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Chronic Illnesses Coverage Under Health Insurance
May 23, 2022

Are Chronic Diseases Covered Under Health Insurance Plans?

The importance of being healthy cannot be emphasized any lesser, considering the ongoing pandemic. While staying healthy is just one side of the story, the other part is ensuring that you have a safety net—in the form of a health insurance cover. Increasing stress, pollution levels, and a sedentary lifestyle are some of the major contributors to more and more individuals being susceptible to life-threatening ailments. Considering the present medical inflation, even a minor procedure can burn a hole in your bank account. While medical treatment is something that absolutely cannot be skipped, the importance of health insurance in India must not be ignored while maintaining a healthy lifestyle. Ailments are of different forms, some that are treated quickly, while others are more prolonging in nature. These ailments that can affect an individual for long periods, while being difficult to treat, are termed chronic illnesses. You can also consider the ailments that last for more than a year and need regular medical attention as chronic illnesses. Some of these diseases limit your regular activities, such as your mobility, and commonly include cancers of different types, heart ailments, blood sugar, high blood pressure levels, arthritis, and more. If the right treatment isn’t sought, some of these chronic ailments can prove to be fatal. Therefore, the right and timely treatment are essential to address them. Moreover, the cost of treatment is steep, and hence, health insurance coverage is essential.

Are chronic ailments included under health insurance coverage?

Yes, many insurance companies provide coverage for chronic illnesses in one of the two ways—standard health insurance plans or critical illness insurance policies . Generally, there is a waiting period for the coverage of these chronic illnesses. So, it is necessary to know what your policy entails. Furthermore, if you are already suffering from a chronic ailment before buying the insurance cover, this waiting period may even extend to 48 months and could be classified as a pre-existing disease. In addition to standard health insurance plans, critical plans are specifically designed to cover these forms of chronic and life-threatening illnesses. Moreover, the nature of pay-out for a critical illness policy, unlike a standard insurance plan, is by way of lump sum payment, thereby helping you provide financial coverage for pre/post-treatment expenses. But even these plans stipulate a waiting period of 90 days from their purchase, along with a survival period of 30 days. *Standard T&C Apply

Why is it essential to disclose chronic ailments when buying health insurance plans?

It is critical to disclose any pre-existing chronic ailment when buying a health insurance policy. Failure to do so may lead to the rejection of your claim application. Such pre-existing chronic ailments increase the risk for the insurer, and hence, it is essential to make adequate disclosure.

What are the key points to keep in mind when buying coverage for chronic illnesses?

  • Disclosing any pre-existing diseases, such as heart issues and diabetes, is crucial to avoid any rejected claims. This includes past treatment sought for those illnesses as well as medicine prescribed in this regard.
  • Accumulate sufficient savings so that any treatment required during the waiting period of the policy can be managed.
  • Factor in the claim settlement ratio of the insurance company as it helps to determine the insurer’s ability to settle claims.
  • Make sure to choose a plan that offers a lifetime renewability option, as relapse of such ailments can occur.
  • Opt for a plan with a lower waiting period.
While it is essential to seek insurance coverage the right way, do not forget to compare health insurance plans before zeroing down on one. This will help to evaluate the pros and cons of every insurance policy that is suitable based on your requirements.   Insurance is the subject matter of solicitation. For more details on benefits, exclusions, limitations, terms, and conditions, please read the sales brochure/policy wording carefully before concluding a sale.  

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