Pre-Existing Disease (PED) Cover from Day 1

Pre-existing diseases (PED) are mostly expensive to treat as they are chronic in nature. Unfortunately, most health insurance plans cover pre-existing diseases after a waiting period of 2 to 4 years as people are already suffering from such diseases at the time of policy purchase. Thus, they increase the liability of the insurer. But the good news is that some health insurance plans do cover pre-existing diseases from day 1.

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      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 Rs 50,000 to Rs 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 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 Rs 2 lakh to Rs 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. 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.

      4. 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 Rs 5 lakh, Rs 7 lakh, Rs 10 lakh and Rs 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

      5. 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

      6. 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 Rs 3 lakh to Rs 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.

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      Disclaimer: Policybazaar does not endorse, rate or recommend any particular insurer or insurance product offered by an insurer.

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      *We will respond in the first instance within 30 minutes of the customers contacting us. 30-minute claim support service is for the purpose of giving reasonable assistance to the policyholder in pursuance of the claim. Settlement of claim (including cashless claim) is the responsibility of the insurer as per policy terms and conditions. The 30-minute claim support is subject to our operations not being impacted by a system failure or force majeure event or for reasons beyond our control. For further details, 24x7 Claims Support Helpline can be reached out at 1800-258-5881. Product information is authentic and solely based on the information received from the Insurer. Policybazaar is acting only as a facilitator and claims settlement shall be at the sole discretion of the Insurer. As per the Insurance guidelines, you are allowed to cancel the policy with-in 15 days from the date of Issuance of policy. For more details, please read the Plan Brochure carefully or talk to our advisor at the time of purchase.

      *All the health insurance plans cover hospitalization expenses including COVID-19 treatment cover up to the specified limits. You can also buy specific COVID-19 health insurance policies such as Corona Kavach Policy and Corona Rakshak policy.

      **All savings and online discounts are provided by insurers as per IRDAI approved insurance plans. #Tax Benefits are subject to changes in tax laws. GST Exemptions depend on fulfilment of qualification criteria and submission of relevant documents.

      *₹1748/month is the starting price for a 1 crore health insurance for an 18-year-old male, with no pre-existing diseases. Discount on renewal premium is subject to the number of wellness points earned in the health insurance policy. For more details about the plans, please read the sale brochure carefully to get upto 100% discount on renewal premium.

      *₹400/month is the starting price for ₹ 5 lakh Health insurance for a 30 year old male & 29 years old female, living in Delhi with no pre-existing diseases

      *₹541/month is the starting price for ₹ 10 lakh Health insurance for a 30 year old male & 29 years old female, living in Delhi with no pre-existing diseases

      *₹762/month is the starting price for ₹ 1 Crore Health insurance for a 30 year old male & 29 years old female, living in Delhi with no pre-existing diseases

      *₹243/month(₹ 8/day) is the starting price for a 5 lakh health insurance for a 20-year-old male, non-smoker, living in Bengaluru with no pre-existing diseases

      *₹2020/month is the starting price for ₹ 1 Cr Health insurance for a 50 year old male & 50 years old female, living in Bangalore with no pre-existing diseases rounded off to nearest 10.

      *₹390/month (₹13 per day) is starting price for 1 cr. Health insurance for 25 years old male, with pre-existing diseases, residing from tier 1 city rounded off to the nearest 10.

      *No medical tests are required unless requested by the insurer’s underwriter. In-case of pre-existing diseases relevant medical proof would be required as per the terms and condition of the policy opted.

      *The values taken for effective cost calculation are indicative values and may change as per the selected plan.

      *Coverage upto double the amount of Sum Insured is available on certain covers for a minimum plan of Rs. 5 Lakh on the first claim only to an individual of upto 45 years of age with no pre-existing diseases. The benefit is available with or without extra cost depending on the plan chosen.

      *Coverage of pre-existing diseases is provided by insurer as per their underwriting policy.

      *The scope of coverage may vary from plan to plan.

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