Knowing Health Insurance facts

Many people with pre-existing chronic illnesses leave themselves out of health insurance benefits because of their false belief that they are not eligible for cover. Meanwhile , others with pre-existing conditions fail to mention their medical history which leads to them getting into trouble while filing a claim. Both these problems are two extreme ends of the spectrum and you can easily avoid these situations if you learn a few simple things about health insurance and chronic diseases.

Future Generali Health Insurance recommends you learn about these 5 important health insurance facts if you or someone in your family has a chronic illness.

Illness at the time of buying a policy:

This can be a source of confusion for many and can lead to rejection of the claim when you are in dire need of financial support. Pre-existing diseases are not only those present at the time of buying the policy but also those that you were treated for earlier. To avoid denial of health insurance claims, make sure you understand the following about pre-existing diseases:

  • Medical history: History of strokes, heart attacks, gestational diabetes in women, etc. The fact that these diseases have not manifested at the time of buying policy doesn’t imply that they are not pre-existing diseases for your health insurance company.
  • Instances of hospitalisation also must be mentioned.
  • Mention if you have taken or are taking medication for some medical issues such as hypertension, diabetes, liver dysfunction, etc.
  • Skin disorders, major injuries and diagnosis of illnesses such as high-blood pressure, diabetes and others in the past.
Waiting period:

In the event that you disclose a pre-existing disease (which you must), your insurer will require a waiting period of 2-4 years to cover the expenses of these conditions. Whatever cost incurred during this period for the treatment of the specific chronic diseases will have to be borne by the policyholder from out of his pocket.

Higher cost of health insurance:

You will have to shell out more money on premiums to get health insurance benefits if you have pre-existing conditions. The practice of charging higher premiums for individuals with a pre-existing ailment at the time of buying a policy is called premium loading. The system allows insurance companies to charge more for carrying the risk of a frequent or increased likelihood of claims. Insurers can use premium loading or waiting period or both to hedge the risk of providing coverage for pre-existing diseases.

Medical check-up:

Your insurance company may ask for lab tests and medical checks if you have a medical condition while taking the policy. The insurer does this to assess the state of your health and your sickness. If your medical condition is serious, the insurance company can deny health insurance coverage.

Permanent exclusions for chronic illnesses

In case your disease is severe, the insurance company can allow you a health insurance policy if your medical condition is permanently excluded from coverage. However, it can put an enormous strain on your finances if you need advanced treatment and hospitalisation in the future

Rather than waiting to be diagnosed with a chronic disease, it’s better to secure you and your family’s health with critical illness policy. Future Generali Health Insurance offers a critical illness policy that provides coverage of up to Rs.50 lakhs for serious diseases and procedures such as cancer, kidney failure, liver failure, primary pulmonary arterial hypertension, multiple sclerosis, organ and bone marrow transplant, open chest CABG and aorta graft surgery.

Dos and don’ts for health insurance

To ensure that your claims are not rejected and you get the adequate amount of money when you make health insurance claims, there are a few dos and don’ts you should be aware of. Hiding your pre-existing disease to lower your premium is a bad idea because it can haunt you when you need health insurance coverage the most. Note that your health insurance company can deny your claim after the waiting period for a specific disease, if you have concealed a chronic disease.

Sometimes you may not even be aware that you have some pre-existing illness in your body while you are buying health insurance. To avoid that, go for regular medical check-ups and be aware of your medical issues. Also, read the policy wording carefully for inclusions, exclusions, deductibles, , waiting period and other important clauses before you sign below the dotted line. Finally, compare various insurers before you settle with the best health insurance policy for you or your family.