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Health Insurance For Parents With Pre-Existing diseases: Impossible Is Nothing!

Neha Gadoo Neha Gadoo 27 January 2017

Recently released Bollywood movie Piku portrayed a beautiful father-daughter relationship and the eccentricities that abound within it. The movie had its moments that felt like pages right out of our lives. We all love our parents dearly, as varying the degree of love and its expression may be. The parallel I found to real life was how, just like our parents always felt protective about us, we reciprocate it too.

Health Insurance for Parents

As adults, most of us carry the burden of guilt of not doing ‘enough’ for our folks. In this day and age, most of our parents are fairly independent both financially and otherwise. However the burden of rising (read un-affordable) healthcare costs more often than not results in either the parent delaying a treatment or compromising on the quality of treatment. This is why I cannot emphasize enough, the extreme importance of buying health insurance for our parents in this time and age. To ensure they get timely and quality healthcare treatment, above all "peace of mind"

I recently came across a twitter conversation:

I noticed, from @b50’s tweets while the awareness & will to buy family & parents’ health cover has increased, given the spate of lifestyle diseases in recent times, the challenges posed to get a clear health insurance policy for parents who suffer from a pre-existing diseases have increased manifold.

Is it worth taking all the effort?

The common perception has been that getting health insurance for people around 60 years of age, especially with any medical history with elaborate medical checkups is extremely tricky and tedious. Also cases accepted have long list of terms, conditions and exclusions laid by Insurance companies. Its true that Insurance companies (burdened with major losses in the health insurance business) are very rigid and paranoid with respect to accepting proposals for people with older age. They end up either apply additional premium or terms, or worse, just reject the proposal altogether. However, it is important to understand that not all proposals are rejected and there are many insurance companies who are still open to evaluating health insurance proposals for senior citizens. In all my years of experience, I can recall Insurers accepting as many proposals with PeD, as many as they have denied. It is still worth going through the trouble, because health cost inflation over the last few decades has been consistently through the roof.

My own father, the planner that he has always been, bought health insurance early in his career. However, as years passed that sum insured amount was hardly sufficient. So I went through the cycle of getting my parents insurance topped up much after they turned 60. I wouldn’t say it was a cakewalk to get them insured but I wouldn’t term it a nightmare either.

Some Common Questions with respect to Health Insurance for Parents:

Understanding policies and the procedures involved to buy that policy for parents would be fairly simple when we address the most important and common questions in hand. Like:

  1. What is a pre-existing disease?
  2. What are the steps to buy health policy for parents who have existing ailments?
  3. On what conditions is a policy proposal accepted?
  4. What happens if you have not mentioned everything in your proposal form?
  5. What are the top plans in the market today, that you can buy for your parents?
  6. What if you face rejection?

What according to Insurance companies is a Pre-existing disease?

Let’s get down to defining boundaries. Pre-existing disease is any disease, condition or symptom that you as family member or your parents as applicants are aware of, when buying the policy. This means,

a) Existing diseases, conditions, including sign/symptoms that the applicant(s) suffer from.

b) Past Hospitalizations/surgeries

This does NOT mean that the occurrence of minor infectious ailments like Malaria, Jaundice, Typhoid, etc. will hinder your chances of a health policy. Like I mentioned school exams earlier (you can easily tell how I dreaded those things!), fearing these temporary ailments would be like worrying about class tests when the ultimate test is clearing the boards! In most cases, these ailments are cured without the need for any hospitalization and would not give insurance companies any added reason to deny you a policy on these grounds. You see, contrary to popular belief, insurance companies are not that trigger happy either!

What if you/your parents are unaware of an existing ailment?

When it comes to buying a health policy, there is only one golden rule – that you be as transparent as possible about all your medical conditions and history that you are aware of, in the proposal form. Note, in case you are buying health insurance for your parents it is important to take efforts in including all diseases, conditions known. A quick way to do this is to go through your parents' medical file as well as medicine box and ensure you have included all the diseases or conditions that get observed from this evaluation.

How to go about buying Health Insurance for Parents with PeD?

Let’s assume you have zeroed in on the policy that you want to buy for your parents. What’s next?

  • Step 1: You fill out the proposal form, pay the required premium and apply for the policy. The tough part is almost over!

  • Step 2: The Insurer will evaluate the case. Depending on the age, health declarations mentioned and sum insured selected, the insurer will have to do any or all of the following:

  1. Additional Info: If you have made any health declarations, the Insurer would want to know more. So you’re likely to be given another form to state your PeD clearly, leaving no question of doubt!

  2. Tele-Underwriting: You would receive a call from the Insurance Company’s panel of doctors who would try and understand the declaration in detail. They will, in their professional capacity, translate it to the insurer.

  3. Medical Checkup: Despite that, if they are still not entirely convinced, the insurer may require you to go through a medical check-up to evaluate the present-day scenario of the mentioned condition.

  • Step 3: Based on what they find after all those evaluations, the company will decide on one of the following
  1. Either accept the case “as is”, and issue you the policy. Phew!

  2. Or accept the case on the condition of additional premium. If you agree to it, the policy is then issued.

  3. Or in case of multiple declarations on health or a critical illness, decline the case altogether! Sad, but was worth a try.

Related Article: How To Buy Health Insurance In 6 Easy Steps

What kind of medical tests are we talking about?

When you hear of medical tests, you naturally think of the usual suspects - BP, cholesterol, diabetes. They have been our known evil for years now. At best, you’d also think of fasting blood sugar, complete blood count, urine routines, lipid profile, X-rays and general physical examination. But there are a lot more complicated sounding ones in addition to these routine ones. There’s HBA1c, SGPT, SGOT, serum creatine, PSA, USG and the tread mill test, stress tests (If you thought you didn’t have any, I recommend you check now!). Depending on the declarations you’ve made, if insurers are still not convinced, (they are a hard bunch to please!) additional tests may be demanded too!

Get things streamlined before the medical checkup.

Test results could go wrong due to any reason! But there is no reason to get worked up over it. Now that you have managed to convince your parents about to not let fear of

PeD get in the way of buying health insurance, make sure to check-off these things ahead of the tests so that nothing out-of-the-ordinary messes up their system.

  • Ensure that they are regularly taking their usual medication.

  • Ensure, to your best effort, that they don’t fall ill on the day of the tests.

  • Ensure that they reach reasonably before time to avoid any kind of last minute anxiety! (We all know how things turn out when that happens, don’t we?)

Medical history cheat-sheet:

Depending on all medical conditions, both declared and observed, here is what you can broadly expect from the entire exercise.

How would the insurance companies find out if you decide to hide the Pre-existing Disease?

Insurance companies are large enterprises with multiple mechanisms to detect any misrepresentation made in the proposal form. For instance, once you have bought the policy, before the start of any treatment or hospitalization, doctors record the existing medical history. That includes defining the medication and time since when the patient is suffering with the specific ailment. Insurers as part of their regular documentation require this document before they begin with any claim settlement.

What happens if you live in the constant fear of not having mentioned everything in the form?

It is important, practically and emotionally, (especially if you stay away from them), that you take stock of your parents’ current health condition. You may not get to observe their everyday activities and may only notice when the occasional sneeze and cough gets chronic. But you SHOULD be in the know of any ailment or pain of any kind that your parents may be suffering from and getting treated for.

The easy way to start this as mentioned earlier would be to find out and keep track of what their medications are. When you start this practice, you are bound to know more about the ailment and, specifically, their condition. Do it, even if you’re not agreeable, like Piku did.

Next, ensure your parents’ medical papers/file is updated with the latest prescriptions, lab reports/test results. And continue to keep a check on that file from time to time.

There is never enough time for any of us to do anything. But it’s just one medical check-up once in a while. It may cost you a match/movie/lunch plan every once in a while but it would be worth accompanying your parents to their health checks. Not only to keep them company, but also keeping yourself updated about their health!

Top 5 of the best plans for your parents in the market

Now that you have processed all of that, here is a little something to start with – the 5 popular plans in the current market that will work best for your parents! In case you have questions here, you can always contact Coverfox Health Insurance experts by leaving a missed call at 1800 209 9920

What if, after all this, you face rejection? Is there a hack?

The open-market retail health insurance policies have very stringent medical evaluation (underwriting) before accepting the case. I’m sure you got that by now. But here’s something positive to observe. At Coverfox, out of all the policies we issue monthly, about 10% of them are for parents over 50 years. For every 100 cases of parents only about 35 get rejected! That’s still 65% success rate. This obviously includes cases of additional loading of premium, which would again be 1 in every 5 cases.

So, with these real numbers, we deal with month on month it is easy to see how insurance for parents is not an elusive unicorn it has been believed to be! You could fear rejection less than you need to, much to your parents’ satisfaction as well! But, despite this, if you are facing rejection, it’s good to know that, there is still some respite in the form of Group health insurance policies from Banks.

If you’d wish to know about them.

Bank Mediclaim Policies

  • They are usually available till the age of 69/70

  • Service might be an issue. I recommend personal follow-up/visits to follow up with the same.

  • Above all, consider this as a last resort - only if you face rejection from all possible Insurance Companies!

While Coverfox is happy to help you navigate through this supposed tiresome process, at the end of the day, your family’s health should be worth every trouble. Insurance most definitely takes the load off a little when dealing with hospital rounds that become more frequent and mostly unavoidable as parents grow older. As tedious as it may be, It is still worth a shot. Maybe even a lesson to all of us to get ourselves insured early in life, keeping a long term view, so our children and we ourselves don’t have to deal with the processes and paperwork it may bring. Peace of mind is worth everything!

For any further questions, comments, clarifications, feel free to write in the comments below or tweet to @themahavir or @coverfox.

Update: I recently wrote an eBook that covers each aspect of getting your parents covered under health insurance in greater detail. I recommend you read as well as share it with your friends. You can download this Parents Insurance Ebook.

Neha Gadoo
Written by Neha Gadoo
Daring and Bold, Neha loves philosophy, trekking and walking bare feet in the rain. Loves talking and can stare out of a car window for hours continuously.