What Exactly is a Pre-Existing Disease in Health Insurance?

When you purchase a health insurance policy, insurers assess your medical history to understand the potential risks. One of the most important terms you will encounter is ‘pre-existing disease’ policy.

It refers to any medical condition which you had and received treatment for before getting a health insurance policy. These conditions are only covered by your policy after the mandatory waiting period has been completed.

What is Considered to be a Pre-Existing Disease?

A pre-existing disease refers to any injury, illness or medical condition which existed before the start date of your health insurance policy. It does not matter whether the condition is major or minor.

If you had the symptoms, received medical advice or underwent tests, and took medication for it before the purchase of the policy, insurers will classify the condition as pre-existing.

What are a Few Examples of Pre-Existing Diseases in Health Insurance Policies?

If a doctor diagnosed you with a condition before your policy began, it automatically qualifies as a pre-existing disease. Some examples include diabetes, hypertension, asthma, high blood pressure, heart disease and thyroid disorders. Even if the condition is under control, it will still be considered a pre-existing disease.

What Is the Waiting Period for Pre-Existing Diseases in Health Insurance Policies?

A waiting period is the time you must wait before the insurer covers expenses related to your pre-existing condition. Most health insurance plans impose a waiting period ranging from 12 to 36 months for pre-existing diseases.

During this period, the insurer will not approve any claim related to the treatment of that condition. However, after you complete the waiting period specified in your policy terms, your condition will be covered.

What Happens If You Do Not Disclose a Pre-Existing Disease to the insurer?

A full disclosure of your pre-existing disease to your health insurance provider is essential. Otherwise, if you misrepresent a pre-existing condition, the insurer will end up rejecting your claim, cancelling your policy, refusing renewal and denying any future coverage.

Remember, every insurance contract operates on the principle of utmost good faith. Hence, you must provide accurate and complete information in the proposal form.

How to Choose the Right Health Insurance Policy with a Pre-Existing Disease?

Wondering how you can select the best health insurance policy for your pre-existing disease? Well, here are a few ways to do that:

● Waiting Period Duration

Make sure to choose a plan which has the shortest waiting period possible.

● Premium Costs

You need to balance affordability with adequate coverage.

● Network Hospitals

Make sure that your preferred hospitals are a part of the insurer's network.

● Claim Settlement Reputation

Choose an insurer who has a strong track record of claim approvals.

Final Words

A pre-existing disease should never stop you from purchasing a health insurance policy. Instead, it should motivate you to compare plans carefully and check waiting periods. Also, make sure to disclose your condition truthfully to the insurer to avoid any claim rejections later on. When you take these steps, you strengthen your coverage and ensure better coverage.