When Ishaan Yadav, 44, got diagnosed with diabetes, he decided to get a health insurance cover for himself. The insurance company, however, asked him to get a series of tests done, before offering him a policy. Yadav’s application was rejected by the company following the results, as he was deeming unfit for a regular health plan, because of his high-risk condition.
But Yadav is not alone; there are many like him who think about buying a policy later in life but often gets too late. Later when you go to buy an insurance policy, either you get rejected by the insurer or most critical illnesses are excluded from the policy or even if the policy includes such illnesses, it comes with a waiting period of around 3-4 years. Experts say what most people don’t realize is that buying health insurance becomes harder once you have a pre-existing disease.
Catering to such people, various companies have disease-specific plans, such as those for cancer and diabetes. Even though these plans are easier to opt for and provides cover immediately, they come at extra cost. Critical illness plans offer cover even after the insured have been diagnosed with any of the listed critical illness. Industry experts say disease-specific plans are especially for those who missed buying an individual health insurance policy at an early age. When compared to regular health insurance plans, these plans are restrictive.
If you have been rejected for a health insurance cover or you are prone to a specific illness, these critical illness plans might be your best bet.
Find out what these plans include:
Higher Premium Rates:
Disease-specific critical illness plans come at a very high price. Hence, firstly it is suggested to opt for a basic health insurance policy. With a healthy lifestyle, a diabetic person can get a normal policy as it covers everything but after a waiting period of 4 years. But if the illness is severe, and the diabetes is out of control, then he/she has to opt an illness-specific plan.
One of the plus points of these plans is that, generally, there is no waiting period for the illness for which you have bought a critical illness plan. For instance, a cancer policy will cover the illness from the first day. For other communicable diseases such as dengue, a nominal waiting period of around 15 days is applicable.
Co-Payment and Sub-limits:
In the event of a claim, Co-payment is the percentage of cost that the policyholder has to share with the insurer. The policyholder pays that percentage from his/her own pocket, and the insurer pays the remaining amount. For certain expenses such as doctor’s fees, the insurer pays up to a certain limit in case of sub-limit. These clauses in health plans are quite common.
Treatment respective limits come with a cap on the amount the policyholder can claim for a particular surgery. Therefore, even if the policy you have opted for has a high sum insured, for a particular illness such caps restrict the amount you can claim. Hence while buying the policy, one should find out which illnesses are excluded in the policy to avoid getting a shock later.