How Does a Pre-existing illness Impact your Health Insurance Premium Cost?


how does a pre existing illness impact your health insurance premium cost

Your health insurance policy is a safety cushion that keeps you safe from rising medical costs. To avail of its benefits, you need to pay a regular premium. The premium cost is based on various factors, and one of them is the pre-existing medical condition. If you are buying health insurance for pre-existing disease, there are a lot of things to keep in mind, from knowing the insurance needs to the premium amount.

Firstly, let us understand what does pre-existing illness mean?

Pre-existing disease refers to any medical condition, ailment, or injury that existed before buying the health insurance policy. Health issues with long-term effects such as diabetes, hypertension, and COPD are considered under pre-existing conditions, unlike minor health problems such as susceptibility to flu.

According to the Insurance Regulatory and Development Authority of India (IRDAI), a pre-existing disease is a disease, illness, or injury or related condition(s) for which medical advice was received/ or was diagnosed by medical practitioner within 48 months, before the effective date of the policy issued by the insurer or its reinstatement.

>>Also Read: Health Insurance Pre-Existing Conditions

Buying Health Insurance for Pre-existing Disease

Earlier, it was difficult for persons with pre-existing conditions to opt for a health cover. However, with the availability of customised products, you can now choose a health policy based on your needs and stay worry-free; although, you may have to undergo some procedures including pre-policy medical check-up, subject to the underwriting policy of the insurer. You should note that your health insurer will not deny the coverage because you have a pre-existing condition. However, there is a waiting period you must complete to avail the coverage for pre-existing diseases. The plan will cover pre-existing diseases after 48 months from the policy start date.

Not disclosing details about your pre-existing disease condition in health insurance proposal form can make you face some challenges in the future. Therefore, when you are buying a health cover, it is important to mention such relevant details without hiding them. It is particularly necessary to avoid rejection of claims.

How Does it Impact the Premium?

There are various factors such as age, family medical history, lifestyle, etc. which impact the premium costs. Usually, those who are young would pay a lesser premium as they are not likely to have any pre-existing condition. The premium cost of a health insurance policy is higher for persons with a pre-existing condition. Also, the premium may get loaded, considering the health risks of people with pre-existing diseases. It is applicable at the time of buying a policy. However, there is no loading if the policy is renewed continuously every year without a break. 

Furthermore, there are cases where the health insurer will apply a long waiting period along with premium loading to cover an ailment.

In many health insurance policies, there is an option of reduction in the waiting period. That is, the policyholder has the chance to reduce the applicable waiting period from 48 months to a lower period of 24 months. The premium will change if one selects this option. It is quite beneficial for those who are looking for coverage for their long-term treatment involving hefty hospital bills and pre-and-post hospitalisation medical expenses.


You can get adequate coverage without any worries, even if you have a pre-existing condition. The burden of medical expenses becomes lighter if you opt for the best health insurance plan. At the same time, make sure to mention your medical history at the time of buying a health cover. Keeping in mind the points mentioned above will help you avoid any hassle in the future.

Protect your health by taking a step in the right direction. Choose a health policy from Care Health Insurance (Formerly Religare Health Insurance). Visit the official website to buy health insurance online and pay the premium digitally.