Money Saver India
Pre-existing illness? Pick these plans

Pre-existing illness? Pick these plans

If you’re buying health insurance after 45 and have a pre-existing illness, only a few plans will honour a claim even linked to the illness until four years are up.

Insurers typically require you need to wait for four years for any pre-existing illness to be covered. While a youngster may have no problem with such a clause, the older you are, the more likely you’ll find this unacceptable. This is particularly so because pre-existing illnesses doesn’t only include illnesses you may have received treatment for in the recent past. It includes illnesses for which there were signs or symptoms in the 48 months prior to the payment of the first premium. To the insurer, it doesn’t matter that you didn’t know; you ought to have known. Even illnesses linked to the pre-existing disease are excluded.

Some insurers, though, have reduced the waiting period for the coverage to be extended to pre-existing illnesses. If you don’t think you can wait four years for a pre-existing illness to be covered, here are your options:

Immediate coverage

Group insurance: Not many know that public sector banks offer health insurance. These plans are the same as those you’re signed up to in a company. The big advantage with these group insurance plans is that pre-existing illnesses are covered from the very first day. What’s more is that they’re much cheaper than regular plans, thanks to the bulk discount. They do have their downsides, though. For more on the subject, go here.

Immediate, with conditions

Star Health Senior Citizen’s Red Carpet: This plan, available to those between the age of 60 to 75 years on commencement, will cover pre-existing illnesses in the first year, unless you have received treatment for the very same illness in the last 12 months. The restriction severely reduces chances of the plan being of use, but it’s your best shot – unless you opt for group insurance – at finding coverage for a pre-existing illness immediately. Worse still, you need to pay the first 50% of any bills arising out of hospitalisation for pre-existi­ng conditi­ons.

From second year

Bajaj Allianz Silver Health: Bajaj Allianz will pay for hospital bills arising out of hospitalisation on account of a pre-existing illness from the second year. However, the total coverage will be no more than 50% of your sum assured in a policy year. If your sum assured is Rs4 lakh and bills related to a pre-existing illness is Rs3 lakh, you’ll have to pay Rs1 lakh yourself.

From third year

ICICI Lombard Complete Health Insurance: If you buy coverage for Rs3 lakh or more, this plan will cover all pre-existing illnesses once two years are up. If your sum assured is under Rs3 lakh, though, you’ll need to wait the usual four years.

SBI Life Smart Health Insurance: The pre-existing illnesses you declare to the company will be covered under the policy once two years are up.

From fourth year

L&T Classic: According to the brochure, ‘After 3 continuous renewals of the policy, you can claim the payment of relevant medical expenses incurred on your pre-existing diseases’.

IFFCO Medishield: The brochure says that ‘Any pre-existing disease, for a period of 3 years of continuous coverage from inception of Insured’s first Medical Policy’.

From fifth year

If you’re completed four years, nearly all companies will cover pre-existing illnesses. Here are the plans that require you to pay four premiums before you’re covered:

Insurance plan Pre-existing illnesses
Religare Care After four years
Apollo Munich Easy Health Standard After four years
New India Individual Mediclaim After four years
Chola MS Individual Health Insurance (Basic Health Cover) After four years
Bajaj Allianz Health Guard After four years
Universal Sompo Retail Individual Health Insurance After four years
Oriental Insurance Individual Mediclaim After four years
New India Individual Mediclaim After four years
HDFC Ergo Health Suraksha After four years
Star Health Medi Classic After four years
Max Bupa Heart Beat Gold After four years
Tata AIG Medi Prime After four years
National Individual Mediclaim After four years

Leave A Comment