How to manage health insurance costs for seniors

On a recent episode of ET Now’s Insurance Mantra, former PwC Global Insurance Leader Joydeep Roy shared valuable recommendations to make health insurance more accessible and affordable for India’s senior citizens — a segment that continues to face significant cost barriers in healthcare financing. He highlighted that affordability challenges require a multi-pronged strategy, going beyond just premium discounts. His suggestions included: Reducing GST on health insurance premiums to bring down costs for policyholders (Already implementedby MOF). Introducing health savings policies that enable individuals to gradually build a medical corpus over time, ensuring better preparedness for future healthcare needs. Leveraging reverse mortgage products — an underutilized financial tool in India. Through reverse mortgages, senior citizens can unlock the value of their self-owned property and receive regular payouts, without having to sell or vacate their homes. This income can then be channelled towards health insurance premiums or medical expenses, providing much-needed liquidity during retirement years. Designing illness-specific health covers, which target particular health risks and help lower overall premium costs. Perhaps the most critical insight he shared was the need to classify senior citizens based on their actual health status rather than age alone. Many fit and healthy seniors end up paying higher premiums merely because of their age group. A shift to health-based classification can lead to fairer pricing, risk-appropriate underwriting, and better inclusivity. As India’s elderly population continues to rise, these innovative approaches — from financial instruments like reverse mortgages to product and regulatory reforms — could play a transformative role in making healthcare more accessible, affordable, and sustainable for older adults. #InsuranceMantra #HealthInsurance #SeniorCitizens #ReverseMortgage #InsuranceForAll #AffordablePremiums #InsuranceAwareness #JoydeepRoy #PwC #HealthSavings #InsuranceReforms #ETNow #InsuranceInnovation #FinancialInclusion

A new report says that 59% of Indians delay buying personal health insurance and rely only on their company policy. And honestly, that’s understandable. When your employer gives you a ₹5–10 lakh cover, it feels like enough. Premiums are paid, forms are handled — no extra effort. But here’s what I have seen after working with hundreds of professionals: People who build their own protection early — they don’t just secure their health, they build independence. Because true peace of mind isn’t about being covered by your company. It’s about being covered by yourself. Why Personal Health Insurance Is an Act of Freedom? ✅ It stays with you — even when jobs change. In today’s world, people switch careers, take breaks, start businesses. Your company policy ends the day your ID card stops working. ✅ You can choose the coverage you need. Employer policies are one-size-fits-all. Personal plans can grow as your needs grow — from ₹10 lakh to ₹25 lakh, or add critical illness cover later. ✅ It helps you plan bigger goals confidently. When you know that one hospital bill won’t derail your savings, you can invest freely — in dreams, not just in safety nets. 💡 Don’t buy insurance out of fear. Buy it because it gives you freedom — to work where you want, take breaks when you need, and live without financial worry. The smartest financial move isn’t just about earning more. It’s about protecting what you’ve already earned. #HealthInsurance #FinancialPlanning #FinancialFreedom #FinancialWellbeing #MoneyMatters #PersonalFinanceIndia #FinancialAdvisorIndia #InsuranceAwareness #SmartInvesting

Most people think health insurance fails because of bad luck. It doesn’t. It fails because of fine print. In 2024 alone, over ₹26,000 crore in claims were denied not for fraud, not for misrepresentation, but for rules hidden in plain sight. Your ₹10L cover may not mean ₹10L of protection. Sub limits quietly cap treatments : a ₹5L hospital bill could fetch just ₹2L. Room rent limits slash every cost by ratio even your surgery. No Claim Bonus doesn’t raise these limits. Restoration benefits look good in brochures but rarely apply to the same illness. Co payments make you share the pain, both emotionally and financially. And if you get treated outside your zone, zonal co pays step in. Then come waiting periods : two to four years for certain diseases. If they’re linked to a pre existing condition, the claim collapses. Even top up plans have a catch, they trigger only if a single hospitalization crosses the threshold. Multiple smaller ones? You’re on your own. Only super top up gives you continuity. And perhaps the most deceptive of them all “Reasonable & Customary Charges.” A clause that lets insurers retroactively decide what your treatment should have cost and cut payouts if they think it’s too high. Truth is, health insurance doesn’t fail when you buy it. It fails when you need it most. So before you trust a promise, read the exceptions. Before you rely on protection, question the conditions. Because the gap between care and collapse is often just one clause you didn’t notice. #HealthInsuranceDecoded #InsuranceAwareness #ReadTheFinePrint #InsuranceLiteracy

Life and Health Insurance just got more affordable! In a landmark move, the GST Council has made life and health insurance policies 100% tax-free effective September 22, 2025. Policyholders will now save the 18% GST previously charged on premiums, making protection plans-whether term, ULIPs, endowment, family floaters, or senior citizen health covers-more accessible across income groups. This “Diwali Gift” aims to ease financial burdens, boost affordability, and improve insurance penetration, especially among middle-class and economically weaker sections. While insurers may face operational adjustments, the long-term impact ensures broader financial security for Indian families. For more updates and industry bulletins, join the IRA Elite Circle today. Explore the IRA Elite Circle brochure: https://lnkd.in/gSF4v3bk To Join the IRA Elite Circle: https://lnkd.in/gDx8ijEq Contact us for more info: programs@iracoaching.com 8688331743 #InsuranceUpdate #GSTCouncil #HealthInsurance #LifeInsurance #FinancialSecurity #DiwaliGift #AffordableInsurance #InsuranceAwareness

💡 Day 43: Health Insurance – A Must-Have for Everyone We often insure our cars, phones, and homes — but forget to insure the most valuable asset of all: our health. 🏥 Medical emergencies can strike without warning — and one hospital visit can drain years of savings. Health insurance isn’t an expense; it’s a financial shield that protects your family and future. Here’s why it’s non-negotiable 👇 1. 💰 Covers rising medical costs – Healthcare inflation in India is ~14% per year. 2. 👨👩👧 Family protection – One policy can safeguard your loved ones. 3. 🩺 Cashless treatment – Access quality hospitals without upfront payments. 4. 🛡️ Tax benefits – Premiums are deductible under Section 80D. 5.💡 Peace of mind – Focus on recovery, not bills. 📌 Tip: Choose a plan that covers OPD, critical illness, and maternity if relevant to your stage of life. 💬 Do you remember when you first bought health insurance—or are you still planning to? Let’s normalize talking about health and money together. #FinancialLiteracy #HealthInsurance #PersonalFinance #WealthBuilding #MoneyMatters #InsuranceAwareness #60daysFinancialChallenge

Meet Kenny. He’s one of millions of Americans who are about to face a major increase in health insurance costs – and most don’t even know it yet. Enhanced Premium Tax Credits (EPTCs) are currently helping 24 million people – including our patients – afford high-quality healthcare coverage through the insurance Marketplace (https://bit.ly/3J5OjYf). These tax credits are applied directly to people’s premiums, keeping coverage affordable and making healthcare more accessible. But unless Congress acts soon, these tax credits will expire at the end of 2025. “When you get sick and you’re not rich, health insurance is absolutely essential. It doesn’t just make life easier, it makes life possible,” said Kenny. “Losing the healthcare tax credit would mean my monthly costs would go through the roof, and I wouldn’t be able to afford my treatments. I need Congress to extend the healthcare tax credit and give people in towns like mine a fighting chance.” Without EPTCs, health insurance costs will skyrocket. Families may be forced to make heartbreaking choices – between keeping their health coverage or paying for food, rent and childcare. Learn how you can help protect access to care at https://bit.ly/4haArbT

The Shutdown, Enhanced Subsidies, and Group Health Insurance We’re in a mess — but maybe this is the best time to stop kicking the can down the road. I’m not in favor of extending the enhanced ACA subsidies, but ending them will come at a cost. It’s not a conspiracy theory; it’s part of the original plan. If these subsidies expire after 2025, millions of individuals could lose Marketplace coverage altogether, while millions more could see what they personally pay for coverage nearly double. Actual premiums charged by carriers won’t necessarily double — but what many households feel in their wallets could. How can it be that premiums aren’t doubling, but the cost of coverage could? Because the true cost of insurance has been hidden behind complex, taxpayer-funded subsidies and temporary enhancements. When those supports end, the real market price surfaces — especially for individuals and families earning 400% or more of the Federal Poverty Level (FPL). For small and mid-size employers, this means: Rising healthcare costs across markets More employees returning to group plans Renewed pressure on benefit affordability Now’s the time to review plan strategy and communicate proactively. Stability in group benefits can be a powerful advantage in an unstable system. #HealthInsurance #EmployeeBenefits #ACA #SmallBusiness #HealthcarePolicy #Leadership

💔 Don’t lose your parents’ health cover when you switch jobs. My friend called me one night — her dad was suddenly hospitalised. When she tried to claim insurance… it got rejected. She didn’t know her company’s health insurance ended the day she resigned. Her parents were covered under that same plan — and suddenly, they had no protection at all. 🎯 Most people don’t realise this — When you switch jobs, your corporate group health cover stops immediately. And your new company’s policy usually begins only after joining, sometimes with a waiting period. That small gap can cost you lakhs in hospital bills. 💸 Here’s how to do it right 👇 ✅ Port your existing corporate health plan to an individual policy ✅ Or buy a separate family floater plan for your parents It’s just a few forms today… but it can save your parents from a financial crisis tomorrow. ❤️ Because your career can wait a week — but your parents’ health can’t. 💡 #HealthInsurance #MoneyMatters #FinancialPlanning #InsuranceAwareness #WealthArchitectsCollective

*Zero GST, Full Advantage: A Chance to Rethink Your Cover* When I bought my first health policy, the cover amount felt huge. To be fair, ₹5 lakhs is pretty astronomical when you're only making 30k a month. Today though, that wouldn’t even cover a week in a good hospital. The same goes for life insurance. A ₹50 lakh policy looked good once. Then I became a father and bumped it up to ₹1 crore. Today, even that figure falls short. If you're like most people (me included), money in hand is money spent - on the next device, a long weekend, or that gift you promised a loved one. But why am I suddenly talking about money in hand? Because of the GST change. With 0% GST on premiums, you'll probably end up with some money in hand… and we know where that'll go… Or, that money could buy you something far more lasting: more cover, more security, more peace of mind. Because just having a policy isn’t enough. It’s about having the right one, and the right amount of cover. Adequacy is as important as access. So here’s my nudge: don’t let this moment slip. Use the GST advantage to review your cover for both health and life. If you’re uninsured, step in. If you’re already insured, step up. If nothing else, ask yourself this: when was the last time you reviewed your cover?

“Material change” in your health insurance policy is like a chef secretly swapping out your biryani for plain rice—and still charging you for the mutton. But the bill? That just went up. Let’s talk about a silent policy mutation that could hit millions: Insurers are sliding in a ‘material change’ clause, letting them hike your premium—or worse, tweak your coverage—right at renewal. All this, wrapped in fine print so convoluted, it could make Kafka proud. 🧠 The fine print rebellion - Insurers are invoking this clause to “adjust” premiums, citing market realities or portfolio losses. - The IRDAI’s guidelines are clear: unless *you* change something, premiums should stay stable during renewal. But loopholes? They’re always in fashion. - Result: You’re loyal, you pay every year, and suddenly—bam!—your healthcare safety net is full of holes (and the patch kit costs extra). 📉 The ecosystem blind spot - Most policyholders trust the renewal process—until their premium jumps 20% overnight. - Founders like PolicyBazaar and Acko have built trust on transparency, but are legacy insurers ready to play by the same rules? - The real pain: In a country where 75% of the middle class is still underinsured, this move could set back hard-won progress. 🛠 Save-worthy: The 3-Question Renewal Playbook 1️⃣ Has my insurer notified me of **specific** changes in writing? 2️⃣ Are these changes backed by IRDAI-approved reasons—or just “market conditions”? 3️⃣ What’s my exit option, and is there a *better* product in the market (hello, Niva Bupa or Star Health)? Here’s the inconvenient truth: If policy tweaks become the new normal, the trust deficit will grow faster than any premium hike. Read your next renewal like it’s a term sheet, not a Netflix T&C. 💬 What’s your take—will this clause push India’s health insurance market forward, or send trust into the ICU? #HealthInsurance #Policyholders #FintechIndia #IRDAI #InsuranceAwareness #ConsumerRights #StartupIndia #HealthcareReform