A lot of talk has been generated over the recent days about the insurance regulator removing a cap on offering those over 65 years of age health insurance policies. It has been dubbed as the dawn of a new era for the elderly. So, has the Insurance Regulatory and Development Authority of India (IRDAI) removed any regulatory cap, or limit, on providing those over 65 years health insurance policies?

Has there really been a sea change in insurance companies offering health covers to those over 65 after IRDAI policy change?

Well, to start with, there was no such cap. In fact, senior citizens should ignore the social media noise, because here is what has actually happened, according experts quoted by MoneyControl.

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The older Health Insurance Regulations, 2016 rules applicable till before April 1, 2024, said, “All health insurance policies shall ordinarily provide for an entry age of at least up to 65 years.” That means insurers could very well offer these senior citizens health insurance policies and some insurers are already doing so.

So, under the rules of the previous policy, IRDAI had mentioned that insurers should try and offer health covers to people at least under the age of 65. That means IRDAI had not barred anyone from offering insurance policies to those above this age, MoneyControl reports.

Notably, IRDAI has skipped mentioning the 65-year age of entry provision in its latest announcement of rules. This has been interpreted as the IRDAI actually allowing insurers to sell medical policies to those above this age level.

What is the current position?

The new policy now in effect does not mean that IRDAI has expressly ordered that covers be made available to senior citizens. Insurers even now have control over the issuing of policies. So, if an insurer deems someone is too big a risk to issue a policy, they may well refuse to do so.

The big change is that “…now, insurance companies may have to design products and put out premium charts for all age groups,” MoneyControl quoted Nikhil Apte, chief product officer, Product Factory (Health Insurance), Royal Sundaram General Insurance as saying.

What does IRDAI omitting the mention of 65 years mean?

“In fact, now, some insurers could design products where the eligible age at entry (at the time of purchase) is between, say, 18 years and just 35, 40 or 50 years at the upper end,” MoneyControl quoted Bhabatosh Mishra, director, underwriting, Products and Claims, Niva Bupa Health Insurance as saying.

“It actually is a much bigger positive news for younger citizens,” Mishra added.

Notably, senior citizens should know that IRDAI has not reacted to any of these reports about what the official position is.

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