Recent Changes in Health Insurance You Must Know in 2024
Health insurance coverage in India remains lower than expected, largely due to widespread confusion about the coverage details, terms, conditions and sudden changes. To address this issue and encourage more people to buy health insurance, the Insurance Regulatory and Development Authority of India (IRDAI) issued new guidelines in 2024. These guidelines became effective on April 1, 2024. In this article, you will get to know about the recent changes in health insurance guidelines by IRDAI in 2024 to understand the new terms and conditions.
List of Recent Health Insurance Guidelines in 2024
Following are the new guidelines for health insurance products under IRDAI Regulations, 2024:
1. No Age Restrictions for Health Insurance
Previously, there was an age restriction for buying health insurance, which was capped at 65 years. Recently, IRDAI has eliminated the maximum age limit to purchase a medical policy. This new guideline especially caters to senior citizens and allows them to buy comprehensive medical insurance without an age barrier.
2. Policies for Severe Pre-existing Medical Conditions
As per IRDAI, health insurance companies can no longer refuse plans for clients with severe pre- existing medical conditions. This applies to severe medical conditions like cancer, heart disease, AIDS, renal failure etc. Moreover, this guideline can increase insurance penetration in India by ensuring a comprehensive medical insurance ecosystem.
3. Waiting Period for Specific Diseases/Procedures Reduced to 3 Years
The IRDAI has shortened the maximum waiting period for specific illnesses or procedures such as joint replacement surgery from 4 years to 3 years. As per this latest guideline, people can file a claim for the treatment cost of listed specific diseases and procedures after serving a waiting period of a maximum of 3 years.
4. Waiting Period for Pre-existing Disease (PED) Reduced to 3 Years
As per the new IRDAI guidelines, the pre-existing disease (PED) waiting period has been cut short from 4 years to 3 years. Therefore, policyholders can settle a claim for pre-existing diseases like hypertension, diabetes etc. after only a waiting period of 3 years. Furthermore, it will prevent insurance companies from denying PED claims after a 3-year period.
5. Customisation Option for Specialised Groups
It has been notified by the insurance regulatory authority that there will be customised health insurance plans for specialised groups like children, senior citizens, students and others. This will allow diverse groups to select insurance plans that best suit their individual requirements. Moreover, it will motivate insurers to expand their range of products.
6. AYUSH Treatment without Sub-Limits
The IRDAI has declared that there will be no sub-limits on AYUSH treatment as well. AYUSH treatment refers to alternative treatment systems through Ayurveda, Yoga and Naturopathy, Siddha, Unani, and Homeopathy. According to this guideline, policyholders can avail the cost of medication via AYUSH treatment systems up to the insured sum limit.
7. Removed Indemnity-based Policies
As per the direction of IRDAI, the insurers have been instructed to issue only the benefit-based policies for covering different hospitalisation expenses and stop them from introducing any indemnity-based plans. This tends to ensure that a fixed amount shall be paid to the policyholders after diagnosing any covered diseases.
8. A Support Channel Dedicated to Senior Citizens
Different insurance companies have been directed by the IRDAI to introduce special channels for handling insurance claims as well as complaints of senior citizens. This is aimed to ensure a tailored and responsive approach towards meeting different requirements as well as settling the grievances among senior individuals.
9. The moratorium Period Shortened to 5 Years
According to the new IRDAI regulations, the moratorium period in medical insurance has been reduced from 8 years to 5 years. This prevents insurance companies from denying claims on non-disclosure of pre-existing medical conditions or misinterpretation after 5 years of ongoing coverage, except in cases of fraud.
10. Multiple Claims across Several Insurers
The insurance regulator is noticed to allow individuals having benefit-based policies to file multiple insurance claims with different insurance providers. This will help in ensuring a wider and flexible approach for the policyholders after getting diagnosed with any illness.
The Bottom Line
Overall, the objective of the 2024 IRDAI recommendations is to enhance and streamline health insurance provision in India. These reformations provide improved protection and increased accessibility for all policyholders by eliminating age limitations, shortening waiting periods, and adding support channels and specialist plans. Additionally, it will motivate more people to purchase comprehensive health insurance policies. If you are looking for plans with great coverage and affordable premiums, you can head over to the website of ACKO and browse their comprehensive health plans.
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