Health Insurance for senior citizens: How the no age restriction new rules will benefit the elderly— Explained

Health Insurance for senior citizens: The recent amendments by the Insurance Regulatory and Development Authority of India (IRDAI) regarding health insurance rules are set to benefit senior citizens significantly. By removing the age ceiling of 65 years for purchasing health insurance, IRDAI has expanded access to health insurance products for individuals of various age groups. Previously, seniors above 65 years could still buy health coverage, but options were limited in the market. 

Smooth access to quality healthcare

"With these policy changes, senior citizens will have a smooth access to quality healthcare. Further, while shortlisting the right coverage that suits their needs, consumers should also evaluate factors like a cashless network of healthcare providers of an insurer, room rent limit, benefits, sub-limits and other policy terms and conditions. These would enable individuals to get coverage that aligns perfectly with their requirements and budget, said spokesperson Ajay Shah, Head – Distribution, Care Health Insurance.

"The Insurance Regulatory and Development Authority (IRDAI) has ushered in a transformative change by eliminating the 65-year age limit for health insurance purchases. This groundbreaking decision, effective from April 1, will ensure health coverage is now accessible to all, transcending age barriers. ’’ Pooja Yadav, chief product officer, Zuno General Insurance.

Will health insurance premiums go up?

According to Ajay Shah, health insurance premiums for senior citizens, especially those with pre-existing conditions, might be higher depending on the sum insured, age, and health condition.

Impact of IRDAI's recent directives on senior citizen health insurance 

“The impact of IRDAI's decision on health insurance for senior citizens is expected to be profound. Insurance companies will likely respond by designing specialized products tailored to the needs of this demographic, including coverage for pre-existing conditions,” said Rakesh Jain, CEO, Reliance General Insurance

Challenges insurance companies encounter when offering health insurance to senior citizens

Managing the higher risks linked with insuring older age groups, like more medical expenses and pre-existing conditions, is a major concern. Rakesh Jain noted that adjusting underwriting practices to properly evaluate and price these risks while staying competitive is a significant challenge.

Moreover, Jain highlighted that providing affordable and comprehensive coverage for senior citizens in the face of increasing healthcare costs needs innovative product design and risk management strategies.

Also Read: Why family floater health plans aren’t for the elderly

Health insurance purchase open to all ages: IRDAI's new policy

Previously, individuals were limited to buying new insurance policies until age 65. However, effective April 1, 2024, the insurance regulator removed the age cap on purchasing health insurance policies.

"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 group as specified by the Competent Authority," IRDAI had said in a notification issued earlier.

Industry experts believe this initiative encourages competition among insurers, potentially resulting in better consumer offerings and services. Ultimately, it sets the stage for enhanced financial security and long-term health planning for senior citizens.

Disclaimer: The views and recommendations made above are those of individual analysts, and not of Mint. We advise investors to check with certified experts before taking any investment decisions.