Health Insurance for Pre-existing Conditions: Understanding Your Options

Many people don’t understand the importance of purchasing a Health Insurance; they generally rely on their savings and employer-offered insurance. Is that enough to protect you and your loved ones?

We live in a fast-paced environment, where long work hours, unhealthy lifestyle habits and excessive stress make us prone to developing the disease at an early age. Our sedentary lifestyle leads to chronic diseases like heart conditions, cancer, and asthma. The rising medical inflation will drain our finances in medical emergencies. So it is wise to protect you and your family with a suitable health Insurance plan.

While purchasing health insurance, a common question arises in every mind: Does health insurance policy cover pre-existing disease? Many people assume that Health Insurance doesn’t cover pre-existing illnesses, but it’s not true. However, The Insurance Regulatory and Development Authority of India (IRDAI) has revised the pre-existing disease list and the pre-existing disease health insurance coverage.

This article will provide insights into health insurance plans and pre-existing diseases/illnesses.

What is a Pre-existing condition in Health Insurance?

A pre-existing condition or illness is a medical condition that the insured has before buying a Health Insurance policy. According to IRDA, if the insured was diagnosed with a disease or medical condition up to 48 months before purchasing the policy, it is called a pre-existing disease.

Pre-existing diseases include all long-term health issues like high blood pressure, thyroid, diabetes, asthma etc.

Pre-existing disease waiting period

Most health insurance policies cover pre-existing diseases after a waiting period. During this period, the Insurer will reject any claim raised to treat a pre-existing condition.

The terms and conditions of the pre-existing condition waiting period differ from plan to plan. Usually, a pre-existing disease waiting period ranges from 12 months, 24 months to 48 months.

However, Star Health Insurance offers a buy-back pre-existing disease (P.E.D.) as an optional cover, allowing policyholders to reduce pre-existing diseases’ waiting period in one of our products. Under a buy-back P.E.D. cover, policyholders can pay an additional premium to avail of coverage for medical conditions early without waiting for their policy’s waiting period to expire.

Things you should know if you have Pre-existing medical condition

Here’re some points one should consider before buying health insurance for pre-existing diseases.

Pre-existing Illness terms and conditions differ from Policy to Policy

The terms and conditions of covering pre-existing illness may vary from Insurer to Insurer. Getting a Health insurance policy that covers pre-existing conditions may be challenging, but options are available to reduce the waiting period.

While determining a person’s pre-existing illness, many insurers may only consider the applicant’s medical history for a period dating back to the past 48 months.

Identify the Pre-Existing disease

Minor health issues like cough, cold, and fever don’t fall under pre-existing disease categories. Not every ailment is a pre-existing disease. Insurers only consider medical conditions and illnesses that have long-term effects on a person’s health as Pre-existing disease.

Never hide a Pre-Existing disease from Insurer

Never hide a pre-existing medical condition you may have when taking a health insurance policy. If such information is hidden from the Insurer, the company can reject your claim if it concerns such a condition.

Choose a Health Insurance plan with lower waiting period

When you buy an individual or family health insurance plan, there is always a pre-existing waiting period that restricts one from filing a claim for a specific period.

The insurance company will reject any claim raised for such diseases during the waiting period. The time duration of the waiting period differs from policy to policy.

So, one should opt for a health insurance policy with a lower pre-existing disease waiting period.

Medical Check-Up

If you have a pre-existing disease, the insurance company will ask you to go for a medical check-up. The insurance premium will be based on the reports.

Go for High Sum Insured

If you have a pre-existing disease, opting for high-sum insured plans is always better. One should consider the rising medical inflation and high costs of surgeries before selecting a health insurance plan.

Check for the premiums

Before buying any Health Insurance plan, check for the premium; the premium will be charged on the higher side due to pre-existing disease.

So, getting health insurance at a younger age is always advisable, as the risk of pre-existing disease is low.

Summary

You can still get a health insurance plan if you have a pre-existing health illness. Just check the waiting period for pre-existing diseases under your chosen health policy. Also, note that Buy-back PED benefit is offered only by Star Health Insurance as an optional cover allowing policyholders with pre-existing medical conditions to purchase additional coverage for health conditions.

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