Since 2024, buying health insurance at an older age has become much easier.
A major change came into effect in April 2024 when the Insurance Regulatory and Development Authority of India (IRDAI) removed the upper age limit of 65 years for purchasing health insurance.
Hence, currently, insurers can offer health insurance to individuals irrespective of their age, enabling more first-time buyers in their 70s and even 80s to obtain coverage, subject to underwriting norms and the terms and conditions of the policy.
Standalone health insurers generally have a wider range of products specifically designed for older adults, often with higher entry ages and features such as chronic disease management or domiciliary care.
However, eligibility ultimately depends on underwriting, existing medical conditions and the applicant’s overall health profile rather than the type of insurer alone.
Before senior citizens make a decision, here’s what they need to know about buying health insurance after 70, which insurers offer such plans, and the key conditions they need to meet.
How do insurers assess risk for applicants in their 70s and 80s?
Insurers evaluate multiple factors before issuing a policy.
While eligibility has improved, underwriting remains risk-based, so premiums, medical evaluations and policy terms continue to vary based on an individual’s health profile rather than age alone.
Apart from age, they consider existing illnesses such as diabetes, hypertension, or heart disease, previous hospitalisations, Body Mass Index (BMI), medication history, lifestyle habits like smoking or alcohol consumption, family medical history and findings from pre-policy medical tests.
“Applicants with well-managed chronic conditions and stable medical reports may receive standard coverage, while others may face higher premiums, waiting periods, disease-specific exclusions, or co-payment requirements depending on the insurer’s underwriting norms,” said Siddharth Singhal, Head of Health Insurance at Policybazaar.
Medical tests needed for health insurance after 70
Medical tests are almost always part of the underwriting process for applicants above 70.
While the exact requirements differ across insurers, common evaluations include blood sugar tests, lipid profile, kidney and liver function tests, urine analysis, ECG (electrocardiogram), chest X-ray, blood pressure assessment, and, in some cases, treadmill tests or echocardiography depending on medical history.
The objective is to assess the applicant’s current health status and accurately price the risk, rather than to deny coverage.
What are the coverages and exclusions?
Most senior citizen health insurance policies cover hospitalisation expenses, day-care procedures, pre- and post-hospitalisation expenses, ambulance charges and, in many plans, domiciliary treatment and modern medical procedures. Some plans also include annual health check-ups and wellness benefits.
Common exclusions include expenses during waiting periods for pre-existing diseases, specific listed ailments during the initial policy years, cosmetic procedures, non-medically necessary treatments, self-inflicted injuries, infertility treatments and consumables unless covered through an add-on.
Coverage details vary across insurers, making it important to carefully review policy documents before purchase.
When can an insurer reject a senior citizen’s application?
Although insurers cannot reject an application solely because of age, they may decline coverage if underwriting identifies an unacceptably high medical risk.
“This could include severe uncontrolled illnesses, advanced organ failure, active cancer treatment, recent major cardiac events, repeated hospitalisations or non-disclosure of medical history,” commented Singhal.
Honest disclosure is critical because withholding health information can lead to claim disputes or policy cancellation later.
How much costlier is health insurance after 70?
Premiums generally increase significantly with age because the likelihood of hospitalisation and medical claims rises.
“A first-time buyer above 70 can expect premiums to be substantially higher than someone purchasing in their 50s or early 60s, sometimes ranging from 50% to over 100% higher depending on the insurer, sum insured, city, health condition and policy features,” says Singhal.
More importantly, waiting until 70 also means losing the advantage of serving waiting periods earlier, making early purchase financially and medically more beneficial.
Health insurance for senior citizens: 5 features you shouldn’t ignore
According to Singhal, senior citizens should focus on the following five aspects before choosing a policy:
- Coverage for pre-existing diseases and the applicable waiting period.
- Co-payment clause, as lower or zero co-payment reduces out-of-pocket expenses during claims.
- Room rent eligibility and sub-limits, since these can significantly impact claim payouts.
- Network hospitals and cashless claim support, especially hospitals located close to where they live.
- Claim-related features, including restoration benefits, annual health check-ups, day-care coverage and the insurer’s claim settlement experience.
Rather than selecting the cheapest premium, seniors should evaluate the overall value the policy offers at the time of a medical emergency.
Super top-up vs high cover: What’s better for retirees?
For many retirees, a combination of a comprehensive base health insurance policy and a super top-up plan can be a more cost-effective strategy than purchasing a very high-sum-insured base policy alone.
A base policy helps cover routine hospitalisation expenses, while the super top-up provides additional protection against large or multiple medical bills once the deductible is crossed, says Singhal.
For example, a retiree with a Rs 10 lakh base policy can add a Rs 40 lakh super top-up at a relatively modest premium, significantly increasing financial protection against high-cost treatments such as cancer, organ transplants or prolonged ICU admissions.
However, the right structure depends on the individual’s age, health condition, affordability, and existing coverage.
Disclaimer: This article is for informational purposes only and should not be construed as financial, insurance, or medical advice. Health insurance eligibility, premiums, underwriting decisions, waiting periods, exclusions, co-payment clauses, and policy benefits vary across insurers and depend on an individual’s age, medical history, health profile, and other underwriting factors. Readers should carefully review the policy wording and consult the insurer or a qualified insurance advisor before purchasing a health insurance plan.
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