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How to buy a health insurance policy that covers pre-existing ailments from day 1

Aditya Birla Health Insurance and Star Health have come with plans that cover your pre-existing conditions immediately after buying the policy

April 26, 2021 / 11:35 AM IST

Until few months back, if a customer with pre-existing conditions or ailments tried to buy a health insurance cover to avail treatment for the specified illnesses, the person used to encounter either one of the two outcomes: the proposal is turned down or the person get coverage, but with a long waiting period, generally ranging between 2-4 years. However, one good news during the ongoing COVID-19 pandemic is the fact you can get coverage for your pre-existing ailments without serving any waiting period. This means, your pre-existing conditions will be now be covered from day one of buying a health insurance plan. Some of the prominent insurers who have come up with such customer-centric plans include Aditya Birla Health Insurance and Star Health. Aditya Birla Activ Health platinum Enhanced-Diabetes, Aditya Birla Activ Health Essential-Diabetes, Star Health Diabetes Safe Plan A and Star Cardiac Care-Gold are some such plans that offer comprehensive treatment at affordable prices.

Pre-existing conditions are not exclusions

There is a common notion amongst the people – mostly those suffering from pre-existing ailments – that they can’t be covered under a comprehensive health insurance plan and even if they get coverage, it will only start after serving a mandatory waiting period. Some even believe that while they might get coverage under a plan, the extent of coverage will be limited and in case of hospitalisation, the plan will not pay the entire claim amount. For this very reason, most people avoided buying a health insurance plan. However, those who took the brave decision of buying the policy decided to hide the same from the insurer.

The fact is, all general and specialised health insurers offer covers to people with pre-existing conditions, but with a mandatory waiting period. This means that while you can avail the coverage for all other ailments from the very next day of buying the policy, you can avail coverage for pre-existing ailments after serving the waiting period as specified in the policy terms and conditions. In most cases, this waiting period varies from two years to four years.

Insurance Underwriting Norms Revamped

The exclusion of pre-existing ailments from taking coverage from day one has always remained a matter of great concern for people suffering from such conditions. However, the good news is that with much-needed changes in the underwriting rules for the benefit of the customers, many prominent insurers have specially crafted plans that cater to the specific needs of the people suffering from such ailments. There are now plans available in the market under which there is minimal waiting period of 30-90 days or even in many cases no-waiting period at all for ailments as critical as Diabetes, Hypertension and Asthma. Whether one is suffering from diabetes, hypertension, asthma or high cholesterol level, all of them can go for a PED cover that starts protecting them immediately after they purchase the policy.

The entire process of buying these plans is also very simple and convenient as once the terms and conditions are explained to the customers, the insurer immediately assesses the customer’s current health conditions after getting important information from the customers regarding their health and the policy is later issued to the customer. The drastic changes in the underwriting rules in the health insurance industry has widely helped insurers to increase the insurance penetration rate in the country. While the option of reducing the waiting period under the normal health plans did exist earlier as well but the customers had to pay hefty premiums for early coverage. However, now by paying the same premium, customers can avail comprehensive coverage for pre-existing conditions from as early as Day-1. Roughly, these plans are 40 per cent cheaper than their variants in past.

Better Insurance Penetration and Quality Coverage

One long standing limitation for people with pre-existing ailments has been long waiting periods to get adequate coverage for most needed ailments. In fact, it is the fear of contracting some most common pre-existing conditions like diabetes, hypertension, high cholesterol and asthma buy people in India buy health insurance. Industry experts suggest that the health insurance penetration in India can be significantly reduced if insurers come up with more plans covering pre-existing conditions. To promote this, some insurers like Star Health Insurance has also come up with specific riders to reduce the waiting period.

Amit Chhabra is Head- Health & Travel Insurance,
first published: Apr 26, 2021 11:35 am