List of Pre-Existing Diseases in Health Insurance (Updated Guide)

What is a pre-existing disease in Health Insurance?

Pre-existing diseases (PED) refer to any health condition, illness, injury, or ailment for which a person was diagnosed, received treatment, or exhibited symptoms within 36 months prior to purchasing a health insurance policy. Most insurers cover PED under various policies.

List of Common Pre-Existing Diseases Covered by Insurers

Common PEDs in adults are diabetes, hypertension, and thyroid issues. However, that's not all that counts as PED in insurance. Here is the common list of pre existing diseases in health insurance:

1. Hypertension

2. Diabetes

3. Thyroid disorders

4. Asthma and other chronic respiratory diseases

5. Arthritis and joint disorders

6. Chronic skin conditions

7. Kidney diseases

8. Liver diseases

9. Hyperthyroidism/hypothyroidism

10. Obesity-related health issues

11. Stroke or neurological disorders

12. Anxiety, depression, and other mental health disorders

13. Polycystic Ovary Syndrome (PCOS)

14. Cancer.

This is an indicative list. Make sure to check the latest PED list with your insurance provider to make a more informed decision.

Types of Pre-Existing Conditions in Health Insurance

Pre-existing diseases fall under different categories. Some of the types of pre-existing illnesses are:

1. Chronic Diseases

Long-term illnesses that require regular treatments or management, such as diabetes, high blood pressure, or asthma.

2. Lifestyle-Related Conditions

Conditions resulting from an individual's way of life, such as smoking, unhealthy eating, or physical inactivity, that lead to illnesses. For instance, obesity, heart disease, or high cholesterol.

3. Hereditary Conditions

Medical conditions that are hereditary, such as thalassemia, inherited heart diseases, and diabetes, fall under this category.

4. Pre-diagnosed Conditions

Illnesses or health conditions that a doctor has already diagnosed before the time of insurance purchase.

5. Undiagnosed Symptomatic Conditions

The health problems with symptoms that were apparent (even if no formal diagnosis was made at the time) before purchasing insurance.

6. Past Medical History

The record of your previous health issues, including surgeries, is something an insurance company will review when issuing a policy.

7. Mental Health Conditions

Mental illnesses such as anxiety, depression, or other psychiatric disorders are present before buying the policy.

Waiting Period for Pre-Existing Diseases in Health Insurance

One of the most crucial things to understand about PED in health insurance is the waiting period. Most of the PEDs have specific waiting periods that individuals must complete before they raise a claim for PED. It may range from 3 years to the policy purchase date.

Let's understand with the help of an example:

Ranjeeta Mishra, a 36-year-old resident of New Delhi, recently purchased her health insurance policy. 3 years ago, Ranjeeta was diagnosed with hypertension and diabetes. However, since her insurance plan covered PED (with a 2-year waiting period), she now has her existing illnesses covered along with other health insurance benefits.

Since the PED in health insurance has a 2-year waiting period, Ranjeeta cannot raise a claim for diabetes/hypertension for 2 years. She can, however, raise claims for other medical emergencies and sudden illnesses.

Tip: Ensure continuous policy renewal; breaking the policy may reset your waiting period or result in the loss of acquired benefits and any bonus (if any).

Tips to Reduce Waiting Period for Pre-Existing Illnesses

Here are some practical ways that can help you get the same health insurance plan at a more affordable premium:

1. Choose Plans with Shorter Waiting Periods

Check out various health insurance plans carefully and choose the one that has a shorter waiting period for pre-existing diseases so that you can enjoy the benefits of coverage faster.

2. Go for Add-ons or Riders

Insurers usually offer health insurance add-ons that help reduce the waiting period for pre-existing diseases. By choosing these and paying a small premium, you can get your coverage sooner.

3. Buy Insurance Early

Getting health insurance at a young age and staying healthy can help you complete waiting periods sooner. This means you can avail the benefits more easily when the time comes.

4. Maintain Continuous Coverage

Make sure you always renew your health insurance policy before the expiry date without any lapse. A break in coverage might reset the waiting period for pre-existing conditions and delay your eligibility again.

5. Use Portability Benefits

If you don't like your current insurance company, use the portability feature to switch insurers. At the same time, keep the record for the waiting period completed under your present policy.

6. Choose a Higher Sum Insured

Usually, choosing a higher sum insured plan gives you the right coverage overall. Along with this, the possibility of greater flexibility and more advantageous benefits for pre-existing diseases also increases.

Conclusion

Choosing the right health insurance plan with pre-existing disease (PED) cover is essential for long-term financial and medical security. By comparing plans with Jio Insurance Broking, understanding waiting

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