Authored by Dhirendra Mahyavanshi

We have seen the advent of technology in the last decade or so, which has impacted all facades of our lives and changed our outlook completely. With the current pandemic staring at us, working from home has become our new normal.

Technology and illnesses

Even our overall lifestyle habits have changed and today we use gadgets to even track our steps, sleep, overall health, ailments, etc. and this would only rise over time. Everyone is trying their best to stay fit and live healthy so that these lifestyle diseases can be kept at bay.

As per the data by the International Diabetes Federation, 463 million people suffer from diabetes globally of which, more than 77 million people are from India, i.e. 8.9 percent of the population.

Also, for hypertension, according to research presented at the 70th Annual Conference of the Cardiological Society of India in 2018, one in five young adults, i.e. about 80 million people, suffered from hypertension in India. Besides diabetes and hypertension, other ailments have also joined the bandwagon of modern lifestyle diseases.

These ailments also result in other co-morbidities too, thereby increasing the probability of medical emergencies.

A common concern among many are, do health plans help if there is pre-existing health insurance?

What is a pre-existing illness?

Pre-existing illness is an illness, ailment, or disease which you suffer from at the time of buying a fresh health plan.

Can you buy health insurance with pre-existing conditions?

There are some health insurance policies that do provide coverage even when you have one or more pre-existing illnesses.

Pre-existing waiting period

This is a very common coverage condition which is found in most health insurance plans. There is a specific “waiting period” only for pre-existing illnesses, which starts from the date the policy is first issued. Coverage for medical complications arising out of pre-existing illnesses is not provided under the health insurance policy during the waiting period.

However, once the waiting period is over, coverage is provided for any medical complication which you might suffer due to your pre-existing condition. The waiting period usually ranges from 2 years to 4 years.

Pro tip: When buying health insurance, check the waiting period if you or any family member has any pre-existing condition and choose the plan with the least waiting period.

Note: The waiting period can also be carried forward in case you port your health insurance plan from one insurer to the other so that it is not wasted!

Pre-entrance health check-ups

In the case of pre-existing medical conditions, health insurance companies usually ask for a pre-entrance health check-up before issuing the policy. This check-up is done to assess the severity of the pre-existing condition and to eliminate high-risk cases. Based on the results of the check-up, medical underwriting is done and the policy is issued.

Pro tip: Pre-entrance health check-up is actually good. The onus for ensuring the severity of the pre-existing ailment is with the insurer and not the insured! Also, since pre-entrance medical checks are done by the insurers, it is usually free of cost for the insured, if the policy is issued!

Premium increase and/or coverage restrictions

If the pre-existing condition is found to be chronic which increases the health risk, the insurance company might load the premium. A higher premium is charged for the chronic pre-existing condition and if you are ready to pay the increased premium, the policy is issued.

Coronavirus and Pre-existing ailment

With the recent Coronavirus pandemic, the pre-existing health conditions pose a serious threat. People with co-morbidities have a higher chance of falling prey to this deadly virus. In such a case, the health insurance plan becomes even more important.

However, the IRDAI has come up with two short-term health insurance solutions that cater to COVID specific hospitalization and treatment expenses, called Corona Kavach and Corona Rakshak Plans. These plans cover COVID related claims and even cover pre-existing conditions. So, if you test COVID positive and have a pre-existing condition, these plans would cover your medical expenses.

Conclusion:

The underwriting practices of different companies are different and what one company might do the other might not. So, if you have a pre-existing condition, always shop around. Compare the available health plans and find out their terms and conditions. Choose a policy that offers relaxed coverage for your pre-existing conditions with the minimum waiting period. Also, do not forget to keep renewing your plan so that your waiting period does not lapse!

Dhirendra Mahyavanshi is Co-Founder at Turtlemint — an InsurTech Company. Views are personal