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Can I Get a Health Insurance Cover if I have A Pre-existing Disease?

Updated On Dec 30, 2020

Pre-existing diseases are the ailments suffered by the person to be insured while applying for a health insurance policy. According to the Insurance Regulatory and Development Authority of India, (IRDAI), pre-existing diseases could be an ailment that is diagnosed at least 48 hours before the issue of the insurance policy. Not all visits to the doctor are categorized as pre-existing diseases. Only ailments that can have a long term effect on the health of the person is categorized as a pre-existing disease. Generally, insurance companies will not offer health insurance coverage for people with pre-existing diseases.

Can I Get a Health Insurance Cover if I have A Pre-existing Disease?

Availing Health Insurance Cover With Pre-Existing Diseases

People with pre-existing diseases can avail of medical insurance under the following conditions:

1.Compare Insurance Companies

Some Insurance companies will offer coverage for individuals with a pre-existing disease, but at a higher premium. Also, the waiting period for certain ailments differs from one insurance company to another. So the best choice is to compare insurance companies and choose the plan that best meets one’s requirements.

2. Pre-existing Illnesses Should Be Exposed

It is important to declare all pre-existing diseases while buying health insurance as the policy is underwritten based on the declaration made by the individual. If it is not disclosed, then the policy can get canceled. Also, the insured will not be offered any claims in the future.

3. Check Waiting Period

People seeking insurance with a pre-existing disease have to go through a specific waiting period to cover the medical ailment but should continue to pay the premiums even during this period. The waiting period is generally 2-4 years and is calculated from the date of issue of the policy. No claims pertaining to the doctor fees, hospitalization fees, and medicines costs for the specific disease be entertained during the waiting period.

4. Check Co-Payment Option
Some insurance companies offer insurance for pre-existing diseases under the co-payment policy. Under this, a certain percentage of the treatment costs will be provided by the insurer while the rest has to be borne by the individual.

Waiting Period and Pre-Existing Diseases

The duration of the waiting period depends on the severity of the condition. During the waiting period, it is important to pay all the policy premiums, to prevent a policy lapse. Some insurance companies will levy a waiting period of two years for a disease condition, whereas another insurance company will impose 3 or 4 years for the same ailment. Thus, thorough research can help to gain the best cover for pre-existing ailments.In case, the insured wishes to switch the insurance provider, they can do it after completion of the waiting period. But while porting the policy, there is no need to repeat the waiting period.

Final Words

It is thus possible to get medical insurance cover with pre-existing diseases but it incurs a waiting period. The cost of treatment and medical fees will not be covered by the insurance provider during the waiting period. It is important to keep the insurance company informed about the pre-existing condition, to avoid rejections in the claims in the future.

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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