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Things you need to know about pre-existing disease coverage

Things you need to know about pre-existing disease coverage
Though health insurance is a boon, for many people it can be a tedious investment because of their condition of health when they apply for a policy or enroll in a new health plan. Since insurance companies have their own financial interests at heart at the end of the day, many companies exclude pre-existing diseases from coverage, the policy holder might have to wait a long time before the coverage starts or he/she might have to pay a higher premium and more out of pocket expenses. Insurers might refuse to pay medical bills, cancel the coverage or refuse to sell you a policy in the first place.

This might be discouraging and more expensive for the policy holder yes, however, health insurance is also a necessity, no matter what the conditions are. So even if you have a pre-existing ailment like diabetes or a heart condition it is imperative you invest in a policy regardless.

So what does the term pre-existing disease refer to exactly?

Any long standing health issue that you might have prior to buying your health insurance policy is deemed a "pre-existing health condition". These include genetic and lifestyle diseases such as asthma, cancer, heart conditions, diabetes and even high blood pressure, asthma and acne. If you suffer from any such condition then the chances of you requiring treatment are higher and you are obviously a greater financial risk to your insurance company. Therefore insurers are wary of such conditions as their profit will suffer.

Here are a few things you need to know about pre-existing disease coverage:

Pre-existing illness can be covered: It might be more difficult to get your insurance company to cover a pre existing medical condition however, it is not true that coverage will be completely denied outright. It depends on your insurer - many companies look at medical records of the past few years and most insurers will impose a waiting period after which the coverage for these conditions will start. However, any other illness or medical treatment will still be covered by your health policy.


The waiting period: As stated, different insurers may approach a pre existing condition differently so it wll serve your purpose to look for one that benefits you. For instance, even though a "waiting period" is imposed on those who have pre existing medical conditions, by which the cover starts only after the period ends, some insurers might reduce the period if you pay a higher premium. The waiting period will also depend on your health history.

Be truthful: It might be tempting to hide a pre-existing medical condition while applying for a health insurance policy, knowing that it will not be smooth sailing for you. However, this can backfire if you have to undergo medical treatment for the same condition later. In this case, the insurer will not pay any bills with regard to the condition and might cancel the coverage and reject any claims made.

The older you are, the more possibility there is that you will suffer from one condition or the other, hence it is always advisable to buy health insurance when you are younger and relatively healthy.

If you do have a health condition that is hereditary and you cannot control, then be open about it to your insurer and do extensive research on what can be done to circumvent the waiting period and/or payment of premiums. Don't disregard buying a health insurance policy simply because you don't see the point of a waiting period or because you find the premiums too high, bear in mind that other illness and medical treatment will be taken care of and your pre-existing condition too will be covered once the waiting period is over.

Written By: Deepak Yohannan

The author is the CEO of, an online insurance price & features comparison portal

For more articles by Deepak Yohannan, please visit

You may contact him directly on Twitter: @dyohannan

Read more about: health insurance
Story first published: Saturday, November 2, 2013, 9:51 [IST]
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