Health insurance policies come with a waiting period of up to four years during which they don't cover some pre-existing diseases (PEDs). A pre-existing disease is a medical condition with which a person is already suffering before buying the policy. The exclusion of PEDs becomes a pain-point for many who would want a comprehensive coverage from day one.
The good news is now you can get coverage from day one. Some insurers such as Aditya Birla Health Insurance, Star Health and HDFC Ergo have some plans that come with day one coverage. Aditya Birla Activ Health platinum Enhanced - Diabetes, Aditya Birla Activ Health Essential - Diabetes, Star Health Diabetes Safe Plan A, Star Cardiac Care-Gold and HDFC Ergo Health Energy Gold are some such plans.
"The option to reduce waiting period existed earlier also in some health plans, but what has changed now is the affordability factor and relaxed underwriting norms. Roughly, these plans are 40 per cent cheaper than their variants in past," says Amit Chhabra, Health - Business Head, Policybazaar.com.
Underwriting norms relaxed
If you are a diabetic person and that too on insulin, buying a health policy becomes almost impossible. However, with these plans, you do stand a chance to get a health cover. "A lot of insurers shy away from underwriting customers who have chronic diseases. Such plans are designed in a way that they benefit patients suffering from chronic diseases such as asthma, high blood pressure, high cholesterol, and diabetes," Chhabra says.
Explaining the underwriting process, Aditya Birla Health Insurance CEO Mayank Bathwal says that the company assesses the current situation of the customer with a short questionnaire in the application form and if required, followed by a few basic medical tests. "This simple process of underwriting helps us to engage our customers on the journey with an expert health coach. This gives us an as-is medical status of the customer and we are able to issue a most suitable cover basis customer's consent."
Quality coverage, better penetration
Long waiting period has been one of the key deterrents for people buying a health insurance. "It is only fear of contracting diseases that makes one buy a health cover. This is the reason why insurance policies should not have a long waiting period. Insurance can penetrate faster if waiting period is brought down to bare minimum," says Star Health and Allied Insurance Co Managing Director S Prakash.
It is for this reason that Star Health has a buyback rider that allows one to reduce waiting period on regular policies also. "With our PED buyback rider, customers can reduce waiting period from 3-4 years to one-year after paying some extra premium. It does require pre-medical check-ups though," says Prakash.
Day one cover policies -- Key features
1) Aditya Birla Activ Health
It is a comprehensive health insurance plan which covers cashless treatment and reimbursement of hospitalisation expenses for illnesses (including mental illnesses) and accidents at over 7,500+ network hospitals.
"It comes with features such as 100 per cent reload of sum insured in case of an unrelated illness, cashless home treatment for specified illnesses like chemotherapy, dengue, and more, cumulative bonus which doubles the sum insured, premium waiver in case of detection of a critical illness, health returns up to 100 per cent of premium by staying healthy, Ayush cover, OPD cover, super reload, post-hospitalisation physiotherapy cover, and dental consultation and investigations," Bathwal says.
The plans have some optional benefits such as personal accident cover, critical illness cover and international coverage for major illnesses.
2) HDFC Ergo Health Energy Gold
It is a wellness management program for individuals with Type 2 Diabetes Mellitus, Impaired Fasting Glucose (IFG), Impaired Glucose Tolerance (IGT) and/or hypertension. The plan not just provides coverage for inpatient hospitalisation expenses but also an ecosystem of wellness program and health rewards that help you monitor your health.
3) Star Health Diabetes Safe Plan
It covers both Type 1 and Type 2 diabetes. The policy can be bought on individual or floater basis. Day one coverage (no waiting period) comes into effect only under Plan A and that too only after undergoing a pre-acceptance medical screening. Plan B will have a 12-month waiting period.
"Since these plans are much more affordable and feature-rich and only about 20 per cent dearer than regular plans having longer waiting period, it's a no brainer that customers with PEDs must consider it," suggests Chhabra.
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