HEALTH INSURANCE AND AGEING TIME FOR A NEW MODEL

GST reliefs are a start, but systemic innovation in policy, design, and partnerships is key to sustainable elderly health insurance coverage

- By Kalyani Sharma

The United Nations Population Fund projects that the share of senior citizens in India will rise to 20.8 per cent of the population by 2050, with nearly one in five Indians expected to be above 60. While it reflects longer life expectancy and a growing recognition of healthy ageing, it also calls for a strategy that fills the gap of affordable, accessible, and comprehensive health insurance for its elderly population.

With rising chronic and lifestyle diseases, the older population of the country faces rising medical costs, complicated claim procedures and limited coverage. India's recent GST reforms exempt health and life insurance premiums from 18 per cent tax but the real question is whether our insurance ecosystem is equipped to support its elderly population.

A growing population with inadequate coverage

Despite the demographic shift, India’s elderly remain among the least insured. The current health insurance system, designed largely for younger, working-age individuals, struggles to accommodate the medical realities of ageing: multiple comorbidities, longer recovery times, and recurring outpatient care.

Neha Sinha, Dementia Specialist, CEO and Co-founder, Epoch Elder Care said, “Despite the rapid demographic change in the country, health insurance coverage for senior citizens in India is still very inadequate. Seniors often pay overvalued prices for insurance once they hit the age eligibility threshold of 60+ due to the higher risk associated with advanced age. Many plans limit the age for eligibility to join (usually between 65 and 70). This effectively leaves most at-risk individuals without any way to enrol in a plan. Health insurance companies frequently use unfair underwriting methods and implement risk management strategies that disadvantage individual consumers.”