As we age, our healthcare requirements rise, and so does our need for health insurance. However, many Indian citizens who are 60 or older do not buy health insurance believing that they are too late to get this insurance.

But do we have a health insurance age limit in India? Let's explore this topic in-depth by understanding the regulations

In this blog we will explore

Understanding the New Health Insurance Rules in India

The Insurance Regulatory and Development Authority of India (IRDAI) removed the upper age limit for getting a health insurance policy in India. Effective from 1st April 2024, any Indian citizen is eligible to get a health insurance policy despite their age. Now, senior citizens in India would be able to get health insurance despite having pre-existing illnesses even if they are 80 or 90 years old. The IRDAI has taken this step to bring more citizens into the umbrella of health insurance considering the current medical costs and inflation.

Why was there an Upper Age Limit on Health Insurance?

Earlier, health insurance plans in India had an age limit, usually set between 60 and 65 years. This was primarily because older individuals are considered to have a higher risk of health issues, making them costlier to insure. Senior citizens are more likely to require medical care, leading to more frequent and higher claims. Older people often have pre-existing health conditions, which increase the risk for insurers.

Benefits of the New Rules for Senior Citizens

The removal of the health insurance family plan age limit is going to offer a lot of benefits to senior citizens.

1. Opportunity for Uninsured Senior Citizens

Many senior citizens previously had to live without a health insurance policy if they did not get one before the age of 65. This change in rules has allowed uninsured senior citizens to get insurance coverage despite their advanced age. With the new rules, they can now be included under their family's health insurance plans, which increases access to health benefits and reduces the number of uninsured seniors.

2. Tailored Plans

Senior citizens often have unique healthcare needs. After the removal of the health insurance age limit, insurance companies have launched insurance plans tailored for senior citizens. Senior citizens can benefit from these plans to get more comprehensive coverage for their needs.

3. Pre-Existing Conditions Coverage

If you are buying an insurance policy in your sixties, likely, you would already have pre-existing health conditions like hypertension and diabetes. Under the new rules, senior citizens are no longer at risk of being denied coverage due to pre-existing conditions. This change provides peace of mind for those who may have faced difficulty obtaining affordable coverage due to ongoing health issues, ensuring that they receive the care they need without worrying about the costs of treatment for pre-existing conditions.

4. Protection from the Rising Medical Inflation

As medical costs continue to rise, many seniors struggle to afford necessary treatments. They may not have enough savings or resources to pay such high medical bills after retirement. The new ability to join family health plans helps protect seniors from the impact of rising medical inflation, offering them more affordable premiums and out-of-pocket costs. This stability allows them to better manage their healthcare expenses without sacrificing the quality of medical care.

5 Tips for Choosing the Right Insurance Policy for Senior Citizens

If you are a senior citizen (aged 60 years and above), you must not let go of this opportunity to get health insurance coverage.

Here are 5 important tips to keep in mind while selecting the right insurance policy.

1. Go for a Plan With a Higher Sum Assured

As you age, you are likely to require medical treatments more frequently. Keeping this in mind, make sure you choose a plan with a substantial sum assured even if you have to pay a higher premium.

2. Check the Hospital Network of Your Insurer

Make sure the insurance policy includes access to your current hospital or other healthcare provider. Additionally, if you have specific needs for specialists (such as oncologists, cardiologists, or physical therapists), check if these professionals are covered within the network. Some insurance plans offer flexibility with out-of-network care, while others have more restrictive networks. See your options carefully before saying yes to a policy.

3.Look for Cashless Benefits

Cashless health insurance allows you to receive medical treatment without having to pay upfront, which can be especially helpful in emergencies. Look for policies that offer cashless treatment options at a network of hospitals, minimizing the financial burden during hospitalization or treatments. This benefit ensures you won't have to deal with out-of-pocket expenses at the time of care, allowing you to focus on recovery rather than financial concerns.

Bottom Line

Currently, there is no health insurance age limit in India. You can buy insurance even if you are a senior citizen and have pre-existing diseases. By taking the time to carefully review your specific needs, comparing all available options, and considering additional benefits that go beyond basic coverage, you can select an insurance policy that provides both comprehensive healthcare and peace of mind for the future.

FAQs on Age Limit on Health Insurance

What amount is good for health insurance?

The ideal health insurance coverage amount depends on factors like age, health conditions, and medical inflation. For senior citizens, it is recommended to have a coverage amount of at least ₹10–25 lakhs in urban areas where medical costs are higher.

Can we get insurance for a 75-year-old?

Yes, it is possible to get health insurance for a 75-year-old. Many insurance companies in India offer senior citizen health insurance plans specifically designed for individuals aged 60 and above.

What is the limit of health insurance in ITR?

Under Section 80D of the Income Tax Act, premiums paid for health insurance policies are eligible for tax deductions. The limit of health insurance deduction for a senior citizen is ₹50,000. For a son-senior citizen, the deduction is ₹25,000 or the actual amount paid, whichever is lower.