Health Insurance for Pre-Existing Conditions

Pre-existing conditions and health insurance are intricately linked, affecting how the coverage is offered and priced.

Many people these days avoid purchasing a health insurance policy if they are suffering from some ailments, such as diabetes or high blood pressure, fearing that insurance companies do not cover individuals with pre-existing conditions.

However, with a few terms and conditions, you can get health coverage for pre-existing conditions with IndusInd General Insurance.Here is a post that delves into understanding pre-existing conditions in health insurance and offers essential insights about comprehensive coverage.

Understanding Pre-Existing Conditions in Health Insurance

Pre-existing diseases in health insurance refer to any health concerns or medical conditions that an individual has been diagnosed with or is suffering from before purchasing the health insurance policy.

According to IRDAI, a pre-existing disease is a health condition diagnosed within 48 months prior to purchasing a health insurance policy. Some common pre-existing diseases are high blood pressure, diabetes, asthma, thyroid, arthritis, heart diseases and kidney diseases.

The diseases can range from mild to high in severity and can significantly affect the terms and conditions of a health insurance policy. Therefore, understanding pre-existing conditions and health insurance policy inclusions and exclusions is crucial to maximising the benefits.

What is Pre-Existing Disease Cover in Health Insurance?

The health cover for pre-existing conditions will have specific terms and conditions that require attention to detail. Our health insurance plans offer comprehensive coverage for a wide range of pre-existing illnesses and diseases after a predetermined waiting period.With us, you get a reduced waiting period for pre-existing health conditions so that you can avail of your health insurance benefits for pre-existing health conditions like high blood pressure and diabetes sooner.

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Our health insurance plans offer coverage against the rising cost of medical treatments and cover a wide range of medical services, ensuring healthcare remains accessible to you in times of need.

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How Does a Pre-Existing Disease Affect Health Insurance Policy?

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Individuals with pre-existing diseases are more likely to file claims compared to those without such health conditions. To offset this higher risk, a higher premium to cover both the existing health condition and potential future medical expenses is charged.The premium for pre-existing disease health insurance varies based on the severity of the disease and the specific policy terms and conditions.

Waiting Period

Another significant impact a pre-existing disease has on a health insurance policy is the waiting period. It refers to a specific duration of time the policyholder must wait before the health coverage for pre-existing conditions becomes effective.However, at IndusInd General Insurance, we understand the value of early coverage for some pre-existing diseases. Therefore, we offer optional add-ons, which reduce this waiting period significantly.For example, the Change in Pre-Existing Waiting Period cover under our IndusInd Health Infinity Insurance plan reduces the waiting period for pre-existing conditions to as low as 12 months.

The waiting period for our IndusInd Health Gain Policy is three years for medical expenses related to pre-existing diseases. In addition, continuous coverage of two years is essential from the date of policy inception of the first policy.To help policyholders reduce this waiting period, we offer the Reduction in Pre-Existing Diseases Waiting Period add-on with our IndusInd Health Gain plan, which reduces the waiting period to a 12/24 months only.

Medical Check-up

Individuals with pre-existing diseases may need to undergo a health check-up to assess their health condition and help us determine the coverage terms for the health insurance policy.

Health Insurance Coverage Permanent Exclusion or Denial

After receiving the health insurance policy application, the risk associated with the pre-existing health condition is assessed.If these conditions do not meet their underwriting guidelines and eligibility criteria, health coverage for pre-existing conditions may be permanently excluded, or in rare cases, the application may be denied entirely.

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Understanding Waiting Period in Health Insurance and its Types

The waiting period refers to the duration of time a policyholder must wait before they can claim the benefits applicable to them. Going through this waiting period is essential to ensure the benefits without the possibility of a claim rejection. There are different types of waiting periods in health insurance.

Initial Waiting Period

It is the initial waiting period that starts immediately after the policy inception. During this period no claims will be accepted except for accidental injuries. IndusInd General Insurance offers a short initial waiting period of 15 to 30 days.

Pre-Existing Disease Waiting Period

It is the waiting period applicable to claiming the benefits applicable to medical expenses related to pre-existing diseases.

Specific Ailments Waiting Period

The waiting period applies to certain specific ailments. The waiting period can vary between insurers and the specific ailments based on their level of severity. You can reduce this waiting period with specific add-ons under our health insurance plans.

Our Reduction in Specific Illness Waiting Period under our IndusInd Infinity Health Insurance plan reduces the specific ailments waiting period to only 12 months, offering early coverage.

Pre-Existing Conditions and Health Insurance Underwriting

Underwriting is the process by which an individual’s risk is assessed by examining their health condition and family medical history.

Pre-existing health conditions play a significant role in the health insurance underwriting process. The level of severity of the pre-existing diseases is used to determine if health insurance coverage can be offered. If the coverage is provided, the waiting period and the extent of coverage that can be provided is further specified.

What Happens if Pre-Existing Illnesses Are Not Disclosed?

One of the most important consequences of not disclosing the pre-existing diseases is a claim rejection. If the claim is raised for a medical expense related to a pre-existing health condition that was not disclosed at the time of inception, it will be considered invalid.This can lead to financial stress, as the policyholder will be responsible for paying the medical expenses out-of-pocket.

If the insurance provider discovers that the policyholder has disclosed pre-existing conditions or has filed claims based on undisclosed conditions, the policy can be cancelled. In addition, such actions can be considered fraudulent, resulting in legal consequences.It is the duty of the person opting for health insurance with pre-existing illnesses, with diagnosed illnesses, medical history of illness/hospitalisation/surgery or major accidental injury to inform the health policy issuing executive about the same and get all necessary checks and tests done before buying the policy.

It is also important to read the type of diseases that are defined as pre-existing conditions to avoid problems when it comes to raising a claim.

How to Reduce the Waiting Period for Pre-Existing Conditions in Health Insurance?

As discussed before, one of the best ways to reduce the waiting period for pre-existing conditions in health insurance is to opt for an add-on which offers the benefit.With these add-ons available at an additional cost, policyholders can reduce the waiting period specified in the health insurance policies.IndusInd General Insurance offers add-on covers to reduce the waiting period in health insurance plans. For instance, the waiting period for PED in our IndusInd Health Gain Insurance Policy can be reduced from 3 years to 2 years or one year.

Factors to Consider While Purchasing Health Cover for Pre-Existing Conditions

Not All Health Plans Include Coverage for Pre-Existing Conditions

The coverage offered in health insurance plans varies between different plans. With us, individuals with pre-existing conditions seeking health insurance coverage may explore our different options that specifically include this coverage to ensure the most required financial protection.

Health Coverage for Pre-Existing Conditions - Terms and Conditions

When a health insurance policy includes coverage for pre-existing conditions, it comes with specific terms and conditions. It is essential to understand these policy terms to ensure the benefits.

Waiting Period for Pre-Existing Conditions in Health Insurance

Check for the waiting period that is applicable for the coverage of pre-existing conditions in health insurance. Without going through the waiting period, the claim for a medical expense relating to pre-existing health conditions may not be approved.

Compare Options for Health Coverage for Pre-Existing Conditions

Compare the features of health insurance across our different plans and the coverage for pre-existing diseases. Check the coverage offered, waiting periods and applicable premiums to choose the best health cover for pre-existing conditions.

Options to Reduce Waiting Period for Pre-Existing Conditions in Health Insurance

Individuals suffering from pre-existing health conditions seeking coverage for their medical expenses can look out for options to reduce the waiting period.Seek optional add-ons to shorten this waiting period. Although they are available at an additional cost, they help access the benefits quicker, reducing the waiting period significantly.

What Should You Do Before Purchasing Health Cover for Pre-Existing Conditions

Disclose Pre-Existing Conditions Thoroughly

Thoroughly disclosing all details about pre-existing health conditions is extremely important. Non-disclosure, incomplete or misleading information can lead to rejections at the time of claim settlement.Be transparent about the pre-existing health condition by providing the duration of illness and the length of any ongoing medication.

Disclose Details of Pre-Existing Conditions Before Purchasing the Health Plan

A common misconception among individuals is that details of pre-existing conditions can be conveyed after purchasing the policy or during claim registrations.However, it is crucial to disclose all pre-existing conditions in health insurance upfront at the time of policy application. It helps in assessing the associated risk and avoid claim rejections.

Undergo Health Check-Ups

Many times when the policy is provided without any medical check-ups, and when the person is sick or needs hospitalisation, the claims get rejected if the person was suffering from pre-existing conditions.So to avoid such hassles, it is always important to do medical tests before buying medical insurance. It ensures the assessment of the current state of health and provides up-to-date information.

Wrapping Up

Health coverage for pre-existing conditions offers financial protection for medical treatment expenses for a wide range of illnesses or diseases that might have been caused by a health condition that existed before purchasing the policy.

However, the premium for such coverage is slightly higher and will be applicable after a specific waiting period. Further, it is crucial to fully disclose any pre-existing conditions before purchasing the policy, as non-disclosure can lead to claim rejections and policy cancellations.

At IndusInd General Insurance, we offer coverage for pre-existing illnesses in our health insurance policies with competitive waiting periods. We also offer optional add-ons to reduce the waiting period to help access benefits faster!

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