Is Medical Checkup Required for Health Insurance?

Some insurance companies require the applicant of medical insurance to get a pre-medical checkup. This helps insurance providers gauge the health risks associated with the applicant and suggest suitable coverage plans and policies. But is it truly necessary to do that for everyone? Well, this article discusses that in detail. Read on to learn more. 

What is a Pre-Health Checkup?

Pre-health checkups or Pre-Medical Tests are conducted by various medical professionals to determine the health status of an individual. Before opting for medical insurance, a lot of insurers insist individuals get this test to assess their medical condition.
For most cases, the sum of insurance and the total number of performed medical tests are associated.

 
Is Pre-Medical Check Up Compulsory for All?

No, presently, the majority of health insurance companies don't ask individuals to get health checkups. This is more applicable if they are below the age of 45 years. Some insurers have extended this age limit to age 60. However, people who are below the age of 45 years with pre-existing conditions have to take a pre-medical checkup.

People who have pre-existing ailments need to undergo a medical check-up regardless of their age. 

While not mandatory, people need to get a medical examination before purchasing a Medical Insurance cover.

 
Benefits of Pre-Medical Tests Before Getting a Health Insurance

Here is a list of some benefits which you get upon opting for pre-medical tests before getting health or medical insurance coverage:

●  Guarantees the Right Coverage

Getting pre-medical tests would ensure that your insurer can provide you with the best medical insurance policy plan – that well suits your needs. This is because when you submit this information to the insurers, they will be able to properly assess your health risks and provide you with coverage that adequately supports you in the future. 

●  Actively Prevents Rejection of Claims

By being transparent with the insurer about your pre-existing ailments, you can avoid claim rejection. This thereby facilitates a swift processing of claims in times of need. For instance, the majority of insurance providers ask individuals to fill out the PED (Pre-Existing Disease) form. Hence, by getting medical checkups done, you can get the supporting documents for this form.

●  Helps in Determining Premium Amount

The premiums which one has to pay upon getting a health insurance policy always depend on the health risks of the applicant. For example, a person with a clean health history is at a lower risk and, hence, has to pay lower premiums. Similarly, on the other hand, a person who has a history of critical illnesses will be considered as a high risk.

●  Aids in Customization of Policies

Insurers can make use of their medical insurance policies and then customize policies even further based on that. This ensures that they get adequate coverage for their health needs. For example, if the medical tests show that a person has a high risk of health issues, then the insurer would suggest additional riders and add-ons for even better protection. 

What are the Charges Applicable for These Types of Tests?

According to the IRDA (Insurance Regulatory and Development Authority), the insurance company covers half of the costs of the medical checkup. The other half of the costs is covered by the applicant. There are, of course, exceptions to this as well, where some companies advise the applicants to cover charges incurred for medical tests by themselves. 

It is not possible to mention the exact number of charges that will be applicable when taking a medical checkup. This is because the total costs vary amongst different diagnostic hospitals and centres.

Also read:-

→ Loading Charges in Health Insurance Explained

→ Mention the list of health policies in India

→ Mention the List of Modern Treatments Covered under Health Insurance

→ Offering Health Insurance to Your Workforce

→ Staying on Your Parents' Health Insurance: Age Limits