Great news for super senior citizens: Health insurance now available for individuals over 65

Starting April 1, 2024, The Insurance Regulatory and Development Authority of India (IRDAI) has removed the age cap on health insurance policies, according to sources. Previously, the purchase of new insurance policies was limited to the age of 65. But after the recent changes which came into effect from April 1, 2024, individuals of any age can now purchase new 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," stated a notification issued by the IRDAI.

IRDAI has also directed health insurance providers to offer customized policies for specific groups like senior citizens and set up dedicated channels to address their claims and concerns.

"It's a welcome change since it now opens the avenue for people above 65 to seek health cover. Insurers, based on their Board-approved underwriting guidelines, can cover people above 65. The coverage is subject to offer and acceptance between the insured and the insurer based on affordability for the senior citizens and viability for insurers," according to an expert in the industry.

The insurers, after the recent notification, have been restricted from denying issuing policies to individuals who are suffering from severe medical conditions such as cancer, AIDS, renal, or heart failure.

As per the notification, IRDAI has reduced the waiting period of health insurance from 48 months to 36 months. All pre-existing conditions must be covered after a 26-month period regardless of whether the policyholder disclosed them initially or not, according to the insurance regulator.

Insurance companies are prohibited from offering indemnity-based health policies that cover hospital expenses. They are only allowed to offer benefit-based policies instead of indemnity-based health policies. This will provide fixed costs when a covered disease occurs.