Should I declare my pre existing condition (PED) when taking health insurance?

Team Digit, 01 Nov 2018

Health insurance is meant to cover you in case you fall ill or get injured. But what if you already suffer from a medical condition before you buy health insurance? Can you still get covered? The short answer is yes, but you’ll have to wait a bit.

Insurance companies have different waiting periods, as we explain below, and there’s a special pre existing condition waiting period as well. Pre existing condition refers to any medical condition you already have.

You may be wondering if it’s worth declaring your pre existing condition in the first place. But in this case, it’s best to be as transparent as possible! Go through your medical files to ensure you have included all the diseases and treatments you would need covered. If you hide your pre existing condition from your insurance provider and they find out about it later, forget waiting period, they may not cover it at all. So, it’s better to wait a while and get your PED covered than not declare it!

So, what are these waiting periods we were talking about? Well, there are actually a few different types. Let’s go through some of the most common ones:

Initial Waiting Period in health insurance

Every policy has an initial waiting period, usually about 30 days, but sometimes up to 90 days. During this time, no ailments will be covered, pre-existing or not. This waiting period only comes into effect once, when your policy first begins – it won’t recur every time you renew your policy. Some insurance policies may cover injuries from accidents during this time, but illnesses are generally not covered.

What is Pre existing condition Waiting Period?

Most policies do include pre existing condition insurance, but there is a 2-4 year waiting period before pre existing condition is covered. The number of years depends on your age, and what the condition is. While the policy won’t cover your PED during this time, it will cover other ailments and injuries.

Specific Ailment Related Waiting Period

Don’t confuse this with the PED Waiting Period, which only applies to medical conditions that you already have. On the other hand, the Specific Ailment Related Waiting Period refers, as the name says, to specific ailments, such as diabetes, hypertension and hernia. These specific ailments are usually not covered for the first 1-2 years of the policy, after which they are covered.

What is Pre existing Condition exclusion?

When due to pre esixting condition there are limits and restrictions on the health insurance claim, that's called as an Pre existing condition.

What is Pre existing condition waiver?

This a benefit cover for pre existing condition which waives off the exclusions and covers expenses that are related to hospitalization due to Pre existing condition.

Before purchasing an insurance policy, it’s important to read the fine print, and find out how long each of these waiting periods are. And there’s some good news!

The Insurance Regulatory and Development Authority (IRDA) has approved health insurance portability. This means that in case you decide to change your insurance provider, you don’t have to go through the pre existing condition waiting period all over again - you can carry it forward from one provider to another!

Explain it like I'm five

We're making insurance so simple, now even 5-year-olds can understand it.

Rahul is pumped up to participate in the running race the next day. He decides to practice one last time before the race. Unfortunately, he twists his ankle during the trial run. Fearing that he will injure his ankle even further in the race, he tells the truth to his PT teacher. As a reward for his honesty, the teacher asks him to participate in the interschool race the coming month. Every honest act comes with a reward – just like pre existing condition declaration in health insurance.

Team Digit

Digit is a General Insurance company on a mission to Make Insurance Simple for people. We are backed by Fairfax, one of the largest insurance companies in the world.

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