Top 10 FAQs (1)

Top 10 FAQs About Pre-existing Disease Coverage in Health Plans

You can make a better decision if you have a clear picture about the clauses in your health insurance plan and plan early to get the extensive coverage.
Top 10 FAQs (1)
Understanding the clauses of health insurance plans is not an easy task. One such clause which is misinterpreted is pre-existing illness cover. To understand this better, let’s go through some of the common questions that get raised.

What is pre-existing disease cover in health plans?

Pre-existing conditions cover coverage for any condition, sign, symptom and illness that is already present in person seeking health insurance. Past hospitalisation and surgeries if any, signs and symptoms of hypertension, obesity, etc. are pre-existing condition/illness regarding health insurance.

Can pre-existing illness be covered under standard health plan?

Yes, pre-existing illness can be covered under a standard health plan, but not immediately after the inception of the policy. Most of the policies come with a waiting period of 2 to 4 years or more.

What types of pre-existing diseases are covered?

There is a long list of diseases namely Diabetes, heart disease, stroke, eye problems, skin diseases, hypertension, hyperthyroidism. These conditions are covered only after the few years of policy commencement.  Any medical condition arising out of already existed ailment is also covered under the plan. However, list of pre-existing illness covered under the plan may vary from insurers.

What is waiting period? How long will it last?

Pre-existing diseases are excluded from your health plan for a defined period which is known as a waiting period. Usually, it lasts for 2 to 4 years.

Is it worth buying health insurance policy with a waiting period?

The rising rate of health care inflation made health insurance became a necessity. As lifestyle diseases are on the rise, Health plan is a necessity. Every policy has a waiting period for pre-existing ailments. You should carefully select the suitable plan with minimum waiting period considering other conditions.

How to work around on waiting period?

Length of the period differs among insurers. Say, you have purchased a health plan with 3 years waiting period for pre-existing illness. Then, it’s better not change the insurer until you complete this period.  

Is there any health also considered ash insurance policy that covers pre-existing illness from Day 1?

Most of the standalone health insurance plans do not give you coverage for pre-existing illness in the first year. Few insurers provide an option to reduce the waiting period at an extra cost.

What if I am unaware of pre-existing ailment and do not disclose it?

Transparency is an important thing while buying health insurance. It’s crucial to include all the medical conditions and illness in the proposal form. In case you are unaware and do not disclose, you may not receive any claim from the insurer. Remember, careful evaluation and medical checkups are done before the plan is offered.

Does pre-existing illness have any impact on the amount of coverage?

It’s a tedious task to buy health insurance if you have any common illness or condition. With the risk of recurrent claims that may arise, insurers are also very restrictive. You may not be able to get a comprehensive coverage as such ailments are excluded for first few years of the policy.

How do I buy health insurance for parents who have pre-existing ailments?

Getting a comprehensive health plan for elderly parents is a challenging task. Considering the age and pre-existing illnesses, health policy will be offered on the grounds of many conditions and exclusions. After medical check-ups, some insurers may turn down or provide a policy with pre-existing ailment excluded. But, few insurers may still offer the plan with conditions such as waiting period, extra premium and co-pay. At an older age, you may have to agree for larger co-pay!


To sum it up, you can take a better decision if you have a clear picture about the clause. Be transparent and plan your health insurance at an early age to get an extensive coverage.