How the govt gave the elderly free health cover, and insurers a reality check
Feb 24, 2025
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A groundbreaking health initiative in India provides free insurance to seniors over 70, marking a significant shift in healthcare access. The podcast reveals how private insurers have long neglected this age group, forcing many to pay exorbitant premiums for minimal coverage. With a staggering 80% of those over 60 uninsured, the government's new scheme offers hope. Listeners will learn about real-life challenges seniors face and the promising transformation in health insurance, aimed at easing their financial burden.
The Indian government's Ayushman Bharat scheme offers essential health insurance for citizens aged 70 and above, addressing decades of neglect from private insurers.
Emerging partnerships between private insurers and elder care startups promise to develop better-suited insurance products for seniors, including long-term care options.
Deep dives
Government Initiative for Senior Citizens
The Indian government has launched the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana, providing health insurance coverage to all citizens aged 70 and above, regardless of their income level. The initiative includes issuing the Ayushman card to eligible seniors, facilitating access to free hospital treatments, which is a significant relief for families facing financial burdens related to elderly care. This scheme addresses the long-standing issue where private insurance companies often neglected individuals over 60, who faced exorbitant premiums and inadequate coverage. Currently, a staggering 80% of seniors do not possess any health insurance, leading to vulnerabilities that this government program seeks to mitigate.
Challenges in Private Health Insurance
Private health insurance companies typically view policyholders over the age of 65 as high-risk and unprofitable, resulting in escalated premiums that many cannot afford. As illustrated by the experience of senior citizen Bisham Malkani, existing policies often fall woefully short in providing adequate coverage for necessary medical treatments, such as cataract surgery. Seniors experience rising costs and restrictions on policy benefits that frequently drive them to forgo insurance altogether. The lack of transparency in premium computations further complicates the situation, with many not aware of increased costs until they reach new age brackets, creating a cycle of inadequate care and financial strain.
Emerging Solutions in Elder Care Insurance
Partnerships between private insurers and elder care startups are emerging as a hopeful avenue for improving insurance offerings for senior citizens. These collaborations aim to create specialized insurance products that are more attuned to the needs of seniors, including long-term home care coverage, which traditional policies currently fail to adequately support. The Jan Oshidi Yojana, which aims to make medicines substantially cheaper for the elderly, exemplifies how government initiatives can effectively address gaps not covered by private insurance. With continued efforts to improve both public and private health insurance landscapes, the potential exists to provide much-needed security for India's rapidly growing aging population.
In October 2024, the government of India launched the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana, a health insurance coverage for all senior citizens aged 70 and over, regardless of income. This is big news for healthcare in India because for the longest time, this is exactly the age group that has pvt insurance companies have been ignoring.
To give you a clearer picture, a person aged over 60 years pays anything between Rs 30,000–50,000 as annual premium for coverage as low as 5 lakh rupees. Even policies for Rs 6–10 lakh are harder to find and cost Rs 40,000–70,000 annually. That’s about 5X the premium someone younger would pay for the same coverage. And it’s not just the high premiums; these policies are of little help to seniors when they need it the most.
In fact, more than four out of every five people aged above 60 aren’t covered by any insurance at all. Only 20% of those over 45 years have a health cover. And the rest are just out there vulnerable to emergencies. The reason being: high premiums and meagre coverage.
Tune in.
**This episode was first published in November 2024
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Daybreak is produced from the newsroom of The Ken, India’s first subscriber-only business news platform. Subscribe for more exclusive, deeply-reported, and analytical business stories.
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