How Do Chronic Respiratory Cases Like Chronic Obstructive Pulmonary Disease Impact Premiums?

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Chronic respiratory cases like chronic obstructive pulmonary disease (COPD) significantly impact health insurance premiums in India by being classified as pre-existing diseases (PEDs). They typically increase your health plan premiums due to high risk, often require mandatory waiting periods (usually range between 3-4 years), and may outline permanent exclusions.


Potential Impact on Premiums and Coverage



  • Premiums:COPD is a chronic, non-curable, and progressive ailment; your insurance providers considered you a high risk of raising claims, leading to higher premiums compared to individuals without such conditions.

  • Pre-existing Disease Waiting Period: Coverage for COPD is usually not immediate. Policyholders typically must wait for a specified time of 1 to 4 years (waiting period) before they can make claims related to the pre-existing condition.

  • Premium Loading: Insurance providers might add a “loading charge” or additional premium fees after assessing medical reports.

  • Reduced Coverage Limits: Some healthcare plans might not include related complications initially or impose sub-limits on specific care facilities or medications.


Let’s discuss the key factors influencing premium costs:



  • Severity of condition: The present stage of the COPD, hospitalisation history and comorbidities drastically impact the risk assessment.

  • Lifestyle: Smoking is the primary cause of chronic respiratory conditions like COPD. Smokers often have to pay higher premiums or loading expenses compared to non-smokers.

  • Age & Location: Older applicants and those living in high-pollution areas, which trigger chronic respiratory conditions, face greater premium increases.

  • Plan Type: Unlike group health plans, individual health plans typically have a stricter assessment for chronic diseases.


What are the Key Risk Factors Triggering COPD?


Determining the risk factors may help manage and prevent the potential causes of COPD. Individuals of any age can be the victim of this disease, but mainly people over 40 years are at a higher risk of this disease. The primary causes of this chronic respiratory case are:



  • Air Pollution

  • Smoking

  • Asthma

  • Generic Factors

  • Exposure to Chemical