What is pre pre-existing disease in health insurance?

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Pre-existing diseases, also called PEDs, are any illnesses or health problems that you may be suffering from before applying for a health insurance policy. As per the Insurance Regulatory and Development Authority of India ( IRDAI), when the insured has been diagnosed with a disease or medical condition within 36 months prior to buying the policy, it is considered a pre-existing disease.


Pre-existing disease includes health issues such as diabetes, heart disease, cancer, high blood pressure, asthma and more. Nowadays, all these long-term health problems are covered under multiple different health insurance plans.


Important Considerations about Pre-Existing Disease


Some of the essential things you need to know about pre-existing disease are listed below:



  • Do not hide your pre- existing conditions from the insurance company while purchasing a policy. Hence, doing so can later lead to claim rejections, which can give you a financial burden.

  • An individual with a history of medical illness can be asked to undergo health check-ups before providing coverage.

  • Generally, pre-existing conditions are covered by most health insurance companies in India after a certain waiting period.

  • Individuals can also get a health insurance policy that provides coverage for pre-existing diseases from Day 1; therefore the premiums can be higher for these plans.


Can Pre-Existing Diseases Impact Health Insurance Plans?


Yes, PEDs can affect health insurance plans in the following ways:



  • Higher Premium

  • Limitations/exclusions on coverage

  • Waiting Period

  • Medical check-ups


Things to Know Before Buying Health Insurance for Pre‑Existing Diseases.



  1. Talk about your pre-existing disease:Remember to disclose your prior medical condition with the insurance provider when you consider purchasing a health insurance policy.

  2. Pre-existing conditions are not included in all plans: It is essential to note that not all health insurance plans offer coverage for pre-existing disease. Don’t forget to check it with your health insurance company.

  3. Go for a plan with a shorter PED waiting period:If you have a pre‑existing condition, select a plan with a shorter waiting period for PED coverage.

  4. Medical check-up can be necessary: Individuals suffering from any health condition before buying a policy may be required to undergo medical check-ups. Therefore, based on the medical reports, your premium may be decided.


Quick Takeaways


A pre-existing disease in health insurance refers to any medical condition that the individual is suffering from before buying the policy.