How Do Health Insurance Companies Deal with Pre-existing Conditions?

When you buy health insurance, one of the first things that comes to mind is why purchase a plan if it doesn’t cover pre existing conditions in health insurance? It's a valid concern because many people feel a health insurance plan should offer immediate protection for all health issues. However, most health insurance plans in the UAE do cover pre-existing conditions, but a waiting period usually applies. During this time, the insurance provider assesses your condition before offering full coverage.

In the following write-up, we will dive deeper into how pre-existing conditions in health insurance are handled.

The above plans and premiums are for AED 1,000,000 Sum insured for 1 Adult of 30 Years for Dubai city.

What are Pre-existing Diseases?

A pre-existing condition in health insurance refers to any health condition or illness that you have been diagnosed with or received treatment for before you start a new health insurance policy. These conditions can be anything from chronic illnesses like diabetes and hypertension to previous injuries or surgeries.

Let's say you have been diagnosed with a heart condition and regularly visit a doctor for treatment. If you apply for health insurance, this heart condition will be considered a pre existing condition in health insurance. This means that the disease was already present before you applied for coverage and it didn’t develop after buying the plan. While your health insurance plan may cover this pre-existing disease, there could be a waiting period before you can claim treatment costs related to the heart condition. Health insurance for pre-existing conditions ensures that you get coverage, but it's important to understand the terms, including waiting periods, before purchasing a plan.

Do Pre-existing Diseases in Health Insurance Are Covered ?

Yes, pre-existing conditions in health insurance are covered by most health insurance plans in the UAE. However, there are important terms and conditions that you must be aware of before purchasing a policy.
Here are the key factors to consider when dealing with pre-existing condition in health insurance —

Waiting Period:

Most health insurance policies in the UAE apply a waiting period for pre-existing conditions. This means your insurance will not cover any claims related to the condition for a certain time, usually between 6 months and 2 years, depending on the insurer and the condition.

Premium Loading:

Insurers may increase the premium if you add the coverage of pre-existing conditions in health insurance. This is known as premium loading. The higher premium helps the insurance provider cover the additional risk associated with your medical history.

Exclusions:

Even after the waiting period is over, some treatments or specific procedures related to the health insurance for pre-existing conditions may not be covered. This could include advanced or experimental treatments for certain conditions. Always check the policy to understand what is excluded.

Tips for Effectively Managing Health Insurance with Pre-existing Conditions

Keep the following tips in mind while applying for pre-existing conditions in health insurance —

Compare multiple insurance policies to find the best health insurance for pre-existing conditions
Disclose all pre-existing conditions in health insurance to avoid claim denials
Opt for policies with shorter waiting periods for pre-existing condition for health insurance
Regularly review and update your policy to ensure it meets your health needs
Consult with insurance experts (like policy bazaar.ae) to understand the best options for health insurance for pre-existing conditions.

How to Buy Health Insurance for Pre-existing Conditions in the UAE?

Buying health insurance for pre-existing conditions can be simple with the right platform.

Policybazaar.ae is a renowned online platform that is known for its wide range of health insurance options from top-notch insurers.

Here are the steps to purchase pre-existing condition health insurance —

On Policybazaar.ae website, go to the health insurance section.
Enter your basic details in the lead form to start the process.
A pop-up will appear where you need to mention any chronic conditions or pre-existing diseases you have.
Based on the information provided, you will receive quotes from various insurers that offer pre-existing conditions in health insurance. Review and compare these quotes to choose the best plan for your needs.

Claim Process for Pre-Existing Condition Health Insurance

In case you need to file a claim for pre-existing condition health insurance, simply follow the given steps —

Initial Notification
- Notify your insurance provider as soon as you require medical treatment for a pre-existing condition. This is especially important in emergency situations.

Some insurers require notification within 24 hours of receiving treatment.

Collect Required Documents
- Gather all the necessary documents, which may include —
  - Completed reimbursement claim form signed by your doctor
  - Detailed medical reports and a discharge summary from the treating physician
  - Copies of invoices or receipts for the medical services received
  - Copies of test results and prescriptions
Submit the Claim
- Submit your claim through your insurer’s website, mobile app, or customer service channels. All documents should be accurately filled out and submitted within the stipulated time frame, usually within 60 days of receiving treatment.
Waiting Period Compliance
- Be aware of the waiting period for pre-existing conditions. Generally, there is a 6-month waiting period before you can claim expenses related to pre-existing conditions.
Review and Reimbursement
- Once submitted, the insurance company will review your claim. This process usually takes between 15 to 21 working days. If the claim is approved, the reimbursement will be deposited directly into your bank account.
Understand Deductibles and Copays
- Be clear about the deductibles and copays associated with your policy. A deductible is the amount you pay out-of-pocket before the insurance covers the rest, while a co-pay is a fixed amount you pay for each claim.

Final Takeaway

Pre-existing conditions are a common part of many people's health histories. While they can complicate the process of obtaining health insurance, decoding how insurers manage pre-existing conditions in the UAE can eliminate much of the stress.

Pre-existing conditions in health insurance can provide critical coverage for these conditions so that you receive necessary medical care without facing prohibitive costs.

You can find a health insurance plan that best meets your needs by thoroughly researching policies, honestly disclosing conditions, and consulting experts. Remember, managing health insurance for pre-existing conditions effectively is key to securing your health and financial well-being.