Pre-existing disease cover policy

Does My Company Health Insurance Policy Cover Pre-existing Diseases?

30th May 2022 8min read 198 views

Many corporates today offer health insurance coverage to their employees. These group insurance plans may provide a high sum insured amount, but the cover might be limited. Let’s look at whether these health plans cover pre-existing diseases.

What Is a Pre-Existing Disease?

A pre-existing disease refers to a chronic medical condition that you may have before you purchase a health insurance policy for the first time. Let’s assume Meena gets diagnosed with a thyroid issue when she is 24. She does not have any kind of health insurance policy at this time. At the age of 28, she decides to purchase health insurance. While buying the plan, she must declare her thyroid issue as a pre-existing condition. Most Mediclaim policy plans have a waiting period of around two years before entertaining claims for pre-existing conditions.

Understanding Group Health Plans

Group health policies cover several individuals under one umbrella policy. Group policies should not be confused with a family floater policy. Only limited people can enjoy coverage under a family floater, and they must all be related. Most insurance companies will cover up to eight family members under a floater Mediclaim policy. Additionally, all the members share the sum insured amount. Every employee covered by a group plan can enjoy the entire sum insured amount. The group policy gets issued in the company's name, and each covered individual receives a health card with their details. They must produce this health card at the hospital to file a claim.

Group Health Plans and Pre-Existing Diseases

Since group policies cover several individuals, customising them can get complicated. In many cases, group plans do offer coverage against pre-existing conditions. While applying, the employee must notify the insurance company of any pre-existing conditions. With group plans, insurance coverage may start right from the first day. There are no waiting periods. To understand whether your company policy includes the cover, you should check with Human Resources. If the group plan does not offer coverage for pre-existing illnesses, you can purchase a top-up policy. The top-up will provide additional coverage over and above the group plan.

Group Plans and Family Coverage

While group health policies provide coverage for employees, they may not work as medical insurance for families. For enhanced coverage, you can opt for a  family health insurance plan. You can opt for a floater health policy for family or choose an individual health insurance policy for family members. You must ensure that the policy you choose will cover pre-existing conditions. At Edelweiss General Insurance, we offer multiple health plans. You can browse through each policy to understand the benefits and find a plan that suits your needs. All our health policies include coverage for pre-existing issues after a waiting period of 48 months.

If you are covered by group health insurance, ensure you check the fine print. Talk to your HR head to find out what’s covered and if pre-existing diseases are included in the policy. If you find the coverage lacking, ensure you purchase a good health insurance policy or top-up for yourself and your family. Before buying a plan, check the inclusions, exclusions and pre-existing disease waiting period. You can visit the Edelweiss General Insurance website today to buy a new policy or renew your existing plan.

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