All health insurance plans come with a pre-existing disease clause. Besides, buying medical insurance for people with pre-existing diseases can be a daunting task. So, before you find out about the limitations in coverage for pre-existing illnesses, know what a pre-existing health condition actually means.
A pre-existing illness is an illness or medical condition that the insured has before purchasing a health insurance policy. As per IRDAI, if the insured was diagnosed with a disease or medical condition up to 48 months before buying the policy, it is termed as a pre-existing disease. Pre-existing conditions include all the long-term health issues ranging from high blood pressure and thyroid to diabetes, asthma, etc.
Most health insurance plans cover pre-existing diseases after a waiting period. During this period, any claim raised for the treatment of a pre-existing disease will be rejected by your insurance provider.
The pre-existing disease waiting period is not the same for diseases across all health plans. While some health insurance plans will have a waiting of 2 years for diseases, other health plans may cover the same disease after a waiting period of four years. It is suggested that you switch to a different insurance provider only after completing your waiting period.
Insurance companies are apprehensive to provide health insurance coverage to people suffering from pre-existing illnesses.It is because people with pre-existing illnesses are more likely to file a claim as compared to other people. This imposes higher financial risk on the health insurance providers and therefore, they avoid offering medical insurance to people with pre-existing diseases. It is not easy to predict sickness in advance. But people who are already suffering from health problems have a great probability of falling sick and raising a claim.
To buy medical insurance, people with pre-existing health issues often have to undergo a pre-policy medical check-up. The results of the medical check-up will determine the premium charged by the insurance company.
Here is a quick rundown of some useful tips that can help you find the best health insurance policy even if you have a pre-existing health issue:
It can be challenging to get health insurance coverage when you have a pre-existing health condition. However, as per the latest IRDAI guidelines, health insurance companies can consider the medical history of only the last 48 months to find a pre-existing disease.
Refrain from hiding any pre-existing health issue from your insurance company at the time of buying the policy. This is essential because if your pre-existing condition is disclosed at the time of treatment, then the insurer can reject your health insurance claim.
When it comes to pre-existing diseases, health insurance companies will only take into consideration your health ailments that will have an impact in the long run. Therefore, if you are prone to flu, cough, cold or fever, then do not fret!
Whether you buy an individual health plan or a family health insurance plan, there is a pre-existing disease waiting period that restricts you from filing a claim for a specific period. During this period, any claim raised for such diseases will be rejected by your insurance company.
Some health insurance providers may have a co-payment clause for pre-existing conditions coverage. Under this clause, you will have to pay a percentage of the claim amount during claim settlement and the insurer will pay the outstanding amount. But not every health policy comes with this co-payment clause for covering pre-existing diseases.
