The value of purchasing a comprehensive health insurance policy is underestimated by the people. They rely on the money and insurance provided by their employers. However, in today's world, the cost of medical expenses is rising, which is not economical for you. As a result, it is recommended that you and your loved ones should be covered with a suitable Health Insurance plan.
Does Health Insurance cover Pre-Existing Diseases (PEDs) that you already have? Certainly not. That is why buying Health Insurance early in life is recommended. This not only ensures a lower premium but also ensures that you get better coverage because the risks of catching diseases are lower at a young age. This article will tell you about pre-existing diseases and health insurance.
Pre-existing diseases are those medical conditions that an insured already has when they buy a new health insurance policy. The pre-existing disease is defined by IRDAI as a) any condition, ailment, injury, or disease diagnosed by a physician within 48 months of the policy's effective date or reinstatement, or b) any medical advice or treatment recommended by, or received from, a physician within 48 months of the policy's effective date or reinstatement.
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Navigating the purchase of a health insurance plan for individuals with pre-existing conditions can be a tricky task, as each insurer has orchestrated clauses with many exclusions. Since every person's circumstances vary, it is essential to carefully assess your unique healthcare requirements and financial capabilities when choosing insurance coverage for pre-existing conditions. Here are a few tips to keep in mind
|Diabetes||A chronic condition that affects blood sugar levels. Requires ongoing management and may involve medication, regular check-ups, and hospitalization.|
|Hypertension||High blood pressure, which requires long-term monitoring and medication to control.|
|Asthma||The serious respiratory condition causes breathing difficulties and wheezing. Often requires medications and occasional hospital visits.|
|Heart Diseases||Conditions like coronary artery disease, heart attacks, and cardiac surgeries. May require specialized treatments and surgeries.|
|Thyroid Disorders||Includes hypothyroidism and hyperthyroidism, which require regular medication and monitoring.|
|Arthritis||Involves joint pain, stiffness, and inflammation, often requiring ongoing medication, physiotherapy, and joint replacement surgeries.|
|Cancer||Life-threatening disease requiring comprehensive coverage for chemotherapy, radiation, surgeries, and other treatments.|
|Kidney Diseases||Chronic kidney conditions such as renal failure and dialysis, require long-term treatment and possible kidney transplants.|
|Mental Health Conditions||Includes depression, anxiety disorders, and bipolar disorder, emphasizing the importance of coverage for mental health treatments and therapies.|
Insurance is a concept in which an health insurance company provides financial support if something unfortunate happens to the policyholder as per the terms and conditions. If a person already has a pre-existing disease then the chances of raising a claim increase. As a result, Health Insurance Companies are reluctant to cover pre-existing conditions. Some Insurance Companies may cover them as per terms & conditions and charge a higher premium for them.
You might be asking whether it's even necessary to disclose your pre-existing disease. However, in this circumstance, it's preferable to be completely transparent. Examine your medical records to be sure you've covered all of the illnesses and treatments you'll require. If you do not disclose your pre-existing disease to your Insurance Company and they discover it later, they will reject your claim. So, rather than not declaring your PED, it's preferable to wait for a time and get it covered.
The following is a list of the possible effects of having a pre-existing disease on your health insurance policy.
Purchasing health insurance for senior citizens with pre-existing conditions might be challenging. The following is a process to purchase Health Insurance for the elderly.
Here are a few key factors to remember about pre-existing conditions and Health Insurance.
There is no particular health insurance policy that covers pre-existing diseases in India. Each insurer covers certain policies mentioned in the policy document after a given period of time.
Each insurer covers different pre-existing diseases which are mentioned at the time of commencement of the policy. To know about the disease you are looking forward to covering, you will have to look for a plan that covers it.
Generally, the waiting period is fixed and non-negotiable. However, you can contact your insurer and ask for the same. Some insurers can charge you higher premiums in exchange for a lesser waiting period.
Yes, you can buy a health plan if you have a pre-existing disease. The insurer will provide you with a waiting period if they cover the disease and then you can claim for insurance after completion of the waiting period.
Your medical history includes all of the health conditions you have suffered from whereas, pre-existing disease are the ones that you have since 48 months from the time of purchasing a health plan and have the chances of recurring in the future.
Yes, most health insurance plans have a waiting period for pre-existing diseases. This waiting period typically ranges from 2 to 4 years.
Disclose your pre-existing health issues honestly at the time of purchasing the policy. Ensure you understand the coverage provided for pre-existing conditions and any waiting periods involved.
Yes, as per the latest guidelines, health insurance companies can consider the medical history of the last 48 months to determine coverage for pre-existing diseases.
No, it is essential to disclose your pre-existing health issues accurately. Hiding it may lead to rejection in the future.
No, health insurance companies typically consider only health ailments that have long-term effects as pre-existing diseases. Short-term issues like flu or fever are usually not included.
Look for a health insurance policy with a lower pre-existing disease waiting period and without a co-payment clause for pre-existing conditions coverage.
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Naval Goel is the CEO & founder of PolicyX.com. Naval has an expertise in the insurance sector and has professional experience of more than a decade in the Industry and has worked in companies like AIG, New York doing valuation of insurance subsidiaries. He is also an Associate Member of the Indian Institute of Insurance, Pune. He has been authorized by IRDAI to act as a Principal Officer of PolicyX.com Insurance Web Aggregator.