Worried If a Pre-existing Disease Can Impact Your Health Insurance?
The advantages of having health insurance are numerous. It gives you peace of mind, offers you an inexpensive alternative to excessive medical expenditures, and lastly, it assures that you never sacrifice your health due to a lack of money. Health insurance has several advantages, but it also comes with limitations. One of these is the coverage offered for pre-existing illnesses.
Numerous people today struggle with lifestyle ailments such as thyroid, obesity, diabetes, hypertension, and others. This is partly because of the increased pressures in our environment and our indulgence in things like smoking, drug use, and alcohol addiction that worsen these illnesses.
Many individuals believe that pre-existing conditions are not covered under health insurance, however, this is not true at all. For these conditions, you may be eligible for insurance reimbursement.
What Does a Pre-existing Disease (PED) Mean in the Context of Health Insurance?
Pre-existing conditions are ones you already have while purchasing insurance coverage, and occasionally even before. They already exist before you pay the insurance payment, as their name suggests. A person may have health issues including high blood pressure, diabetes, asthma, cholesterol, or cancer before the onset of pre-existing disorders.
Earlier POV
PEDs were previously defined as chronic conditions, such as high blood pressure, cancer, diabetes, etc., that a person has at the time of purchasing health insurance or whose symptoms start to appear three months after the date of issuance. In accordance with the previous provision, if a policyholder had any of the diseases on the pre-existing disease list, insurers could reject or completely deny a claim request if made before a specified period. This fear of claim denial also caused many to conceal pre-existing conditions and omit vital health information when purchasing health insurance.
Read more - FAQs on Pre-existing Disease Coverage in Health Plans
New Approach
The Insurance Regulatory and Development Authority of India (IRDAI) defines a pre-existing illness as a medical condition, ailment, disease, or injury that the insured individual had before purchasing a medical insurance plan in accordance with a circular issued by it on February 10, 2020. Any such medical problem that was identified by a doctor 48 months before the policy's issue or reinstatement date is regarded as a pre-existing condition.
What Effects Does a Pre-existing Disease Have on Your Health Insurance?
There could be variations among insurance providers' clauses. Therefore, it is advised to thoroughly read the relevant documents before purchasing a health insurance plan.
More Premium Payouts
Due to the insurance provider's willingness to assume the risk of covering a pre-existing condition, the premium will be on the higher side.
Waiting Time
Coverage for pre-existing diseases happens after a waiting period of up to four years.. It depends on the condition, the level of coverage, and the insurer providing the policy.
Read more- Waiting Period in Health Insurance
Waiting Period + Higher Premium
If you have a serious ailment, such as high blood pressure, you can pay a higher premium and have a longer waiting period for coverage.
Continual Exclusion
If you have a pre-existing condition, the insurance provider may still grant you coverage.
Policy Rejection
Because of your pre-existing problems, the insurance provider may reject your application for insurance.
How Can Someone with a Pre-existing Condition Obtain Health Insurance in India?
People with these ailments, such as diabetes, asthma, or hypertension, or those who join a health plan, are covered by almost all of them. Simply wait until the waiting period ends, and then file a claim as soon as it is necessary. Group health insurance policies offered to employees by their employers may have no waiting period clause.
Keep in Mind These While Purchasing Health insurance for Pre-existing Conditions
Each has its own set of conditions and guidelines. It is in your best interest to conduct extensive research, compare health insurance policies online, read the fine print of your current policy, and learn everything there is to know about the mention of pre-existing conditions.
Policy Premium Amount
You should be aware that the health insurance provider is taking a risk by offering you health coverage. Health insurers, hence, demand a higher premium and raise the cost of your coverage.
Obtain a Medical Evaluation
The insurer cannot later reject the health insurance claim if you submit medical exams and honestly disclose your medical history when purchasing the coverage. It will make sure there are no disagreements when the claim is settled.
Optimize Group Insurance Plan
When a health insurance policy is given by an employer, there is no waiting time clause. Utilize it to receive reimbursement for medical care received for existing conditions.
Policies are Different Between Insurers
There is no optimum pre-existing condition medical insurance. A pre-existing condition might be covered by some insurers while it might not by others. Some might have a shorter waiting period, but others might have a longer one.
Do not Withhold Information About a Pre-existing Disease
It is advisable to be open and truthful with the insurance provider about any pre-existing conditions to prevent complications when settling claims.
Not Every Visit to the Doctor Counts
It's not a problem to see a doctor to get rid of your headache. However, if the headache has persisted for a year and you are taking medicine, it may qualify as a pre-existing condition.
Conclusion
All said and done, choose a health insurance plan that considers your well-being. The features and coverage of your insurance plan play a big part in how reliable it is. Therefore, be careful to choose a plan that meets your needs and includes coverage for various pre-existing conditions. Hence, you never have to worry about money and can get the greatest medical treatment when needed.
Read more- Advantages of Comprehensive Health Insurance
Pre-existing conditions are covered by insurance companies once the insured member completes the waiting period, typically for up to four years. However, do check with the insurer about the coverage of particular illnesses.
They can be. Medical investigation reports can help ascertain whether mental illnesses existed before buying the policy.
Insurers consider only those illnesses and medical disorders that have had a sustained impact on a person's health. Minor illnesses like a cough won't be considered unless you've had them for more than a year and are taking medicine; in that case, it can be considered a pre-existing condition.
She can apply for it, but the insurance provider will follow the proper procedures and let her know if she qualifies.
The waiting period could be shortened by health insurance providers by increasing the premium. In a group health insurance plan, there is no waiting period, be it for pre-existing conditions or any other stuff.