2026 will be remembered as the year health insurance in India was fundamentally redesigned. A series of regulatory changes announced by IRDAI throughout 2025-26 have systematically dismantled the structural barriers that prevented Indians from accessing adequate health coverage.

1. No Age Bar for Buying Health Insurance

IRDAI directed all insurers to remove the maximum entry age for health insurance policies. Previously, most insurers capped entry at 65-70 years, locking out senior citizens from buying new coverage. The removal of the age bar opens the market to millions of senior citizens.

2. PED Waiting Period: 4 to 3 Years

Pre-Existing Disease (PED) waiting periods have been standardized and reduced from a maximum of 4 years to 3 years. Any condition existing at policy purchase becomes covered after 3 continuous years of renewal, down from 4 years earlier.

3. Moratorium Period: 8 to 5 Years

The moratorium period after which the insurer cannot contest any claim except for proven fraud has been reduced from 8 years to 5 years, providing greater certainty for policyholders.

4. Cashless at All Network Hospitals

IRDAI mandated cashless treatment at every network hospital, covering pre-hospitalization, hospitalization, and post-hospitalization expenses, significantly reducing out-of-pocket expenditure.

5. AYUSH Coverage Mandatory

All health policies must now cover AYUSH (Ayurveda, Yoga, Unani, Siddha, Homeopathy) treatments with the same sum insured as allopathic treatments.

6. Mental Health Coverage

Following the Mental Healthcare Act, 2017, IRDAI mandated coverage of mental health conditions on par with physical health conditions.

7. GST Exemption

Effective September 2025, the 18% GST on retail health policies was reduced to nil, reducing premiums by approximately 12-15% and driving 30%+ growth in standalone health insurer premiums.

8. Senior Citizen Premium Cap

IRDAI directed insurers to cap health insurance premiums for senior citizens at 1.5 times the base premium for a standard 40-year-old entrant, preventing prohibitively high premiums.

Sources: IRDAI Master Circular on Health Insurance (2025-26), IRDAI 134th Meeting Report, BimaBazaar Insurance Times