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

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While purchasing a health insurance plan, you will come across several terms, and pre-existing conditions are one of them. People have several queries regarding this, so they should have a clear idea of how it impacts their health insurance plan, primarily concerning the premium and coverage! 

But, first, you need to know what pre-existing conditions mean in a health insurance scenario! 

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The above plans and premiums are for AED 150,000 Sum insured for 1 Adult of 21 Years for Dubai city.

What is a pre-existing condition?

Health insurance pre-existing conditions refer to any medical condition a person has a while (or before) buying a health insurance plan. However, it not only states the present medical condition, but pre-existing conditions also involve a person’s thorough medical history of diabetes, heart attacks, hospitalisation, thyroid, medications and even any major injuries in the past. 

Every insurance provider has a different take on pre-existing conditions. However, usually, they consider the last 5 to 10 years as their ‘look-back’ period to investigate your medical profile. 

In any case, insurance providers do not entertain pre-existing conditions. 

Why do insurance providers not approve pre-existing conditions?

Typically, insurance providers exclude coverage for pre-existing conditions and related illnesses. For instance, if a person is suffering from high blood pressure, he/she will most likely not be covered for the treatments of heart attacks, stroke, angina or aneurysm. 

It also applies in cases where a person has these conditions under control through medication. Now the question is why they do so.

Simply put, people with pre-existing medical conditions are likely to get treatments frequently, which will pose a higher financial risk for insurance companies. 

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What should people with pre-existing conditions do then?

According to the Dubai Health Authority’s insurance law, the insurance providers of Dubai cannot deny mandatory health coverage to people with pre-existing conditions. It is also applicable to other parts of the UAE. 

However, in that case, the insurance plan may come with a 6-month waiting period. But, if the policyholders need emergency medical treatment, the waiting period can be waived in certain cases. 

In general, most insurance companies in the UAE offer health coverage for pre-existing conditions. However, they adopt some ways to mitigate their chances of facing financial risk. Now, this will have an impact on your health insurance policy, which you should be aware of. 

So, here are the areas where a pre-existing condition makes a difference in a health insurance policy –

  • Waiting period 

Usually, a health insurance plan with pre-existing conditions has a waiting period of at least 6 months in Dubai. However, the period can be less or more depending on the insurance company you choose. 

  • Premium loading 

While most health insurance companies in UAE offer coverage for pre-existing conditions, you may have to shell out extra money for premiums. It is a way to cover the additional cost that insurers need to bear for policyholders with previous medical history. 

  • Waiting for period + premium loading 

In some cases, you have to bear the premium loading and agree to the waiting period to get maximum health insurance benefits with pre-existing conditions. 

  • Exclusions 

Some insurers may offer you a comprehensive health insurance dubai plan even if you have pre-existing conditions. However, it may not cover all the treatments that arise from such conditions. Hence, you must check the exclusions before making a final decision. 

If you want to address these problems and leverage most of your health insurance with pre-existing medical conditions, you can follow the tips below –

  1. Purchase a health insurance plan at an early age as the chance of having existing medical conditions is usually less at this point.
  2. Stay with your insurer for a longer period, and do not forget to renew your plan on time every year. They cannot deny you the cover for pre-existing conditions while you already own a plan. However, they can charge a higher premium for the same. 
  3. You can also opt for a group health insurance plan. In some cases, the insurer includes pre-existing conditions of all your office employees. 

Note that, no matter what, you need to provide the right information about your pre-existing medical conditions whenever you buy a new plan. It will help you ensure a faster and smooth claim process. Also, do not forget to go through the policy terms and read them carefully to understand what you are getting into. Moreover, if you have any questions, communicate them and get the answers before you sign the policy agreement.

To conclude, finding the right health insurance policy in the UAE is challenging, let alone for people with pre-existing conditions. However, the best way to bag the perfect plan for you is to educate yourself about this issue and compare different insurance providers.

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