No Age Cap: IRDAI directs insurers to offer Health Insurance to all Age Groups

New Delhi: In a major decision, the Insurance Regulatory and Development Authority of India (IRDAI) has removed the age cap for buying health insurance policies.

Releasing the new Insurance Regulatory and Development Authority of India (Insurance Products) Regulations, 2024, which was notified in the official Gazette on 20th March 2024, IRDAI has specified its directions for the health insurance companies regarding their product designs i.e. the type of their health insurance policies.

IRDAI in these new regulations, which came into effect on April 01, 2024, stated that "Insurers shall ensure that they offer health insurance products to cater to all the age groups."

This is a major shift from the conventional constraints placed on senior citizens, who were earlier unable to buy a proper health insurance policy due to the existing age cap. Until now, individuals were eligible to buy health insurance policies only until the age of 65. However, with the new regulations, now everyone, regardless of age, is eligible to avail of a health insurance policy.

"Insurers may design products specifically for senior citizens, students, children, maternity and any other group as specified by the Competent Authority," the Gazette notification further mentioned.

IRDAI has also asked the Health Insurance companies to provide coverage to persons with all types of existing medical conditions. "Insurers shall endeavor to offer coverage for persons with all types of existing medical conditions," stated the Gazette notification.

Therefore, the new regulations aim to make health insurance policies more inclusive and accessible to individuals belonging to all age groups. Insurers have also been advised to diversify their product offerings to provide for a broader range of health conditions.

These regulations have been implemented after the Health Insurance Consultative Committee, set up by IRDAI, last year submitted its recommendations in this regard. IRDAI member Mr. Rakesh Joshi chaired this committee. It also comprised Dr. Alexander Thomas, National President of the Association of Healthcare Providers India (AHPI), and Dr. Devi Shetty, Chairman of Narayana Health as its members. 

One of the recommendations submitted by this committee was to remove the age cap for buying health insurance policies. Commenting on the matter, Dr. Alexander Thomas, who was a member of this panel, told Medical Dialogues, "We were focused on the issue of senior citizens. One of our recommendations was that there should be an affordable insurance policy for senior citizens and there should be no age cap. The committee submitted its recommendations in early 2023 and I am very glad to see it has been implemented."

"We had also recommended that GST should be removed for the senior citizens and all senior citizens should be covered under PMJAY," he further added.

When asked why the removal of the age cap for health insurance policies is the need of the hour, he pointed out that "for the general population, it is very difficult to get insurance. Otherwise, it is very expensive."

Dr. Thomas also referred to the National Health Conclave in 2023, where this issue was discussed. "After the conclave, we sent recommendations to the Government that the senior citizens should have affordable health insurance policies and there should be no age cap. This was supported by AHPI and Vayah Vikas for senior citizens. So, I think, both working parallelly really helped."

To view the Gazette notification, click on the link below:

https://medicaldialogues.in/pdf_upload/insurance-regulatory-and-development-authority-of-india-insurance-products-regulations-2024-236453.pdf

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