Pre-existing diseases (PEDs) are medical conditions, injuries, or ailments that exist when you buy a health plan. Generally, if you have a PED, you may not buy health cover, considering yourself as ineligible. However, availing of coverage is possible, and you must not delay your purchase any further.
Here are two ways in which PEDs affect health cover:
- Waiting period
The insurer may offer coverage after a certain time from the date of purchase, which is known as the waiting period. This tenurevaries among insurers, and it differs for various ailments. However, the waiting period is often between two to four years.
- Premium loading
With premium loading, the insurer offers immediate coverage for PEDs starting from the date of purchasing the cashless health insurance plan. Premium loading is commonly available for conditions like heart diseases and diabetes.
In some instances, the insurers may levy both the premium loading as well as the waiting period. Moreover, some critical illnesses like cancer and HIV may be permanently excluded from the medical insurance policy.
Special health plans
Insurance companies offer special health plans for comprehensive coverage. Some of these policies include:
- Critical illness plan
Being diagnosed with a critical ailment causes physical, mental, and financial distress. A critical illness health insurance policy ensures that you can meet such unexpected treatment expenses. These plans pay a lump sum when you are diagnosed with a life-threatening ailment. You may use the funds for treatment or to compensate for any loss of income.
- Cancer insurance
Treating cancer is a long and expensive process. The procedure requires advanced methods, like radiation and chemotherapy. When you buy a cancer insurance policy, the insurer pays the sum insured on positive diagnosis, irrespective of the stage of the disease.
- Hypertension insurance
An increasing number of people suffer from hypertension due to stress. Health insurance for high cholesterol policy covers doctor’s consultation fees, diagnostic tests, medications, and hospitalization. With all these facilities, you can focus on getting the best treatment without worrying about the costs.
Chronic ailments strike without warning, and managing these conditions is extremely challenging. A chronic management program provides consultation charges, pharmacy costs, and diagnostic tests to handle the ailment. Additionally, it offers a wellness coach that guides you to a healthier lifestyle.
Recently, the Insurance Development and Regulatory Authority of India (IRDAI) modified the definition of pre-existing conditions. This is a welcome move, as it eliminates all confusion and ambiguity. So, if you have been postponing your decision to buy mediclaim due to aPED, take advantage of the regulatory changes and procure coverage today.