In India the awareness about individual health insurance is growing and many first time buyers, especially older people are in a dilemma regarding which policy to buy if they have a pre-existing medical ailment. Most health insurance companies in India define pre existing conditions as “any condition, ailment, injury or related conditions which existed or the patient has taken treatment within 48 months prior to the purchase of health insurance policy from the company”. Older people with pre-existing conditions should not feel discouraged while buying health insurance policy since there are insurance companies who have plans specially designed for them.
Buying health insurance is important:
Though some mediclaim policies do not cover pre-existing conditions there are other ailments covered. Buying health insurance is a necessity if you want to avoid financial loss during any medical emergency situation. If the ailment of the insurance seeker is not chronic in nature then it should not be a problem to buy health insurance policy or any cause of concern.
Pre existing condition coverage:
How does one determine the pre-existing condition while buying health insurance policy? The illness or injury that insurance customer has contracted more than 48 months ago has to be declared while buying the policy. Once the declaration is made the insurance company will decide on providing the cover and the extent of coverage that can be offered and the premium cost. This decision will be at the insurance company’s discretion and could also reject giving insurance coverage on certain grounds as per the terms and conditions.
Example for rejecting giving coverage:
Insurance companies have their own terms and conditions and provisions to cover or discard giving coverage for those who have pre-existing conditions. One example is in case a person is suffering from kidney failure this condition can be unlikely to get health cover. For those who have diabetes and hypertension, the insurer may take a call depending on the basis and degree of severity or type of illness.
Retired people and pre-existing coverage:
When a person is working for an employer and covered under group mediclaim insurance with pre exisiting it can be tempting for a them to avoid buying individual health insurance coverage. It may not be a wise choice because when they retire they cannot depend on the group insurance. There is a need for individual health insurance cover. There will be some waiting period and once that comes to an end there will be continuous coverage for the insured post retirement.
Compare waiting period under Mediclaim:
The individual mediclaim policies offered by Indian insurers do cover for pre existing condition after certain waiting period. While comparing the policies it is good to understand the waiting periods stipulated by the insurers and then make a wise choice. Under some policies the waiting period can be 2 years and some could be 4 years. Some insurers cover for certain ailments under Indian mediclaim insurance
policies with additional premium cost.
Why should an insured avoid switching insurers?
If the insured is suffering from pre-existing conditions they should think twice while switching the insurer when their policy comes for renewal. As stated earlier the waiting period could be 2 to 4 years and if you switch the insurer then the new insurance company will start the waiting period all over again. The lack of coverage for a prolonged period can defeat the purpose of buying mediclaim policy with pre-existing conditions if you switch insurers and hence increase the waiting period.
Posted in Health Insurance
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