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

Having a pre-existing medical condition can make it challenging to find suitable health insurance coverage, but it is not entirely impossible. With the right approach and careful consideration, individuals with pre-existing diseases can secure health insurance policies that provide adequate coverage for their medical needs.

What are Pre-existing Illnesses?

Pre-existing illnesses, also known as pre-existing conditions or pre-existing diseases, refer to any medical condition, illness, or injury that an individual has been diagnosed with or received treatment for before purchasing a health insurance policy. These conditions can range from minor ailments like asthma or allergies to more severe chronic diseases like diabetes, hypertension, or cancer.

List Of Pre-Existing Disease Cover In Health Insurance In India

In India, most health insurance providers offer coverage for a wide range of pre-existing diseases, subject to certain conditions and waiting periods. Some common pre-existing diseases that may be covered by health insurance policies include:

1. Diabetes
2. Hypertension
3. Asthma
4. Thyroid disorders
5. Cardiovascular diseases
6. Arthritis
7. Kidney disorders
8. Certain types of cancers
9. Respiratory disorders
10. Neurological conditions

How Do Pre-Existing Disease Affect Health Insurance Policies?

The presence of pre-existing diseases can significantly impact the terms and conditions of a health insurance policy. Insurance providers typically impose the following restrictions or conditions when covering pre-existing diseases:

1. Waiting Period: Most insurers impose a waiting period, usually ranging from one to four years, during which the policyholder cannot claim benefits for the treatment of pre-existing conditions. This waiting period allows the insurer to mitigate the risk associated with covering pre-existing diseases.

2. Exclusions: Certain pre-existing diseases or complications arising from them may be permanently excluded from coverage, depending on the severity and the insurer’s underwriting guidelines.

3. Premium Loading: Insurance companies may charge a higher premium or “load” for individuals with pre-existing conditions to compensate for the increased risk they pose.

4. Sub-limits: Insurers may impose sub-limits or caps on the maximum amount they will cover for the treatment of pre-existing diseases.

How to get health insurance in India for pre-existing diseases?

Obtaining health insurance coverage for pre-existing diseases in India requires a proactive approach and careful consideration of the available options. Here are some steps you can take:

1. Disclose All Pre-existing Conditions: It is essential to disclose all pre-existing conditions truthfully during the application process. Failure to do so may result in claims being rejected or the policy being rendered null and void.

2. Compare Policies: Carefully compare different health insurance policies and their coverage for pre-existing diseases. Some insurers may offer more comprehensive coverage or shorter waiting periods than others.

3. Consider Specialized Policies: Certain insurance providers offer specialized health insurance plans specifically designed for individuals with pre-existing conditions. These policies may have higher premiums but provide more comprehensive coverage.

4. Undergo Medical Tests: Most insurers require prospective policyholders with pre-existing conditions to undergo medical tests or screenings to assess the severity and risk associated with their conditions.

5. Explore Group Insurance Options: Many employers offer group health insurance policies that may provide coverage for pre-existing conditions with more favorable terms and conditions.

Points to remember when buying health insurance in India for pre-existing diseases

When purchasing health insurance in India for pre-existing diseases, it is crucial to keep the following points in mind:

Policy premium amount: Be prepared to pay a higher premium for coverage of pre-existing diseases. The premium amount is determined by factors such as the severity of the condition, age, and overall health status.

Importance of medical screening: Undergoing medical screening or tests is essential for insurers to accurately assess the risk associated with pre-existing conditions and determine the appropriate coverage and premiums.

Proper usage of group insurance: If you are employed, explore the group health insurance options provided by your employer, as they may offer more favorable coverage for pre-existing conditions compared to individual plans.