An advantage of buying group health insurance is that benefits can be significantly enhanced over a standard policy. One such benefit relates to pre-existing conditions. In this post, we examine the meaning of pre-existing conditions and how insurance companies cover them. We also look at how employers can offer employees a great deal of coverage of pre-existing conditions by choosing group mediclaim policies. Let’s know about Cover for pre-existing conditions in group health insurance in this article.
What are pre-existing conditions?
For the purpose of insurance coverage, the pre-existing conditions in group health insurance refer to an ailment or signs of it that are present before the purchase of the insurance policy. For example, if someone has had a heart attack, then an insurer would classify most cardiovascular ailments as pre-existing diseases for that individual. Sometimes, when a person suffers from severe blood-pressure abnormalities, insurance companies could use this to classify cardiovascular problems as pre-existing diseases.
You must declare pre-existing conditions in the proposal form. In cases where the insurance provider mandates medical tests, the insurer may identify pre-existing conditions that you were unaware of. Recent regulatory guidelines define pre-existing conditions as diagnoses made up to four years before buying the insurance.
Cover for pre-existing conditions in individual health plans
Insurance companies that offer individual health policies typically cover pre-existing diseases after two to four years. This means that only after paying the premium on a policy for two to four years can you avail of cover for a pre-existing condition. Since a lower waiting period for pre-existing conditions is a competitive edge, many new insurance products have a lower two-year exclusion period.
Sometimes, before issuing a policy, insurers mention pre-existing diseases as a permanent exclusion. The rationale is to ensure that even people with serious pre-existing conditions can buy insurance to cover other unrelated ailments.
Cover for pre-existing conditions in group insurance
One of the ways in which group medical insurance can prove beneficial is that it covers pre-existing diseases from day one for all members. Since purchasing group insurance for numerous families together, the chances, as well as the impact of fraud, are considerably lower. Hence, insurance companies can offer this benefit.
So, a group health insurance provider will not ask you to declare any health condition. Nor will you have to undergo medical tests. This immediate cover of pre-existing conditions is the primary reason why claim settlement in group covers is so high.
The wisdom of waiving pre-existing diseases
Some companies choose to waive coverage for pre-existing diseases. Such a choice depends largely on the persons covered. For instance, assume the group is made up of young people with no medical issues and coverage does not extend to families. Then cover for pre-existing conditions becomes less important. On the other hand, say a group has an average age of 40 or more, and members’ parents are also covered. In this case, the benefit becomes more significant.
Moreover, the decision also depends on the cost the group wants to incur. Some groups might want pre-existing conditions excluded because this lowers their costs. However, in most cases, all waiting periods will be waived off in a group cover. This makes the insurance more expensive, but still extremely affordable.
How SecureNow can help
Designing a group insurance policy means weighing several factors. It is best to take professional advice to figure out which policy is ideal for you. As an insurance broker with 10 years of experience, SecureNow is ideally available to provide this service. Click here to get an instant indicative quote with or without pre-existing disease cover.
Written By-
Mayank Sharma
MBA Finance
He is a professional who brings extensive knowledge and expertise to the field of group health insurance. He has dedicated 7years to helping individuals and businesses navigate the complexities of insurance. Having worked closely with numerous clients and insurance providers, he deeply understands the nuances of group health insurance policies. With a reputation for providing insightful and informative content, he leverages his industry experience to educate readers about the importance of group health insurance and its benefits. Through their articles, Mayank Sharma aims to empower individuals and businesses to make informed decisions about their healthcare coverage, ultimately promoting healthier and more secure communities.
