Health insurance is now accessible to all as the Insurance Regulatory and Development Authority of India (IRDAI), has eliminated the age restriction for purchasing policies, effective from April 1st.
No Age Cap
Earlier individuals could only buy new insurance policies until age 65, but with the recent change, anyone can now purchase a new health insurance policy, regardless of age. So now senior citizens, even if they're 80 or even 90 years old, can buy insurance for their health issues.
In a recent gazette notification, IRDAI said, "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." Besides, insurers have been mandated to offer health policies to individuals with pre-existing medical conditions of any kin.”
Special Insurance Plan
IRDAI wants insurance companies to create special insurance plans just for older people. The goal is to have insurance options that fit the needs of different groups, like seniors, students, kids and pregnant ladies. This rule pushes insurance companies to make policies that cover different stages of life and health needs.
Severe Medical Conditions
Insurance companies must now offer policies to individuals with severe medical conditions like cancer, heart or renal failure, and AIDS. New regulations aim to increase access to health insurance for those affected by these conditions.
The waiting period for pre-existing conditions has been reduced from 48 to 36 months, after which they must be covered as mentioned in the policy wording regardless of disclosure at the time of policy initiation or not. After this period, insurance companies are prohibited by law from rejecting claims because of pre-existing conditions.
Benefit-Based Policies
The new rules also state that insurance companies can no longer offer health policies where the company pays the hospital bills directly. Instead, they must offer benefit-based policies where a fixed amount is paid to the policyholder when they make a claim for a covered illness.
Benefit-based policyholders have the flexibility to file multiple claims with different insurers, providing them with enhanced options.
What are some Benefits?
- Instalments: Insurers can now offer policyholders the convenience of paying premiums in instalments, as per the notification.
- Travel Policies: IRDAI clarified that travel policies are exclusively available through general and health insurers.
- AYUSH treatment: No restrictions on coverage for AYUSH treatments. Treatments including Ayurveda, Yoga, Naturopathy, Unani, Siddha, and Homeopathy will be covered up to the sum insured without any limitations.
- Filing Grievances: it seems to set up special channels to handle the claims and grievances of senior citizens ensuring a more tailored and responsive approach to their requirements.
- More Options: with health policy that covers benefits (like hospitalization), one can claims it with different insurance companies for the same illness.
IRDAI’s Aim
The IRDAI aims to promote a more inclusive healthcare system and expand the market. This modification to the guidelines may allow all Indians over 65 to receive better health benefits, and improve healthcare coverage's accessibility and affordability for people, guaranteeing a safer and healthier future for everybody.
The end note, earlier due to the age cap, many senior citizens were left without any health insurance which is extremely important for covering medical costs in any unforeseen situations. With these updates in the regulations, citizens of all ages can be covered under healthcare.
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