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Understanding Pre-Existing Conditions in Health Insurance

Rishika VermaWritten by Rishika Verma Published On 2024-06-25T11:21:48+05:30  |  Updated On 25 Jun 2024 11:21 AM IST
Understanding Pre-Existing Conditions in Health Insurance
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You are looking to the future, focusing on your health, and deciding to invest in a good, comprehensive health insurance plan. But then you start wondering about the asthma that you struggled with as a child or that surgery you had a couple of years ago. How will these pre-existing conditions affect your health insurance?

Health insurance is a cornerstone in every financial plan that acts as a safety net in case of a medical emergency. Yet, making sense of the ins and outs of pre-existing medical conditions is easier said than done. This article will teach you more about pre-existing conditions and how they affect your health insurance.

An Overview of Pre-Existing Conditions

Simply said, a pre-existing condition is any health issue already present before the effective date of your new health insurance plan. This could be chronic diseases like diabetes, asthma, or heart disease, or even things like old injuries or surgeries. These are factors that insurers closely monitor because of the heightened likelihood of a claim shortly after the policy goes on risk.

How Do These Conditions Impact Health Insurance?

If you have pre-existing conditions, they will impact your health insurance policies in the following ways:

  • Waiting Period: Health insurance policies generally have a waiting period for any pre-existing condition to prevent fraud. This is a set period, which can be as short as three months or as long as three years or more, depending on the insurance company. For this time period, the policyholder is not eligible to be reimbursed for treatment regarding pre-existing diseases. Accidental injuries will be covered during this period.
  • Higher Premiums: Insurance companies may demand higher premiums due to the policyholder’s pre-existing condition. This is a way of offsetting the claims the policyholder will likely make.
  • Coverage Exclusions: Some insurance policies may have provisions which exclude all expenses the policyholder makes over a particular disease. Anything they might spend on their pre-existing condition will not be eligible for reimbursement.
  • Medical Examination: Health insurance companies subject any potential policyholder to detailed questioning about their health before determining the policy terms. If the answers they receive indicate a too-large risk, they demand a higher premium or simply refuse to provide a policy.

How to Buy Health Insurance When You Have Pre-Existing Conditions

If you have a pre-existing condition and are wondering how to approach the matter of health insurance, the best advice is to be as informed as possible. Here are some tips to guide you along the way:

  • Disclose all conditions: Never lie about any aspect of your medical history. It might lead to a denial of your claim and potentially an investigation culminating in the cancellation of your policy.
  • Compare policies: Not all health insurance policies are identical, and some insurers might be more or less accepting of pre-existing conditions than others. Do your research before making a decision.
  • Read the fine print: Find out the specific terms and conditions. Different waiting periods, exceptions, and rules are to be expected.
  • Consider riders: Some policies might look poorly equipped to deal with your pre-existing condition on the surface but will also feature optional add-on covers. Acquiring them as part of the base policy might be a good idea.

Trust ACKO for All Your Health Insurance Needs

Acko is a digital-first insurance company taking an innovative approach to health insurance in India. Their idea is to simplify insurance for people. The company can offer price-effective health insurance plans through an online distribution model.

Are you sceptical about buying health insurance from ACKO to cover pre-existing conditions? Here are some reasons to convince you:

  • Transparent policies: ACKO Insurance is known for its transparency. When buying a policy, the terms and conditions about pre-existing conditions are spelt out clearly. So you do not see any surprises when you make a claim.
  • Reduced waiting periods: ACKO has been working on reducing the waiting periods for pre-existing conditions. Traditional insurance companies may make you wait for up to four years for some pre-existing conditions. However, ACKO’s waiting period is typically shorter, so you can get the health care you need when needed. In fact, you have zero waiting period under the ACKO Platinum Health Insurance plans.
  • Customised plans: ACKO recognises that people are all different, and each person's health needs vary enormously. ACKO allows you to build a customised plan depending on your particular requirements and the current state of your health.

Conclusion

Pre-existing conditions are a significant factor affecting health insurance. But they should not stop you from getting the coverage you want. With the correct information and determination, you can get the best medical insurance policy to keep you healthy without too much financial pressure. You can quickly browse through ACKO’s website to check out the best health insurance policies for pre-existing conditions.

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Rishika Verma
Rishika Verma

    Rishika joined Medical Dialogues in the year 2023 and is currently working as PR Coordinator . She is a graduate from Delhi University . She can be contacted at editorial@medicaldialogues.in Contact no. 011-43720751

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