How Do Pre-Existing Diseases Impact Your Health Insurance Premiums?

People undervalue the importance of getting comprehensive health insurance or family health insurance plans. They depend on the funds and insurance that their jobs offer. However, the cost of medical bills is increasing in the modern world, which is not economical for you.

Hence, it is advised that you purchase a suitable health insurance plan to cover you and your loved ones, including super top-up health insurance or a top-up health insurance plan.

Do pre-existing conditions (PEDs) that you already have to get covered by health insurance? Definitely not. It is advised to purchase health insurance plans early in life because of this. Due to the decreased chance of contracting diseases when young, doing so guarantees not only a lower premium but also better coverage. *

You can learn more about pre-existing conditions and health insurance top up in this post.

What exactly is an existing disease?

The medical issues that an insured person already has when they purchase a new health insurance policy are known as pre-existing diseases.

IRDAI defines a pre-existing disease as #:

  1. a) any condition, ailment, injury, or disease diagnosed by a doctor within 48 months of the policy’s effective date or reinstatement.
  2. b) any medical advice or treatment suggested by or obtained from a doctor within 48 months of the policy’s effective date or reinstatement.

Why is declaring a pre-existing condition important?

You could wonder if it’s even required to mention any existing medical conditions. However, it’s best to be totally open and honest in this situation. Make sure you’ve covered all of the ailments and treatments you’ll need by reviewing your medical records. Your insurance company will reject your claim if they learn about your pre-existing condition after you fail to report it to them. Therefore, it is better to wait and get insured rather than not declaring your PED.

A pre-existing condition’s impact on your health insurance

The following is a list of potential consequences for your health insurance plans if you have a pre-existing condition.

  • Premium loading

Because the insurance company is taking the chance of covering a pre-existing condition, the premium will be on the higher side. Only at the time of the insurance purchase is this premium loading applicable. If the policy is renewed without interruption, it cannot be charged again. You can use a health insurance premium calculator to calculate the average cost of premiums. *

  • Waiting period

This is the amount of time that must pass before your pre-existing conditions are covered by your insurance policy; the length of time varies depending on the insurance company writing the policy. *

  • Waiting period + Premium loading

When covering an illness, you may sometimes charge a higher premium and impose a lengthy waiting period. *

  • Medical examination

Your insurance provider might ask you to have a physical if you have a pre-existing condition. the insurance premium will be determined by the test results. The insurer may decline to sell a policy if the results are negative.

  • Permanent exclusion

The insurer can decline to offer you coverage. if you already have a sickness. You must acknowledge the policy’s permanent exclusion for the pre-existing condition indicated in the policy agreement. By doing this, you will lose coverage for pre-existing conditions but provided the policy’s terms, and conditions are met, you will retain coverage for other health situations. *

  • Policy denial

Due to pre-existing conditions, the insurance provider is permitted to decline to provide you coverage. In such cases, they will reject your application for a health insurance policy.

* Standard T&C Apply

# Visit the official website of IRDAI for further details.

Insurance is the subject matter of solicitation. For more details on benefits, exclusions, limitations, terms, and conditions, please read the sales brochure/policy wording carefully before concluding a sale.

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