Can I get mediclaim coverage for pre-existing diseases?

Have a query regarding health insurance or mediclaim policy? Maybe we can help.

Drop us a line and our expert, Harsh Roongta, CEO of Apnapaisa.com, will answer it.

Please write to us at getahead@rediff.co.in with the subject line as: Health insurance query.

Today, Harsh has answered queries about:

Medicliam policies for a young family

Mediclaim policies for aging parents

Mediclaim policies for pre-existing diseases

I am 35 years old, my wife 30 years and my daughter 5.5 years. We had mediclaim insurance in 2006-2007. We discontinued it due to some problems. But now we do not have medical insurance cover.

Can you suggest a good medical insurer. We both are dentists. And how much should we get insured for? What should be the creteria for selecting a insurance policy?

Health insurance should be the priority of every individual and his dependents. Before zeroing in for any Mediclaim policy, you should take into account important features like sub-limits, co-pay and coverage of pre-existing diseases and not just the premium amount.

Below you can find a table for a sum assured of Rs 3 lakh each for all your family members.

I am 31 years old and working for an MNC. My company or most of the other companies provide mediclaim/ health insurance to the employees till the end of service. Keeping this thing in mind, if a person wants to buy a policy near retirement age, it would be difficult and costly too. I have read on the internet about New India Insurance "Bhavisya Arogya" policy. As per this policy, one can buy it as per current age and health conditions for desired sum assured value. One has to pay the premium till 55 years of age. And after that, a person does not need to pay the premiums. The company takes care of the medical expenses.

It looks good to me at this stage. I believe, looking at the current medical expenses, it would be good to buy for sum assured value of Rs 5 lac. Would you please suggest its pros and cons on whether to buy it or not?

On the face of it, the policy looks quite beneficial since medical benefits are made available after retirement, when they are most useful as earning would have stopped. However, unlike a regular mediclaim policy where the sum assured is for one year and is available again next year, the amount of policy (say 5,00,000 in your case) is meant for the entire lifetime after retirement.

Moreover, the biggest drawback is that a maximum of only 20,000 will be payable per illness/ accident. This amount as you see is quite inadequate and makes the policy non useful.

But you should provide for yourself both for inadequacy of employer policy while you work and for your post retirement years when the years when the employer's policy may no longer be available.

Below are a few plan which you can look at while buying an insurance policy for yourself.

I am employed, 24 years of age and want to buy a mediclaim policy for my entire family including my father (58), my mother (54) and myself. The problem is that my father had a paralysis attack in 2005, but after that he is well and doing his job perfectly.

I wanted to know about a policy that conveniently covers all three of us. Moreover I have also heard that private mediclaim providers do not cover preexisting disease and even discontinue the policy if claimed twice or thrice.

Please provide me a solution.

The IRDA has recently come up with a guideline which states very clearly that no insurer can deny renewal of the policy till the age mentioned under the policy unless it is for any fraud or misrepresentation.

Getting a policy for your father looking at his health condition would be a bit difficult. Every company (including PSU companies) has a clause, which states that any pre-existing disease will not be covered for a certain number of years.

Getting a cover for yourself and your mother would be much easier.

Below is a table which has a few insurance company which you can look out for while buying life insurance. The premiums mentioned below are for a sum assured of Rs 3 lakhs each.

I am working in railways. I have a family consisting of my wife who is 37 years old and a daughter who is 7 years old. I am 45 years old.

I have diabetes for the past 10 years and my wife for the past three months. I want to go for a health insurance where pre-existing diseases are covered. Kindly advise.

Every general insurance company has a laid down waiting period to cover pre-existing disease. In that waiting period, any claim application due to your existing  disease will not be covered.

Once the waiting period is over your pre-existing disease claim will be settled. Secondly, to cover your family members, you can go for family individual plan for a sum insured atleast Rs 3 lakh per person. 

To know more on waiting period for pre-existing disease along with other related information you can logon to our site (http://www.apnainsurance.com/health-insurance-india/comparison.html), to compare mediclaim plans from all the general insurance company.

Here are a few suggested plans: