisions to health insurance policies in India, aligning with its goal of achieving “Insurance for all by 2047”. The latest change ensures that health insurance coverage is now accessible to individuals of all ages, a departure from the previous age limit of 65 years.
Rakesh Goyal, Director of Probusinsurance.com, highlighted this development, noting that insurers were previously restricted from offering health insurance beyond the age of 65. However, with the new directive, individuals above this age threshold can now secure coverage.
Dr. S. Prakash, MD/CEO of Galaxy Health & Allied Insurance Company, praised the initiative, emphasizing its benefits for elderly individuals who often contend with non-communicable diseases (NCDs) and related organ damage. Conditions such as degenerative bone and joint diseases prevalent among seniors will now be better managed with insurance coverage, reducing morbidity.
The removal of age restrictions is expected to lead to specialized insurance plans tailored for seniors and potentially more competitive premium pricing due to a broader demographic pool seeking coverage. Nevertheless, insurers retain the right to decline coverage for excessively risky cases.
Additionally, IRDAI announced a reduction in the waiting period for pre-existing conditions from four to three years, providing a further advantage to policyholders.
What Does This Mean for Senior Citizens?
With the revised rules, individuals above 65 years who were previously ineligible for health insurance can now obtain coverage. Insurance companies are likely to introduce specialized plans for seniors, and pricing adjustments may occur initially but are expected to stabilize over time, according to Goyal.
Key Considerations for Purchasing Health Insurance for Senior Citizens:
- Verify Waiting Period for Pre-existing Diseases (PED): Understand the waiting period for coverage of pre-existing conditions.
- Check Copay Option: Ensure the plan offers a copay option or review the copayment terms.
- Comprehensive Coverage: Opt for a plan that comprehensively covers various medical needs.
- Lifetime Renewability: Confirm the plan offers lifetime renewability to avoid coverage gaps.
- Hospital Network: Check the network of hospitals covered by the insurance plan.
- Claim Settlement Ratio: Review the insurer’s claim settlement ratio for reliability.
- Policy Inclusions and Exclusions: Examine all policy inclusions and exclusions for clarity on coverage.
These pointers serve as guidelines to help seniors navigate the revised health insurance landscape and make informed decisions regarding their coverage needs.
