February 17, 2021 6:23:56 pm
Written by Amit Chhabra
Recently, Subhash Yadav got his father Ashok Yadav, 56 hospitalised for the treatment of severe dysglycemia – uncontrolled hyperglycemia – high blood sugar which cost him Rs 1.08 Lakh. Ashok had a 15-year history of Type 2 Diabetes which required regular unplanned readmission to the hospital and each hospitalisation cost him Rs 1 Lakh – Rs 2 Lakh.
Subhash often thought of getting his father covered under a comprehensive health insurance cover but always dropped the idea. He assumed that the pre-existing ailment of his father – Type 2 Diabetes will be a barrier in securing health insurance.
However, Subhash went into complete surprise after meeting his childhood friend Rakesh Kadam who told him that Subhash’s father can easily get a health insurance policy that will even cover his Diabetes apart from all other ailments. On further discussion, Rakesh told him that his mother is suffering from the same condition and each time his mother is hospitalised, the expenses are paid by his insurer.
Though, one important thing to remember is that the pre-existing ailments are only covered post serving a mandatory pre-defined waiting period. Fortunately, there are now even policies available in the market that offers coverage for your pre-existing ailment from a waiting period ranging from 0 Days to 4 years.
Buying health insurance for people with pre-existing conditions
Health Insurance has seen a rapid jump in demand, driven by Covid-19 and overall healthcare insurance. People with pre-existing conditions are even more susceptible to high medical costs and hence consider buying health insurance mandatory. In such a scenario, the IRDAI and insurers have together been able to come up with some revolutionary improvements in products, terms and conditions and the way health insurance is sold, hence making it very simple and easy to buy.
This has been possible due to 1) Digital underwriting processes have become the norm and customers now have to no longer go for physical medicals. Only in very rare cases do physical medicals happen, 2) There has been significant product innovation as well; whereby products now offer Disease management benefits also. This means customers get wellness benefits along with the health insurance policy, to ensure their PED condition doesn’t become worse, 3) and probably the most important is lower waiting periods.
Typically plans come with 2-4 year waiting periods in health insurance plans for existing diseases. And this can be a cause of concern for a lot of people, especially those who think they may have to claim in the coming months only. There are now options for such customers to opt for Day 1 Coverage plans, which means their pre-existing conditions are covered from Day 1 itself. This is a very important innovation for customers with PEDs.
One of the most common pre-existing ailments for which customers were mostly denied health insurance coverage a few years back is hypertension, also known simply as high blood pressure. People with a long-standing complaint of high blood pressure, usually 10–15 years long were denied coverage under a comprehensive health insurance policy.
However, with changes in underwriting guidelines, now people with a history of hypertension for even more than 20 years can easily get a health insurance policy. A health insurance plan for hypertension helps you to save costs in case of admission, and also covers your doctor’s visit and OPD bills provided you have an OPD cover.
Today, customers with any pre-existing ailment, be it even cancer, heart, kidney, or lung-related disease can easily get a comprehensive health insurance policy without getting a physical medical done.
Disclosing pre-existing conditions crucial
Health insurance policies almost are sold and purchased in the utmost good faith. If you hide any information at the time of filling the application form, the insurance company can reject your claims in future on the basis of false information. If you want to avoid any such claim rejection, you should disclose your pre-existing conditions and every other detail honestly.
Also, while a health insurance policy, it is important to keep some important things in mind that include the sum insured that must be decided as per your family size and age of the family members. Second most important thing to consider is the waiting period of the health insurance you plan to buy. Always go for a policy with a minimum waiting period for major critical illnesses.
Further, look for plans that come with zero co-payment and sub-limits for treatment of different conditions and room rent.
The author is the Head- Health Insurance at Policybazaar.com. Views expressed are that of the author.
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