How Pre-Existing Medical Condition affects your Health Insurance?

Given today’s fast paced and often unhealthy life and lifestyles, health insurance has become a necessity. For taking care of expenses arising due to different kinds of medical emergencies, health insurance can be your best friend. However, individuals who are suffering from any pre-existing medical conditions may not always they may be seeking.

What is a Pre-Existing Condition?

When it comes to pre-existing medical conditions or diseases, it is important to understand what it means. If an individual suffers from any medical condition or disease before taking a health insurance policy, such a condition is termed as a pre-existing medical disease or condition. This may include any health issue, from extremely serious conditions like cancer or diabetes to slightly less serious conditions like high-blood pressure, asthma or acne.

Health insurance companies are seldom willing to provide coverage to individuals who are suffering from any pre-existing medical condition. This is due to that fact that such individuals would be in greater need of medical assistance and therefore, pose a higher financial risk to the insurance company. For this reason, health insurance providers will be hesitant in providing a policy to individuals who are suffering from a pre-existing medical condition. It’s not easy for such individuals to find adequate insurance coverage. Often, their insurance policies could be cancelled, the insurer may refuse to cover the medical bills or at worst, insurers may altogether refuse to provide a health insurance policy altogether.

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Things you should know:

Considering the above, here are some points to keep in mind when one shops for health insurance policies:

  • Policies Differ from Insurer To Insurer:

    The terms and conditions pertaining to coverage of pre-existing medical conditions differ from policy to policy. Though it may be difficult to get a policy which provides cover for pre-existing ailments, there are some exceptions as well. There are some insurance providers who, while determining an applicant’s pre-existing medical condition, will consider their medical history in entirety. Some other providers may only consider at the applicant’s medical history for a period dating back to the past 4 years.

  • Every Doctor’s Visit is Not Counted:

    If you have been making frequent trips to your doctor for minor ailments like cold, cough, fever, etc. during winters, you needn’t worry. Every trip to the doctor will not count as a red flag when you’re applying for health insurance. Insurers only consider medical conditions and ailments which have had a long term effect on a person’s health. Other minor ailments and their side effects, like the ones mentioned before, do not determine a person’s health.

  • Never Hide a Pre-Existing Medical Condition:

    It is very unwise to keep information like a pre-existing medical condition which you may have, at the time of taking a health insurance policy. If such information is hidden from the insurer, it could very well lead them to reject your insurance claim, if it concerns such a condition.

  • You Can Get Coverage for Pre-Existing Medical Conditions:

    A majority of individuals are under the incorrect impression that insurance providers do not provide cover against pre-existing medical conditions. However, that is no longer true. Nowadays, for health insurance policies, insurance providers include a waiting period or exclusion for pre-existing medical conditions. For this duration, the insurance provider will not cover the costs of treatments, medicines and fees for doctor’s visits made by the individual pertaining to his/her pre-existing medical condition. All these aforementioned costs will only be covered once the waiting period is over. However, the policy will continue to provide cover for expenses which may be incurred on account of other illnesses, which are covered under the policy.

  • Waiting Periods can be Reduced:

    Waiting periods for health insurance policies differ from one insurance provider to the other. While some insurance providers may have a waiting period of 2 years, some others may require one stretching to 4 years. If you wish to shift to another insurance provider, it is advised to do so only after you have completed your waiting period with your current provider. The reason behind this is, in spite of you having completed 2 out of 4 years of your waiting period, the completed years will not be counted when you switch and you will be required to start all over again. However, nowadays, certain providers are offering policies which allow the policy holder to cut down on their waiting period in lieu of some extra premium payment.

GST rate of 18% applicable for all financial services effective July 1, 2017.

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