15 Mar, 2013 12:46 AM

Health insurance : Pre-existing disease coverage

Health insurance is a necessary expense. However, for people with pre-existing conditions, getting comprehensive health coverage can be difficult. Before we begin discussing pre-existing disease coverage, let us first define the term 'pre-existing condition'.

A pre-existing condition refers to any health problem faced by the individual prior to seeking health insurance. Pre-existing conditions include any and every health issue ranging from the usual suspects like cancer and diabetes to high blood pressure, asthma and even acne.

Insurers dislike pre-existing conditions:

Insurers are reluctant to provide coverage to people who suffer from pre-existing ailments. This is because such people are

more likely to require treatment and thus, present a higher financial risk to insurance companies. There is no way of predicting whether a healthy person will get sick, but an insurance company may well be wary of people who already have health problems. After all, insurance companies are also trying to run profitable businesses.

Getting Insurance if you have pre-existing conditions

The problem is that people with pre-existing conditions often get the short end of the insurance stick. This could result in cancellation of coverage, refusals by the insurer to pay medical bills, or even an outright refusal of a health insurance policy.

So how do you work around this? Here is some information that could help as you go shopping for health insurance:

1. Different insurers have different policies It is difficult to get health coverage when you have an existing ailment, but not all insurers are alike. Some insurance companies will consider a person's entire medical history when determining pre-existing conditions; others will only look at his/her medical records over the last four years.

2. Every trip to the doctor does not count Insurers will only be looking out for ailments and conditions that have a long-term effect. Thus, even if you are prone to colds, coughs and fevers every winter, stop worrying! These will be left out of the insurer's scanner since they are short-term problems with negligible side-effects

3. Hiding a pre-existing condition This is a bad tactic because if you do end up requiring treatment for such a condition, the insurer could reject your claims.

4. Pre-existing illnesses can be covered There is a misconception that pre-existing illnesses can never be covered by one's health insurance policy. That is not true. Insurers usually require an exclusion or waiting period for pre-existing conditions. During this period, doctor's visits, medicines and treatments for the person's pre-existing ailments will not be covered by the policy. These costs will only be covered once this period ends, but in the meanwhile, expenses incurred due to other illnesses will be paid for by the policy.

5. Working around the waiting period Different insurers have different waiting periods. Some policies have waiting periods of two years, while others require four years. It is advisable to shift to a different insurance policy only after the completion of this waiting period; otherwise, even if you have completed two out of the stipulated four years, it will not be counted and you will have to start afresh. Nevertheless, some policies allow policyholders reduce the waiting period by paying extra premium.

As you can see, even people with pre-existing health problems can get insurance. It is just a matter of being informed and shopping extensively for the best deals.