By Rajit Mehta, MD & CEO, Antara Senior Care
For a major part of India’s modern history, its identity has been firmly rooted in the definition of a young nation—one with a growing workforce and enviable demographic dividend. This reality is shifting as we speak and will change completely within the span of a generation.
By 2050, the population aged above 60-plus years is projected to more than double to about 350 million. One in every five Indians will be a senior citizen and the 80-plus population will have shot up by 279% (UNFPA) on the back of higher life expectancy facilitated by better healthcare. But unfortunately, this will also be accompanied by a higher burden of chronic conditions needing continuous care. Nearly 75% seniors have at least one chronic illness, 40% require assistance with daily activities, 15% experience cognitive decline, and 35% face mental health challenges.
At a macro level, this means that our models, structures, frameworks, and approach to caring for the elderly and particularly how this care is funded must be reconfigured and reimagined.
Ageing is not a one-time event like an acute illness—it is a gradual decline that may or not come with disease. It is a journey that demands planning, continuous care, and financial resilience.
As we age and move through various phases of ability, we need preventive care, assistance with activities of daily living (ADL), rehabilitation, assisted living services at home or in a home, and transition care. India’s traditional hospital-centric healthcare model, though covered by insurance, is designed around acute illnesses. Currently, it does not meet long-term care needs and the standard health insurance policy does not cover ageing-related care despite established benefits. Consequently, families in India bear over 75% of senior care costs out-of-pocket, depleting their savings, compromising quality of life, and burdening caregivers.
This paucity of financial solutions, particularly insurance, has created care gaps.
As India ages, we urgently need a financing ecosystem that can support lives that are not just longer but dignified.
For generations, caregiving responsibilities were absorbed within households. This traditional care economy functioned as India’s default senior care infrastructure. However, today, nearly 70% of urban households are nuclear.
Simultaneously, the expectations of seniors themselves are evolving. A new generation is getting older and is increasingly seeking to maintain its independence, autonomy, and state of empowered living. They are exploring structured support systems that offer safety, social engagement, and professional care outside the family construct.
Given their need for financial predictability and independence, people are increasingly planning ahead, ensuring that they can access quality care in their retirement years without placing financial strain on their families. Retirement-focused mutual funds have grown, with assets under management increasing by 226% over five years.
These figures indicate a financial readiness that is not met with fully developed financing infrastructure. But early signs of progress are evident. Regulators are pushing for universal coverage, and insurers are exploring senior-focused health plans and retirement-linked financial solutions. These developments signal a growing recognition of the scale of India’s ageing transition. However, most of these innovations remain limited in scope, and still largely centred around hospitalisation rather than the broader continuum of care that ageing requires.
A key barrier to progress lies in regulation. Assisted living homes (ALHs), which play a crucial role in delivering structured, long-term senior care, currently lack formal recognition within the Insurance Regulatory and Development Authority of India (IRDAI) framework. This absence of regulatory classification prevents ALHs from being integrated into insurance-backed financial mechanisms. As a result, even where care infrastructure exists, it remains inaccessible to many seniors due to affordability constraints. As IRDAI strengthens efforts towards its goal of “universal insurance coverage by 2047”, a key step will be to incentivise insurance products that match people’s life-cycle needs, particularly for their silver years.
Addressing this regulatory gap is essential. Formal recognition of assisted living and long-term care services would allow insurers to design products that cover non-hospital care, including daily assistance, rehabilitation, and supervised living environments. This would shift senior care from an out-of-pocket expense to a pooled risk model, making quality care more predictable and financially viable for families.
Bringing about this shift requires partnerships among insurers, care providers, government agencies, and advocacy groups to design products that address both medical and non-medical care requirements. Through pilot programmes, insurers and care providers can refine product features, pricing, and claims processes based on real-world feedback and outcomes.
Insurance-backed models can play a transformative role in making senior care more accessible. This shift can also encourage families to opt for preventive and supportive care earlier, improving health outcomes and lowering long-term healthcare costs.
The opportunity is therefore both social and economic. Implementing comprehensive insurance solutions for assisted living creates a win-win scenario for all stakeholders. Seniors and their families gain peace of mind and financial protection, while insurers tap into a growing market with tailored products. Care providers benefit from enhanced service standards and increased demand and policymakers can ensure better social outcomes for India’s ageing population.