Pre-existing Medical Conditions and Individual Health Insurance: What You Need to Know

Posted by vishal on September 5th, 2023

In today's fast-paced world, it is important to take care of our lifestyle and get regular check-ups done to make sure that your health is good. Although unhealthy eating habits, lack of hygiene, and the constant stress we face all contribute to a vulnerable state of well-being; sometimes our medical conditions are due to genetics.So, you have to be prepared for any unforeseen situation and this is where having a individual health insurance policy becomes paramount. By having insurance coverage in place, we ensure that our recovery is not only prioritised medically but also financially supported.

When you find yourself hospitalised and undergo necessary treatments, your insurance provider steps in to take care of the medical bills through either a cashless treatment or reimbursement process. However, it's important to note that health insurance for an individual often comes with certain conditions and limitations. It is essential to be well-informed and understand these factors to avoid any unexpected surprises.

Pre-Existing Medical Conditions

Pre-existing diseases refer to medical conditions that you already suffer from before purchasing a health individual insurance policy. These conditions need to be examined thoroughly and understood before finalising any plan. Failure to disclose pre-existing diseases accurately could lead to complications and potential claim rejections in the future.

It's important to remember the fundamental purpose of health insurance plans for individuals: to act as a safety net against future uncertainties and illnesses. Pre-existing diseases, on the other hand, are considered events that are already guaranteed to occur in one form or another.

Common examples of pre-existing diseases often include conditions such as cancer, chronic obstructive pulmonary disease (COPD), diabetes, high blood pressure, acne, asthma, sleep apnea, extreme obesity, anxiety, and atherosclerosis, etc.

Current Scenario

The world of health insurance is undergoing a remarkable transformation. In response to the growing demand for comprehensive coverage, many insurance companies are now offering health policies that include coverage for pre-existing conditions. This progressive shift allows policyholders to reduce the lengthy waiting periods typically associated with such conditions (which averaged around four years). 

While this shift is promising, it is crucial to understand that each insurance company has its own set of terms and conditions when it comes to covering pre-existing conditions Therefore, it is vital to carefully review and compare policies to find the one that best suits your specific needs and offers comprehensive coverage for your pre-existing conditions.

Key Factors To Consider Before Purchasing Health Insurance Individual Policy

1. Waiting Period: 

Look for health insurance plans that have a minimum waiting period before coverage for pre-existing diseases takes effect. Understanding and comparing waiting periods across different policies can help you make an informed decision.

2. Claim Settlement Ratio: 

It is essential to check the claim settlement ratio of the insurance company you are considering. It will tell the claim percentage settled by the insurer. Opting for an insurer with a high claim settlement ratio ensures a smoother claims process.

3. Lifetime Renewability: 

Look for best health insurance plans that offer the benefit of lifetime renewability. This ensures that you can continue to renew your policy even as you age, without worrying about losing coverage for pre-existing conditions.

Wrapping Up

Transparency and honesty play a vital role in this process. Providing accurate information about your medical history and pre-existing conditions during the policy application ensures that there are no surprises or potential claim rejections in the future. If you want to claim timely coverage on your insurance, it is imperative that the company knows everything about your pre-existing medical situation. It would help in a smoother and simpler process for both the parties. Contact Niva Bupa insurers to learn more about health insurance for individuals.