IRDAI Removes Age Limit for Health Insurance: A New Milestone in Healthcare Accessibility
IRDAI Removes Age Limit for Health Insurance: A New Milestone in Healthcare Accessibility
Effective from 1st April, 2024, individuals of any age can now purchase health insurance policies, marking a significant milestone in the country’s insurance landscape.
24 April 2024
In a landmark move aimed at revolutionising healthcare accessibility in India, the Insurance Regulatory and Development Authority of India (IRDAI) has eliminated the age restriction for purchasing health insurance. Effective from 1st April, 2024, individuals of any age can now purchase health insurance policies, marking a significant milestone in the country’s insurance landscape.
A Historic Shift in Health Insurance Dynamics
Previously, individuals above the age of 65 faced significant challenges in obtaining health insurance coverage. However, with the removal of the age cap, insurance coverage becomes inclusive and accessible to all demographics. This move is part of IRDAI’s broader vision to enhance market penetration for insurance products and provide comprehensive protection against healthcare expenses to every citizen.
Siddharth Singhal, the Business Head of Health Insurance at Policybazaar.com, hailed the removal of the age cap as a significant step towards ensuring equitable access to healthcare for senior citizens. Singhal emphasised that this move offers elderly policyholders the opportunity to avail comprehensive health insurance coverage without any age-based limitations.
Key Changes and Their Implications
The new regulations introduced by IRDAI come with several key changes and implications:
1. Removal of Age Cap: Effective from 1st April, 2024, individuals of any age can purchase health insurance policies, eliminating the age barrier that previously restricted access for senior citizens.
2.
Coverage for Pre-existing Conditions: Insurers are now mandated to provide coverage for select pre-existing conditions, provided certain conditions are met. This move ensures that individuals with pre-existing medical conditions such as cancer, heart or kidney failure and AIDS can access insurance coverage without discrimination.
3.
Reduction in Waiting Period: The maximum waiting period for pre-existing diseases has been reduced from four to three years. Insurers are now prohibited from rejecting claims if policyholders have paid premiums for three years.
4.
Moratorium Period: After 60 months of continuous coverage, insurers cannot reject claims citing non-disclosure of pre-existing diseases, except in cases of proven fraud.
5.
Change in Policy Structure: Insurers are now prohibited from offering indemnity-based health policies. Instead, they can only provide benefit-based policies, where a fixed amount is paid to the policyholder in case of a covered illness.
Implications for Policyholders
The removal of the age cap and the introduction of these new regulations have several implications for policyholders:
· Increased Access to Coverage: The removal of the age cap expands the eligible base of customers who can purchase health insurance, providing coverage to individuals previously excluded from the market.
·
Reduced Waiting Period: The reduction in the waiting period for pre-existing diseases from four to three years ensures quicker access to coverage for policyholders.
· Comprehensive Coverage: Insurers are now required to offer comprehensive coverage to all age groups, including senior citizens, as well as students, children and for maternity needs.
· Enhanced Consumer Protection: The new regulations provide enhanced consumer protection by ensuring coverage for pre-existing conditions and prohibiting claim rejection after the moratorium period.
Addressing Challenges and Ensuring Affordability
While the removal of the age cap and the introduction of these new regulations mark a significant milestone, challenges remain, particularly regarding pricing and affordability:
· Premium Increase with Age: Premiums typically increase with age due to increasing health risks. Insurers may increase premiums by 10-20% for every five-year age bracket.
· Policy Evaluation for Senior Citizens: Senior citizens should carefully evaluate policy features, including waiting periods, coverage limits and exclusions, to ensure comprehensive coverage.
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Affordable Offerings: Insurers must develop innovative and affordable offerings to provide health coverage to senior citizens. Several insurers have already launched new products targeted at the elderly, making health insurance more accessible to the silver population.
Expert Perspectives on IRDAI’s Regulatory Reforms
Dr. Manisha Karmarkar, CEO of DPU Super Specialty Hospital, Pimpri, Pune commended IRDAI’s efforts to empower senior citizens and enhance access to healthcare. She highlighted the importance of reducing the waiting period for pre-existing conditions and providing comprehensive coverage to all demographics.
Sumit Bohra, President of the Insurance Brokers Association of India (IBAI), emphasised the need for insurers to innovate and penetrate the underserved senior citizen health insurance market. He underscored the importance of designing products tailored to the unique needs of senior citizens, including reduced waiting periods and higher coverage limits.
Anuj Parekh, Co-founder and CEO of Bharat-Sure, highlighted the challenges and opportunities associated with IRDAI’s decision. While applauding the move towards inclusivity, he cautioned that insurers may face challenges in catering to the 65+ age group. He emphasised the importance of aligning insurer interests with customer needs to ensure comprehensive and equitable coverage.
The removal of the age limit for health insurance marks a significant milestone in India’s healthcare landscape, making insurance coverage inclusive and accessible to individuals of all age groups. IRDAI’s new regulations ensure comprehensive coverage, consumer protection and enhanced accessibility to healthcare for all citizens. As the country’s elderly population continues to grow, these changes are poised to bring about a new era of healthcare accessibility and affordability, ensuring a healthy and secure future for all.
