Know how pre-existing diseases can affect your health insurance premium rates

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Know how pre-existing diseases can affect your health insurance premium rates
Know how pre-existing diseases can affect your health insurance premium rates

New Delhi : According to India's National Health Family Survey (2019-2020), lifestyle diseases like obesity, hypertension, and diabetes are rising. The survey lists these illnesses as the most common type of non-communicable diseases affecting Indians. So, one could say patients suffering from any of these illnesses must declare it. Although it means you will have to pay a higher premium rate, it's a small price to pay when securing your future with a comprehensive health insurance plan. 

It is equally important to disprove some of the myths associated with such insurance policies. PED or pre-existing disease covers are among the most misunderstood aspects of health insurance policies. For instance, you might think that your parents’ PED disqualifies them from owning a comprehensive senior citizen’s health insurance plan. However, this is not true. Although there are a few hurdles to overcome, people with PEDs can benefit from insurance coverage at a higher premium rate.

Understanding PEDs in health insurance plans

Any disease or illness diagnosed before buying a health insurance plan is called a pre-existing disease (PED). According to the latest revision to this definition by the Insurance Regulatory and Development Authority of India (IRDAI), such conditions must be diagnosed at least 48 months before an insurance plan is bought to be identified as PEDs.

This means that if you have an existing illness, but it is not diagnosed at least 48 months before buying a health insurance policy, it will not be regarded as a pre-existing condition. You can enjoy instant coverage for the condition from the day you purchase the policy. This updated definition has made it easier for people with PEDs to get insured and file claims.

Insurance companies pay special attention to applicants with PEDs because they are more likely to fall sick and frequently file claims. Generally, you must wait for a certain time before your insurance plan covers your PED-related expenses.

Nonetheless, you can get financial assistance for your PED-related expenses. Thus, you no longer have to think twice before purchasing a senior citizen’s health insurance plan for your parents or grandparents, who are already suffering from cancer, asthma, cholesterol, etc.

Impact of PEDs on health insurance premiums

A pre-existing disease (PED) cover comes at a cost. While PED covers usually come with a waiting period, you will also have to pay higher premiums for such covers. 

However, the bottom line remains that a PED should not discourage you from securing the futures of yourself and your family members.

Once you’ve revealed the details of your PEDs to your insurance provider, your pre-existing condition can influence your insurance coverage and premiums in the following ways.

● Pre-existing disease-related waiting period: Your insurance provider will have a list of PEDs covered by the plan and their waiting periods. Generally, these waiting periods can range from a few months to a couple of years. Your insurer will not cover any PED-related medical expenses incurred during this waiting period. 

For instance, let us assume your parents suffer from a PED like diabetes and need to seek medical assistance for the same during this period. The cost of these treatments will not be covered by their senior citizen’s health insurance plan. 

● Higher premiums: As an applicant with a PED, you are viewed as a riskier financial bet by your insurer. Thus, you may need to pay higher premiums to enjoy health insurance coverage. With increased premiums, the waiting period for your PED may be removed.

It is important to note that insurance companies can charge higher premiums and still impose a waiting period on your pre-existing condition. Moreover, certain conditions are permanently excluded from your health insurance policy. You should carefully go through this list to ensure that the plan covers your family’s PEDs.

Screening process

Changes in the screening processes followed by insurance providers have helped people with PEDs get better health insurance coverage.

Nowadays, companies don’t refuse to onboard people with PEDs directly. Instead, they screen the health status of individuals through basic tests and questionnaires. This helps insurers understand the financial risks linked with such individuals and provide them with adequate coverage at an affordable price. 

Policies offered by Bajaj Finance

If you want to avoid waiting for periods and avail of instant PED coverage, opt for a health insurance plan offered by companies like Bajaj Finance. For example, the Aditya Birla Group Activ Insurance Plan by Bajaj Finance comes with a sum insured of Rs. 1 crore and offers instant PED benefits.

With this plan, you can get cashless claim settlement benefits across 8,200 network hospitals. Even if you exhaust your sum insured, your benefits will be restored automatically with this plan. You can visit the Bajaj Finance website and explore various insurance policies with no PED waiting periods, and purchase one that best suits your insurance needs.

Over time, health insurance policies have become more accessible to people with PEDs. They can now find plans that eliminate long waiting periods against a slightly higher premium amount. Thus, if you or your parents suffer from a PED, you can opt for a senior citizen’s health insurance plan or an individual health insurance plan that offers same-day PED coverage.