Pre-Existing Disease (PED) Cover from Day 1

List of Health Insurance Plans Covering Pre-existing Diseases from Day 1

Multiple health insurance plans offer coverage for pre-existing diseases from day 1. Under these plans, no PED waiting period will apply to raise a claim for pre-existing diseases. Take a look at the various health plans that offer pre-existing disease coverage from day 1:

1. Aditya Birla Activ Health Platinum Essential Plan

This comprehensive Aditya Birla Health Insurance plan provides coverage for pre-existing diabetes, high blood pressure, asthma and high cholesterol from day 1. The plan comes with a sum insured option ranging from ₹50,000 to ₹1 crore.

Key Features:

• Coverage for in-patient hospitalization, modern treatments and day care procedures are available
• Pre-post hospitalization expenses and the cost of ambulance services are covered
• Cashless home treatment is available for specific illnesses like dengue, chemotherapy, gastroenteritis, etc.
• Annual preventive health check-up facilities and second e-opinion for major illnesses are available
• 10% cumulative bonus for every claim-free year is available
• AYUSH treatment, mental illness hospitalization and obesity treatment are covered
• Health returns for up to 50% of the premium are granted to healthy people
• Optional health insurance benefits like maternity cover, OPD cover and hospital cash benefit are available
• Critical illness cover, personal accident cover and international coverage for major illnesses are also available as optional covers

2. Aditya Birla Activ Health Platinum Enhanced Plan

This health plan by Aditya Birla General Insurance Company offers day 1 coverage for pre-existing chronic illnesses like asthma, diabetes, high blood pressure and high cholesterol. It is available for a sum insured ranging from ₹2 lakh to ₹2 crore.

Key Features:

• Cost of day care treatments, in-patient hospitalization, road ambulance service and pre-post hospitalization are covered
• Coverage for domiciliary hospitalization, mental illness hospitalization and home treatment are available
• Modern treatments, obesity treatment, OPD treatment and AYUSH treatment are covered
• 100% reload of the sum insured and free annual preventive health check-ups are available
• Waiver of premium available on the diagnosis of a listed critical illness
• 50% cumulative bonus is offered for every claim-free year
• Recovery benefit, dental consultation & investigations cover and a second e-opinion for major illnesses are also available
• Maternity benefit, critical illness cover and hospital cash benefit are available as optional covers
• Option to add personal accident cover, PPN discount and international coverage for major illnesses are also available

3. Care Supreme Plan with Instant Cover

The Care Supreme plan offers comprehensive coverage for pre-existing diabetes, asthma, hypertension and hyperlipidemia from day 1 with the instant cover benefit. It comes with a sum insured of ₹5 lakh, ₹7 lakh, ₹10 lakh and ₹15 lakh.

Key Features:

• Coverage for in-patient hospitalization and domiciliary hospitalization are available
• Road ambulance charges, organ donor expenses and pre-post hospitalization expenses are covered
• Unlimited automatic recharge and unlimited e-consultations are available
• 50% cumulative bonus for up to 100% is granted on every claim-free year
• No room rent limit or ICU charges limit
• Health services, consisting of health portal and discount connect benefits, are available
• Women care, mental health well-being, annual health check-up and newborn baby cover available as optional benefits
• Optional covers, like waiting period modification, cumulative super bonus, be-fit benefit, etc. are also available

4. HDFC ERGO Energy Health Insurance Plan

The HDFC ERGO Energy Health Insurance plan covers the medical expenses resulting from pre-existing diabetes and hypertension from day 1. It provides a sum insured ranging from ₹2 lakh to ₹50 lakh.

Key Features:

• In-patient treatment, ambulance charges and day care procedures are covered
• HbA1C check-up benefit, organ donor cover and AYUSH cover are available
• Both pre-hospitalization and post-hospitalization expenses are covered
• Restore benefit, shared accommodation benefit and wellness programs are available

5. National Parivar Mediclaim Plan with Pre-existing Diabetes/Hypertension Cover

The National Parivar Mediclaim plan provides coverage for PED diabetes and hypertension from day 1 with the Pre-existing Diabetes/Hypertension optional cover. It comes with a sum insured amount ranging from ₹1 lakh to ₹10 lakh.

Key Features:

• Coverage for hospitalization costs, AYUSH treatment and domiciliary treatment are available
• Cataract surgery, modern treatment and day care procedures are covered
• Mental illness cover, HIV/AIDS cover and ambulance charges are available
• Hospital cash benefit, preventive health check-ups and reinstatement of the sum insured are available
• 5% cumulative bonus for up to 50% is available on every claim-free year
• OPD treatment and critical illness cover are available as optional covers
• No pre-policy medical check-up is required below 60 years unless critical illness cover is opted

6. Niva Bupa ReAssure 2.0 Plan with Smart Health+

The Niva Bupa ReAssure 2.0 plan covers the cost of hospitalization or day care treatments arising out of pre-existing hypertension and diabetes from day 1 with the Smart Health+ rider. The plan also comes with an optional cover that can completely remove the PED waiting period. The sum insured amount for this plan ranges from Rs 3 lakh to Rs 1 crore.

Key Features:

• Unlimited reinstatement of the sum insured forever and lock the clock benefit are available under ReAssure+
• Unlimited carry forward of the unused sum insured is available with the Booster+ benefit
• Pre-post hospitalization costs, organ donor expenses and modern treatments are covered
• Emergency road ambulance, air ambulance and second medical opinion are available
• Home care treatments, alternative treatments and e-consultations are covered
• Annual health check-ups from day 1 and shared accommodation cash benefit are available
• Up to 30% savings on renewal premium is possible with the live healthy benefit
• Disease Management and Acute Care variants under the Smart Health+ riders are available
• Personal accident cover, hospital cash, safeguard and safeguard+ cover are available as optional benefits
• Option to buy room rent modification, co-payment and the annual aggregate deductible cover is also available

7. Star Diabetes Safe Insurance Plan

This Star Health Insurance plan for diabetes provides coverage to both Type 1 and Type 2 diabetes patients. It covers hospitalization due to pre-existing diabetes from day 1 under Plan A. This diabetes health insurance plan comes with a sum insured of Rs 3 lakh, Rs 4 lakh, Rs 5 lakh and Rs 10 lakh.

Key Features:

• Hospitalization expenses due to diabetes and other ailments are covered
• Pre-existing diabetes is covered from day 1 under Plan A and after a waiting period of 12 months under Plan B
• Coverage for pre-hospitalization, post-hospitalization and day care procedures are available
• Outpatient treatments, modern treatments and emergency ambulance charges are covered
• 100% automatic restoration of the sum insured is available
• Donor expenses for a kidney transplant, dialysis expenses and the cost of artificial limbs are covered
• Personal accident cover is available
• No pre-acceptance medical screening is required under Plan B.

8. Universal Sompo A Plus Plan

The Universal Sompo A Plus plan offers comprehensive medical coverage for diabetes and hypertension from day 1 under the Diamond plan on payment of an additional premium amount. It also comes with an add-on cover to waive off pre-existing disease waiting period. The sum insured of this plan ranges from ₹3 lakh to ₹1 crore.

Key Features:

• 100% auto-restore benefit is available once every year
• Hospitalization expenses, including pre & post-hospitalization expenses, are covered
• Coverage for psychiatric illness, day care procedures and AYUSH treatment are available
• Preventive health check-up benefits are available on every claim-free year
• Assistance services, domiciliary hospitalization and second opinion are covered
• OPD cover and global cover are available under the Diamond plan
• Add-on covers, such as PED waiting period waiver, maternity cover and non-medical items are available

Health Insurance Underwriting Norms Relaxed for PED Coverage

For people with pre-existing diseases, such as diabetic patients who are on insulin, buying a health insurance policy can be a difficult task. A lot of insurance companies hesitate from underwriting customers with chronic illnesses/diseases.

However, under the above-mentioned health plans, pre-existing disease cover has been designed in a way that benefits patients suffering from asthma, high cholesterol, high blood pressure, and diabetes. The company assesses the applicant’s current health situation with a short questionnaire in the application form and a few basic medical tests.

The underwriting procedure also helps insurance companies in India to engage with their customers throughout their journey with a health coach expert. This way they can understand the current medical condition of their customer and can provide the most suitable health coverage with the customer's consent.

Day 1 PED Coverage Ensures Better Insurance Penetration

One of the major limitations in buying health insurance for people with pre-existing medical conditions is longer waiting periods. It is ironic because only the fear of contracting these diseases compels people to buy an insurance policy in the first place. Thus, health insurance policies should not have long PED waiting periods of 4 years or more.

Moreover, penetration in health insurance will be faster if the waiting period clauses are omitted or kept at a bare minimum. Keeping this in mind, Star Health Insurance offers a buyback rider to reduce the waiting period on regular health insurance plans. With a PED buyback rider, you can reduce your waiting period to 1 year from 3 years just by paying a nominal extra premium. However, it requires the policyholders/applicants to go through pre-medical screening.

Bottom Line

If you or anyone in your family has any pre-existing illness like diabetes, hypertension, etc., then you can consider buying health insurance plans with PED coverage from day 1. You can always compare these plans online based on the coverage and the premium on websites like Policybazaar.com.