Health Insurance Coverage for Pre-Existing Diseases
To be healthy, a plant must be properly cared for. Many factors, from our lifestyles to our family history, can put us at risk of developing diseases. We all need to be aware of how important health insurance is for our health. Unexpected events such as a planned operation or hospitalization can cause problems. People with Pre-existing disease (PED) should be aware that they cannot get coverage through their health insurance for Pre-existing condition.
They can rest assured, however, that they will be able to get coverage under the best insurance policy after the waiting period has ended.
Let’s get to the bottom of pre-existing diseases in insurance.
What does “Pre-existing” Health Conditions mean?
It is important to know what pre-existing conditions and diseases mean. A pre-existing condition is a medical condition that an individual has before they take out a policy. This could include any type of health problem, including serious conditions such as cancer, diabetes, or milder conditions such as asthma, high blood pressure, or acne.
Pre-existing conditions are not covered by health insurance companies. These individuals are more likely to need medical attention and pose a greater financial risk for the insurance company. Pre-existing conditions will make it difficult for insurance companies to offer policies to such individuals. These individuals may not be able to find the right insurance coverage. Their insurance policies may be cancelled or the insurer may not cover their medical bills. Worst, they may even lose their health insurance policy.
Announcements by IRDAI on Pre-Existing Conditions for Health Insurance
A February 2020 update stated that the protocols for “health Insurance Pre-existing Conditions” were amended.
Read about health insurance Pre-existing diseases, the new amendment by IRDAI, and how it is beneficial for policyholders having a Pre-existing disease.
According to the amendment, any disease or illness that is diagnosed within the first three months of the date of purchase will not be considered pre-existing. IRDAI made a thoughtful decision to reduce the pre-existing diseases waiting period.
Note: However, the amendment in health insurance Pre-existing conditions is not applicable to travel insurance.
What are the IRDAI Guidelines for Health Insurance Pre-Existing Conditions Beneficial to Policyholders?
These guidelines are beneficial to policyholders:
- This will dramatically reduce claim rejection rates
- It eliminates most of the ambiguities associated with pre-existing conditions
- Insurers will be less likely to disclose their true medical history and will receive a claim without being rejected.
Now, health insurance is a necessity. Pre-existing conditions made it difficult to obtain full coverage. There were risks of rejection and an increase in waiting periods. People who cannot afford ongoing treatment for their pre-existing condition and were subject to rejection of claims are able to benefit from the IRDAI guidelines. They will be able to claim even if they have been diagnosed with chronic diseases following the amendment.
Trusted brands like Care Health Insurance (formerly Religare Health Insurance) offer cashless health insurance plans to people with pre-existing diseases so that they can avail the best possible treatment without worrying about arranging money to pay the hospital bills.
How can I get health insurance for my parents with pre-existing conditions?
There are some things you should consider if your parents have a preexisting condition before you choose the right coverage.
- Waiting period: India has no waiting period for health insurance that covers pre-existing conditions. Pre-existing conditions will be a factor in any medical insurance you choose for your parents. Typically, this is 48 months. Make sure you choose the minimum waiting period before finalizing any health insurance options.
- Sum Insured Before deciding on a sufficient sum insured option, it is important to consider medical inflation as well as the high cost of surgery.
- Online medical check-up: Parents can get health insurance online without undergoing any pre-policy medical screenings. However, in some cases one might need to undergo a medical exam at the discretion of the underwriter.
- Affordable Premium: Your parents’ health insurance will likely have a slightly higher premium than that of someone with a pre-existing condition. After careful comparison of all plans, you’ll find the most affordable plan.
Consider these Things if you have a pre-existing medical condition
These are the main points to remember when shopping for health insurance policies.
- Policies differ from one insurer to the next: Policies may differ in the terms and conditions that cover pre-existing conditions. Although it can be difficult to find a policy that covers pre-existing conditions, there are exceptions. Some insurance companies will take into account the entire applicant’s medical history when determining a pre-existing condition. Other providers might only look at an applicant’s medical history up to 4 years ago.
- Each Doctor’s Visit Is Not Counted: You may have been visiting your doctor frequently for minor conditions like colds, coughs, and fevers. You don’t have to worry about winters. When you apply for health insurance, every visit to the doctor is not considered a red flag. Insurers will only consider long-term medical conditions or ailments that have had an adverse effect on a person’s health. A person’s health is not affected by minor illnesses and side effects like those mentioned above.
- Do not conceal a pre-existing medical condition. It is very unwise to keep information like a pre-existing medical condition which you may have, at the time of taking a health insurance policy. If this information is not disclosed to the insurer, they may reject your insurance claim if it concerns such a condition.
- You can get coverage for pre-existing medical conditions: Most people believe that insurance companies do not cover pre-existing conditions. This is incorrect. Nowadays, for health insurance policies, insurance providers include a waiting period or exclusion for pre-existing medical conditions. The insurance provider will not pay for the cost of treatment, medicine, or fees for doctor’s appointments if the person has a pre-existing condition. These costs will not be covered after the waiting period has ended. The policy will still cover expenses incurred due to other illnesses.
- You can reduce waiting periods: The waiting periods for insurance policies that cover health are different from one provider to another. Some insurance providers have a waiting period that is 2 years while others require a waiting period that can be up to 4 years. If you wish to shift to another insurance provider, it is advised to do so only after you have completed your waiting period with your current provider. This is because even though you have completed 2 of the 4 years of your waiting periods, these years won’t be counted in your new provider’s calculation. You will need to start over. Some providers offer policies that allow policy holders to reduce their waiting periods in exchange for a premium payment.