Effective April 1, 2024, the Insurance Regulatory and Development Authority of India (IRDAI) has removed the age cap for individuals purchasing health insurance policies. Previously, individuals were restricted to buying new insurance policies only until the age of 65. However, with the recent changes, anyone, regardless of age, is now eligible to purchase new health insurance.
Key Highlights:
Age No Longer a Barrier:
- Earlier, individuals faced an age limit of 65 years when purchasing new health insurance policies.
- The recent changes mean that people of any age can now buy health insurance coverage.
Inclusive Healthcare Ecosystem:
- The move by IRDAI aims to create a more inclusive healthcare ecosystem in India.
- Insurance providers are encouraged to diversify their product offerings to cater to all age groups.
Tailored Policies:
IRDAI has instructed health insurance providers to design products specifically for various demographics:
- Senior citizens
- Students
- Children
- Maternity
- Any other group specified by the Competent Authority
Insurers must offer health insurance products to cater to these diverse segments.
Handling Claims and Grievances:
- Insurers are required to establish dedicated channels for handling claims and grievances of senior citizens.
- This ensures better service and support for older policyholders.
Coverage for Pre-Existing Conditions:
- Insurers are now prohibited from refusing to issue policies to individuals with severe medical conditions like cancer, heart or renal failure, and AIDS.
- The waiting period for pre-existing conditions has been reduced from 48 months to 36 months.
- After 36 months, all pre-existing conditions should be covered, regardless of whether the policyholder disclosed them initially or not.
Benefit-Based Policies:
- Insurance companies are no longer allowed to introduce indemnity-based health policies.
- Instead, they can provide benefit-based policies that offer fixed costs upon the occurrence of a covered disease.
The removal of the age cap on health insurance purchases is a welcome change, allowing people above 65 to seek health coverage. It also encourages insurers to adapt their offerings to meet the diverse needs of policyholders. With these reforms, IRDAI aims to enhance access to healthcare and promote a healthier, more secure population.
