Numerous studies have shown that with improved Life-Expectancy in India, its ‘Silver’ population viz persons aged 55 years and more is on the upswing. However, the penetration of health insurance among Silvers is alarmingly low. It is estimated that India's elderly population is likely to exceed 330 million by 2050, thus making this issue a ticking time bomb with no solution in sight unless immediate proactive steps are initiated.
Research indicates that 98 percent of senior Silvers in India have no health insurance coverage to fall back upon and hence are economically exposed to back-breaking medical costs, at an age when incurring such costs becomes increasingly likelier.
Several research studies point out that most of India's Silvers hail from the unorganized sector, sans post-retirement benefits. While, the intent of healthcare coverage under programs such as Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) cannot be faulted, reports suggest that there is still the last mile hurdle to be crossed at many empaneled hospitals. Prompt addressal of such issues is crucial to make this universal health initiative a complete success.
Notably, the IRDAI has rolled out reforms in 2025 that eliminated maximum age limits for entry, limited annual premium increases to 10 percent and lowered waiting periods for pre-existing conditions to three years. These steps will go a long way to facilitate easier access and affordability for seniors. However, broader awareness about these reforms and efficient execution on the ground are the keys to ensuring the success of these reforms.
Silvers are confronted with numerous hurdles in availing health insurance. The premium increases significantly with age, and most insurers follow the safe practice of imposing waiting periods for pre-existing conditions, co-payment terms, and entry age limits. Additionally, several Silvers are primarily dependent on pensions or their savings, and hence affordability emerges as a serious issue.
I have also seen several cases where persons holding good corporate jobs are blind-sided by their corporate health insurance group cover. In most cases, it is linked to one’s contract and the minute one’s career ends, either through retirement or termination, which is more prevalent today, one is left vulnerable in terms of having no healthcare cover. The older one is at this stage, the more difficult it becomes to get adequate health cover and makes one a sitting duck for a deep pocket medical intervention hit.
Furthermore, many of the abovementioned persons work in urban areas that expose them to pollution related ailments that come home to roost at a later stage of life. Even those who have health insurance coverage from a young age fail to top up over time and get stuck in a time warp. This renders them very vulnerable inspite of having health cover as medical costs are currently escalating at a double digit rate.
So, for those that miss the bus in their earlier years, it could well become a permanent miss if they leave it for too late. As for those without adequate health insurance coverage, irrespective of your age today, the time to Act is - Now.
(Ashok Kumar heads LKW India. The views expressed here are his own