Is age just a number for health insurance? IRDAI's recent rule changes open doors for elderly

Ageless health coverage: Are you over 65 and worried about purchasing health insurance? Now you can breathe a sigh of relief! According to the recent rule change by the Insurance Regulatory and Development Authority of India (IRDAI), the maximum age limit for purchasing health insurance policies has been eliminated. Previously restricted to offering coverage only up to the age of 65, insurers are now open to providing health insurance to individuals above 65 years without any age restrictions.

The health insurance regulations have undergone notable adjustments, bringing about favourable changes for policyholders. Effective immediately, these revisions will be applicable to all new policies and seamlessly integrated into existing ones upon renewal.

Enhanced policyholder protection

Another crucial alteration is the reduction in waiting periods for pre-existing conditions. Formerly, insurers could impose waiting periods of up to 8 years, particularly for pre-existing ailments. This duration has now been significantly shortened to 5 years, offering relief to policyholders. After continuous coverage for 60 months, insurers are barred from rejecting claims based on non-disclosure or misrepresentation, except in cases of proven fraud.

“After completion of sixty continuous months of coverage (including portability and migration) in health insurance policy, no policy and claim shall be contestable by the insurer on grounds of non-disclosure, misrepresentation, except on grounds of established fraud. This period of sixty continuous months is called a moratorium period,” the IRDAI regulations stated.

Pre-existing disease wait period slashed

Furthermore, the waiting period for pre-existing diseases has been reduced from 4 years to a maximum of 3 years for both new and existing policyholders. This means that individuals with conditions like diabetes or hypertension can now avail coverage for related hospitalisation claims after paying three premiums, instead of the previous requirement of four.

The reduction in waiting periods and the elimination of maximum age restrictions mark a notable step towards enhancing the accessibility and effectiveness of health insurance policies in the country. These changes aim to provide greater financial security and peace of mind to policyholders, ensuring that their healthcare needs are adequately covered.