Effects of a Pre-Existing Disease on Your Health Insurance
Updated On Apr 27, 2021
A pre-existing disease is defined as an ailment or condition that has been diagnosed by the doctor, at least 48 months before the date of issuing the health insurance policy. General fever and cold will not be covered under pre-existing diseases and it generally refers to long-term diseases like diabetes, hypertension, cardiac conditions, etc. The insurance company will approve the insurance request after medical evaluation and after a brief waiting period.
How Pre-existing Diseases Affect Health Insurance?
Indeed, people with pre-existing diseases cannot get health insurance easily unlike other healthy people, but still, they should declare the pre-existing disease while buying health insurance, as the policy is underwritten based on this declaration. The other ways how pre-existing diseases affect health insurance are as follows,
1. Waiting period of the insurance
Some insurance companies will agree to cover pre-existing diseases at the regular premium, without escalating its cost, but will impose a waiting period to cover that particular illness. This waiting period can be anywhere between 2 to 4 years and differs between different insurance providers. Hospitalization costs or hospital bills for the pre-existing diseases in this waiting period will be covered under the insurance policy.
2. Increased Premium Costs
Some insurance companies offer instant coverage for pre-existing diseases, but at a higher premium. The coverage cost will be added to the premium, to cover the risks of insuring a person with an existing medical condition. Premium loading for some diseases like diabetes and hypertension and cancer is common. But premium loading will happen only at the time of buying of policy and according to the IRDAI, the insurance company should not increase the premium after issuing the policy and renewing it without taking a break. Though the premium is higher, it is still beneficial, as it is possible to cover the disease under the insurance policy.
3. Premium Loading
Some Insurance companies will load both the premium and also impose the waiting period. It depends on the particular disease, the nature of the policy, and the insurance company.
Coverage of Pre-Existing Diseases Under Health Insurance
The health insurance companies will not offer insurance cover to people who are suffering from pre-existing illnesses. This is because people with pre-existing illnesses are likely to file a claim and impose a huge financial burden on the insurance company. Thus, people with pre-existing diseases have to undergo a tedious procedure to seek insurance for pre-existing diseases.
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Different insurance companies have different policies, and some insurers consider the entire medical history of the individual, whereas others take into account the medical history of the past few years. Shopping around policies and choosing the best-fit one can be of much help for those seeking medical cover with pre-existing diseases.
Bottom Line
Thus a pre-existing medical condition cannot stop an individual from seeking medical insurance. They can still avail of insurance with some strings attached to it. But in any case, they should not hide any information about their health to the insurance company, as it can result in declining claims, and in worst cases revoking the policy itself.
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.
