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Meaning Of Pre Medical Tests In Health Insurance

Updated On Jan 31, 2023

In today’s highly uncertain times and due to our changing lifestyle, health complications have become a common thing. With the rising number of health issues, the medical expenses for the treatment of these diseases have also witnessed a constant rise. This makes it important to be prepared against these health emergencies beforehand. For the same, the best idea is to invest in health insurance plans that will provide you with protection against health uncertainties. However, to buy a health insurance plan, you also need to take a pre-medical test. In the section below, let us discuss all about the meaning of pre-medical tests in health insurance.

Meaning Of Pre Medical Tests In Health Insurance

What is Pre Medical Tests in Health Insurance?

A pre-medical test in health insurance means the health check-up/examination that is conducted by the insurer before providing health insurance coverage benefits to policyholders. These tests are conducted in order to check the physical fitness of the policyholder. On the basis of the physical fitness test, the premium will be set for the policyholder. The premium of health insurance is also determined on the basis of age and other factors. 

Listed below are some of the benefits of pre-medical tests in health insurance:

  • These tests help the insurers in getting a proper understanding of the proposed policyholder’s health.
  • It helps the insurer to prevent policyholders from lying about pre-existing diseases if any. Thus, based on the pre-existing diseases, it will become easier for the health insurance company to set the right premium amount.
  • These health reports are also helpful during the claim settlement process. Moreover, as the health tests are already done, it also reduces the chances of claim rejections.
  • Many health insurance companies even offer discounts based on health reports. For instance, if there is no trace of nicotine in your blood sample, then you may stand a chance to get additional discounts.
  • A pre-medical test is also helpful in getting the right coverage. For instance, once your health is assessed rightly, it becomes easier for the health insurance company to provide you with the right kind of health insurance plan for you. 

Tests Performed for Pre Health Check-ups

There are different tests performed for health check-ups. Listed below are the different types of health tests that are included in pre-health check-ups:

  • Blood count
  • Blood sugar level
  • Lipid profile test
  • ECG
  • Blood serum test
  • Blood pressure test

Depending on your insurer, the number of tests performed for pre-health check-ups can even increase. 

Who is Responsible for Paying for Pre-Medical Tests in Health Insurance?

According to the Insurance Regulatory and Development Authority of India or iRDAI, it is mandated that half of the pre-medical test costs will be borne by the health insurance company. The remaining half shall be borne by the individual willing to buy the health insurance plan. However, there are a number of insurance companies that completely bear the cost for pre-medical tests, provided that the tests are conducted at diagnostic centers, as enlisted by the insurer. 

Take Away

Thus, in a nutshell, it can be said that it is a wise decision to undergo a pre-medical test before buying a health insurance plan. This will also help in reducing the chances of claim rejections and serve many other benefits.

Also Read: 

Health Insurance Premium Payment Modes


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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