What is PED in Health Insurance?
Navigating Health Insurance with Pre-Existing Diseases
Some people carry a medical history when they approach a health insurance provider. It could stem from an old injury, a past surgery, or long-term medical conditions such as high blood pressure or diabetes. These conditions are classified as PEDs or 'pre-existing diseases,' and they play a critical role in determining the terms and cost of health insurance coverage and premiums.
Understanding PEDs in Medical Insurance
According to the Insurance Regulatory and Development Authority of India (IRDAI), a condition diagnosed or treated within 48 months before purchasing a health insurance plan is known as a pre-existing disease or condition. Some common PEDs range from lifestyle ailments like allergies, high blood pressure, etc., to serious medical problems such as diabetes, cancer, sleep apnoea, chronic obstructive pulmonary disease (COPD), and more.
In the medical insurance sector, an insurer offers coverage for pre-existing diseases to the policyholders only after a specified waiting period. For most cases, this waiting period varies between 12-48 months based on the insurance plan and provider you choose.
Although you can claim reimbursements for medical costs related to other health conditions during the initial waiting period, specific coverage for Pre-Existing Diseases (PEDs) begins only after the waiting period is completed.
How Do Pre-Existing Diseases Affect Health Insurance Plans?
A general medical insurance plan offers financial aid to the policyholder(s) in case of health emergencies. Insurers estimate the likelihood of a claim for these medical insurance plans to be 50-50.
On the other hand, when a person opts for pre-existing disease or PED cover, both the beneficiary and the insurer are aware that claims will be filed at some point due to the specified medical conditions. Due to this reason, you see the following effects in health insurance policies covering pre-existing illnesses:
●Greater Premium
Because of a pre-existing medical condition, the health insurance company charges a slightly higher premium. It is a default effect across all insurance companies as they assume a greater risk while covering the policy seekers.
●Significant Waiting Period
Policyholders need to serve a predetermined waiting period when they are availing of PED health insurance coverage. The waiting time changes depending on the company you choose and your health status when you apply.
With Star Health, you can reduce the initial waiting period for PED health insurance policies by submitting a flawless medical history report. Our company provides a variety of medical insurance policies specialised for individuals with pre-existing conditions. So, you can select a plan that offers optimal coverage with a short waiting period.