Why Health Insurance Companies Do Not Cover Pre-Existing Conditions?

by Vinaya HS on March 11, 2018

in Finance

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Individuals often believe that they do not need a mediclaim cover when they are in the pink of health. However, a medical condition or a disease may be contracted at any given time, resulting in huge out-of-pocket expenses. Therefore, it is necessary to seek coverage to remain financially protected at all times. By doing so, you may focus on receiving quality treatment without any financial burden.

There are numerous aspects to keep in mind while choosing from among various health insurance plans such as premium cost, offered features, co-pay amount, and co-insurance, among others. One of the most important aspects to take into consideration is whether your insurance provider will offer you coverage for pre-existing diseases.

Understanding pre-existing diseases

As the name suggests, a pre-existing disease is one that exists before purchasing a mediclaim cover. This may include any health issue such as asthma, diabetes, high cholesterol, and high blood pressure, among others.

You may note that some health insurance providers are reluctant to offer coverage to those with pre-existing diseases. Such individuals are in greater need of medical assistance. They, therefore, are considered as high-risk individuals, who tend to increase the liability of the insurance provider.

The good news, however, is that some insurers do offer health insurance plans to those with pre-existing diseases. Some even provide services of wellness coaches to help you combat the disease. They guide you on a path to better health by offering suggestions that fit your lifestyle. Besides, such plans also provide cover for numerous medical expenses such as diagnostic tests, pharmacy costs, and medical consultation expenses, among others.

You may keep the following four points in mind while buying health insurance plans against pre-existing conditions.

1. Difference in insurance plans

Various insurers have their own eligibility criteria while deciding whether or not to provide coverage to individuals suffering from pre-existing conditions. While some health insurers take into consideration an individual’s entire medical history, some only take the past few years into account. You may, therefore, do your research and request medical insurance quotes from those insurers offering health coverage for pre-existing illnesses.

2. Nature of the disease

Insurance providers often look out for diseases that are chronic in nature, i.e. those which have a long-term effect. Hence, minor conditions like cold, fever, and cough are not considered as pre-existing illnesses as they do not have major side effects.

3. Failure to disclose a pre-existing condition

Many individuals fail to disclose the nature of their ailment to the insurance provider at the time of purchase of the policy. It is important to note that insurance providers may reject the insurance claim if you require treatment for such a condition.

4. Waiting period

While some insurance providers may offer insurance for those with pre-existing diseases, it comes with a certain waiting period. This is the timeframe that you must wait for before beginning to enjoy the benefits of the insurance policy. While some insurance providers have a waiting period of four years, some have a period of 30/90 days from the start of the policy date. You may, therefore, identify such insurers and opt for those health insurance plans that offer the lowest waiting period.

In case you suffer from any pre-existing medical condition, fret not. With numerous insurance providers offering coverage towards the same, you may choose from a plethora of options. You may either visit your nearest branch or buy health insurance online. By doing so, you may enjoy financial security and remain protected at all times.




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