Pre-Existing Disease Cover in Health Insurance

Health Insurance

Crossing the timeline of the pandemic and many more critical health conditions, having health insurance for you and your family is of grave concern. These offer financial security when in need of emergency health care. However, consider whether your health insurance covers PEDs (pre-existing diseases). 

Nobody wants to welcome health problems that occur because of family medical history or improper lifestyle habits. Therefore, specific health insurance helps you avoid these situations that become a barrier to your health. 

What is a Pre-Existing Disease?

As you can understand by the name, pre-existing illnesses are conditions the concerned policyholder or the insured already has before buying a health insurance policy. IRDAI (Insurance Regulatory and Development Authority of India) states that any condition diagnosed 48 months (about four years) before purchasing the policy will be a pre-existing disease. 

Therefore, any disease that was not in your knowledge or diagnosed before the commencement of the insurance policy will not fall under PED. Some common pre-existing illnesses comprise high BP, cholesterol, diabetes, thyroid, asthma, etc.

Per-Existing Conditions Waiting Period

Generally, health insurance policies offer coverage for PEDs after a considerable waiting period. Your insurance provider can reject all your claims for treating PEDs during this period. Typically, health insurance provides coverage for pre-existing conditions after the policyholder waits between 1 – 4 years. It is called the regular waiting period. 

Every health plan differs based on the regular waiting period for pre-existing illnesses. One health insurance policy may cover a disease after a 2-year waiting period, while another may take four years for the same condition. Additionally, a specific waiting period is for treatments with a fixed two-year time. These treatments include hernia, cataracts, piles, etc. 

Shifting to another health insurance provider after serving the waiting time is advisable. It ensures you do not have to restart your waiting period. The good news is you can look for plans with a waiting period reduction offer. It suggests you may need to pay an additional amount to lower your waiting period for PED. 

Essential Things to Know Health Insurance for Pre-Existing Medical Disease 

Having half-knowledge won’t do you any good. Therefore, before you invest in a health insurance plan for PEDs, you must become familiar with a few crucial facts. 

  1. Reveal All Pre-Existing Illnesses
  2. When purchasing health insurance, you must reveal all your pre-existing diseases. If the insurance provider discovers any chances of non-disclosure, they have the right to reject your claim. To not deal with any complications while raising claims, delivering honest information without hiding any health details is essential. It will ensure to lessen your burden during medical emergencies. 

  3. Different PED Insurance T&C 
  4. Before providing you with health insurance, the provider may demand medical check-ups and screening for PEDs. Some companies also evaluate your medical history and age before offering coverage. Every insurer has different waiting periods, screening processes, and PED lists. Hence, before selecting any policy, ensure to read their T&C. 


Health insurance plans offer financial help for sudden medical catastrophes and emergencies. However, you can also consider health plans to cover health issues that occur over time with past medical history and lifestyle changes. These policies will cover diabetes, cholesterol, blood pressure, asthma, etc. Ensure a review of the waiting period and policy terms and conditions before purchasing. 

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