As lifestyles change and non-communicable diseases become more prevalent among younger populations, the need for comprehensive health insurance has never been more critical.
The National Family Health Survey has highlighted the increasing incidence of conditions like hypertension, diabetes, and thyroid issues in young individuals.
Pre-existing diseases encompass a range of conditions, including high blood pressure, cancer, obesity, and depression.
When buying health insurance, coverage for these conditions is not immediately provided. Insured individuals may have to wait for a specific period, typically ranging from one to four years, before PEDs are covered. This waiting period varies among insurers.
Honesty is crucial when purchasing health insurance. It is essential to disclose any pre-existing conditions to the insurance company during the application process.
While premiums may be higher for individuals with PEDs, failing to disclose these conditions can lead to claim rejections or even policy termination later on.
In 2020, the Insurance Regulatory and Developmental Authority of India (IRDAI) redefined pre-existing diseases to provide better clarity and coverage for policyholders.
Under the new definition, any condition or ailment diagnosed within 48 months before buying the health insurance plan is considered a pre-existing disease.
Transforming Health Insurance Coverage
However, illnesses diagnosed within the first three months of purchasing the policy are no longer categorized as PEDs.
The amended definition has been a game-changer, reducing ambiguity around PED coverage and lowering claim rejections.
This change has encouraged individuals to buy health insurance with greater confidence, knowing that their pre-existing conditions will be covered after the waiting period.
Health insurance policies typically cover the costs of treatments related to pre-existing conditions after a waiting period.
The duration of this waiting period varies based on the severity of the condition and the insurance company.
For common PEDs like thyroid, hypertension, and diabetes, the waiting period is usually between one to two years, while severe conditions may require up to four years of waiting.