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Are Pre-Existing Diseases Covered in Health Insurance?

Updated On May 03, 2021

Health is a vital component in order to live a happy and sound life. However, it undergoes various problems owing to different factors, ranging from lifestyle habits to family history, thereby giving birth to various diseases. Therefore, in order to keep the ailments at bay, it is necessary to go through a regular health check-up. Nonetheless, a healthcare emergency can arise anytime for which we must keep ourselves financially well prepared. Investment in health insurance would give you a financial shield that would prevent you from draining out financially at the time of unfortunate events such as emergency hospitalization or a planned surgery.

However, people suffering from pre-existing diseases (PED) should be aware of the fact that they cannot avail coverage under a health insurance policy right from the start. A waiting period for a specific duration is decided for the insured person prior to getting a claim for such diseases. However, once the waiting period gets over, the policyholder can avail coverage under the best health insurance plans.

What are Pre-Existing Diseases in Health Insurance?

Pre-existing disease means an ailment or a disease that the policy buyer was suffering from at the time of buying a health insurance plan. A pre-existing disease includes all kinds of health ailments such as high blood pressure, asthma, diabetes, thyroid, cancer, etc.

Tips to Find Best Health Insurance Plans with Pre-existing Disease

Individuals with pre-existing diseases are required to undergo various treatments and procedures. This could eventually lead to refusal from the insurance company to pay the expenses/bill, cancellation of policy, etc. Highlighted below are some useful tips to help out the proposer in finding an optimum health insurance plan for themselves, especially if they have an existing health ailment:

  • Don’t Hide Pre-existing Disease: A policy buyer must refrain from hiding any previous health ailments as if it gets disclosed during the treatment, then the insurance company can even reject your health insurance claim.
  • Different Insurance Companies have Different Insurance Plans: Getting health insurance cover with a pre-existing disease can be difficult, however not all insurance providers are the same. Some insurance companies take into account the entire medical history of the policyholder at the time of determining pre-existing health ailments, while other insurers would take into account just the medical history of the few years in the past.
  • Chronic Diseases: Only those health diseases that will have an impact for the long term are taken into consideration by the health insurance providers. In case an individual is prone to flu, cold, cough, and fever, then it is nothing to worry about. As the insurance providers will not take into account short-term health issues as they do not have any long-term side effects.
  • Waiting Period: If you are purchasing a family health insurance policy or an individual health insurance policy, there is a specific waiting period that limits you from registering a claim for a specific time duration. The duration of waiting periods varies depending upon the insurance provider and the medical conditions of an individual. It also depends upon the severity and duration of your pre-existing ailment.
  • Waiver of Pre-existing Disease: In case, you wish your health insurance company to cover Pre-existing diseases, general health insurance providers have a waiting period of two years. Therefore, it is advisable to begin early with your health insurance plan.


The waiting period for health insurance companies differs from insurance company to insurance company, generally, it varies between 2 years and 4 years. Also, it is advisable to switch your insurance company only after you complete your waiting period so that the insurance policy gets accrued after you switch the insurance company and you are not required to begin again. Nevertheless, there are insurance companies that provide a reduction in the waiting period by paying an additional premium amount.

Disclaimer: This article is issued in the general public interest and meant for general information purposes only. Readers are advised not to rely on the contents of the article as conclusive in nature and should research further or consult an expert in this regard.

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