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Health Insurance Plans for a Pre Existing Condition

Health Insurance Plans for a Pre-Existing Condition - All you need to know about pre existing conditions in a health insurance plan in this article. Visit Kotak Life to know more on Health Insurance

  • 3,921 Views | Updated on: Dec 27, 2023

When you suffer from chronic health conditions, the odds of medical emergencies increase. But for this very reason, insurers tend to avoid issuing health covers to people with pre-existing medical conditions. Such diseases raise the probability of frequent health claims. Without the safety net of health insurance, how do you prevent the rising healthcare costs from affecting your savings?

Fortunately, even with pre-existing conditions, you can get health insurance. But the coverage is subject to specific conditions. Awareness about the rules can help you find the right financial cushion for medical contingencies. The first step is to understand what pre-existing disease (PED) means.

What is PED in health insurance?

Pre-existing conditions refer to any disease or injury for which you were diagnosed or have undergone treatment in the 48 months preceding your health plan purchase date.

However, past medical treatments for minor health problems like seasonal flu or cold will not impact your access to a health plan. Only conditions that can lead to significant health complications are classified as PEDs. Some examples include diabetes, hypertension, heart attack, and other critical disorders.

How to get health insurance with PEDs?

  • Never suppress information about your health conditions.
  • Premiums and availability of health insurance depend on your medical history. But, to avoid rejection of your health cover application or hefty premiums, do not provide inaccurate details to your insurer.

    Claim settlement requires treatment details. Your current treatments can depend on your past medical history. Thus, your treatment details may record your past medical problems. Therefore, your insurance provider will discover your PED. If they find out that you have suppressed facts, they can decline payouts.

  • You may have to pass through a waiting period.
  • Many health insurance policies cover PEDs after a gap of two to four years called the ‘waiting period’. During this phase, you cannot raise claims for treatments, medical bills, or doctors fees for your PEDs. But your insurer will settle claims for other medical expenses covered in your policy.

  • Consider buying coverage for critical illnesses.
  • Diabetes increases the risk of heart disease and liver damage. High blood cholesterol levels, hypertension, and diabetes also increase the risk of stroke and heart problems.

    Hence, a history of high blood pressure, elevated blood sugar and cholesterol levels, and similar lifestyle disorders makes critical illness insurance essential. Ailments like heart attack, stroke, and liver cirrhosis can result from PEDs. These disorders often require expensive long-term treatments. The costs of quality healthcare can lead to debts or sale of assets, disrupting your financial stability.

Critical illness insurance offers lump-sum payouts upfront on the detection of such life-threatening ailments. It can fund your therapies, keeping your finances unaffected. Also, unlike regular mediclaim policies, you need not produce hospital bills to claim payouts. You are free to undergo treatment anywhere you choose.

To meet specific healthcare needs for critical illnesses, Kotak Life has introduced the Kotak Health Shield plan. It covers four critical diseases under a single policy:

  • Cancer
  • Cardiac problems
  • Liver diseases
  • Nerve-related disorders such as damages from stroke

You can also extend your base coverage through optional benefits, including:

  • Daily Hospitalisation Cash to meet extra medical expenses not included under the plan
  • Premium Waiver on the diagnosis of listed conditions, keeping the coverage in-force even if you fail to pay premiums
  • Income Benefit to shield your family from financial shortfalls if you face a career break due to ill health

Hence, if you are suffering from PEDs, you can buy the Kotak Health Shield health plan. It can provide relief from the financial burden of adequate medical assistance arising as aftermaths of your PEDs.

- A Consumer Education Initiative series by Kotak Life

Amit Raje
Written By :
Amit Raje

Amit Raje is an experienced marketer who has worked in various Fintechs and leading Financial companies in India. With focused experience in Digital, Amit has pioneered multiple digital commerce in India. Now, close to two decades later, he is the vice president and head of the D2C business department. He masters the skill of strategic management, also being certified in it from IIMA. He has challenged his challenges and contributed his efforts in this journey of digital transformation.

Amit Raje
Reviewed By :
Prasad Pimple

Prasad Pimple has a decade-long experience in the Life insurance sector and as EVP, Kotak Life heads Digital Business. He is responsible for developing user friendly product journeys, creating consumer awareness and helping consumers in identifying need for life insurance solutions. He has 20+ years of experience in creating and building business verticals across Insurance, Telecom and Banking sectors

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Ref. No. KLI/22-23/E-BB/2435