How a Pre-existing Disease Can Impact Your Health Insurance Premium?

People often overlook the value of a comprehensive health insurance plan. Instead, they rely on their money and health insurance provided by their employers. In today’s world of rising medical costs, that may not be a prudent strategy. It is recommended that an appropriate health insurance plan cover you and your loved ones. Do health insurance plans cover all kinds of people?

Does health insurance coverage cover pre-existing conditions? Not in all situations. That is why purchasing a health insurance plan for your family early in life is advised. This provides a reduced premium and greater coverage, as the risks of contracting diseases are lower at a young age than in an older body. However, if you opt for family medical insurance plans once you or someone in your family has already contracted a chronic disease, things may get more difficult for you.

However, if you already have some disease, it does not mean you cannot get a pre-existing disease cover in health insurance.  Some health insurance companies provide pre-existing disease cover health insurance which can be beneficial for you. So, let us look at how a pre-existing disease can impact your health insurance premium.

What is a Pre-Existing Condition?

A pre-existing health condition occurs when an individual has a health condition or disease before purchasing a health insurance coverage. This could be anything from cancer or diabetes to somewhat less critical illnesses like high blood pressure, asthma, or rosacea.

Health insurance providers are rarely willing to cover those with pre-existing health conditions. This stems from the fact that such people are more likely to require medical help and constitute a greater economic threat to the insurance provider. As a result, insurance providers think twice before selling policies to people with pre-existing health conditions. If they offer you insurance it will be critical illness insurance which comes with a higher premium and a set of terms.

How Does Health Insurance Policy for Existing Disease Work?

These are the ways in which health insurance policy for an existing disease works:

  • Some insurance providers will agree to cover pre-existing conditions at the standard premium, without increasing the cost, but with a waiting time before covering that ailment. This waiting time can last two to four years, depending on the insurance company. Hospitalisation expenditures or hospital bills for pre-existing illnesses will be covered during this waiting time by the insurance policy.
  • Some insurers provide immediate coverage for pre-existing conditions but at a greater cost. The insurance cost will be applied to the premium to address the dangers of insuring someone with a pre-existing medical condition. Premium loading is frequent for diseases like diabetes, hypertension, and cancer. However, premium loading will only occur at the policy purchase, and the IRDAI states that the insurance provider should not raise the price after delivering the insurance and continuing it without interruption. Even though the fee is greater, it is still advantageous because the disease can be covered under the insurance plan.
  • If you have a pre-existing condition, your insurance provider may require you to undergo a medical examination. The results of the tests will determine the insurance rate. If the outcomes are unfavourable, the insurance provider may fail to issue coverage.
  • The insurance provider may grant you coverage, but it will not cover your pre-existing condition. You must acknowledge that the pre-existing disease is a lifelong exclusion in the plan. You may be unprotected against an illness or disease in this case, but you will be insured for other health risks if the policy’s contract terms are met.


Thus, you must always remember that it is very important to declare if you have any pre-existing medical conditions. In such a case, your insurance provider and you can agree on how to deal with the issue and create a plan that works for you both.

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