What is pre pre-existing disease in health insurance?

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.