Group Health Insurance August 28, 2021

Yes, a group health insurance plan provides coverage for pre-existing conditions from Day 1. It is offered to the employees of an organization where the latter pays the premium to cover the former against numerous health conditions. This is unlike regular health insurance plans where one needs to wait for two-four years from the policy commencement date to get cover for pre-existing conditions. A pre-existing condition means health conditions you have before buying a policy. Keep reading to know more about cover for pre-existing conditions under Group Health Insurance.

Do You Need to Undergo Medical Examination Under a Group Health Insurance Plan?

Group health insurance covers a group of members (50 or more) who are employees of an organization/company. And, you don’t need to undergo any medical examination, but you need to declare your pre-existing conditions upfront to get coverage for the same. If the pre-existing condition cover isn’t available under the base cover, you may have to undergo a medical examination.

What is a Pre-existing Diseases Waiver Cover?

This is an optional benefit provided under a group health insurance that offers coverage for pre-existing conditions from day one if the same isn’t covered under the base cover. For this benefit, the policyholder needs to pay an extra premium.

Pre-existing Disease Waiting Period Modification Option

If your group health insurance doesn’t provide you coverage for pre-existing conditions, opt for waiting period modification cover. With this, you can reduce the waiting period. This will help you get what you want with a little alteration.

What Happens In the Case of Non-Disclosure/ Misrepresentation of Pre-existing Diseases?

In such a case, the insurer may exercise any of the following:

  • Permanently exclude your pre-existing disease/condition
  • Add an extra waiting period for the undisclosed disease or condition
  • Levy underwriting loading from the first policy year or renewal, whichever is later.

What are the Benefits of a Group Health Insurance Plan?

The following are the benefits that you’ll get when you’re covered under a group health insurance plan.

Coverage Against a Wide Range of Medical Expenses – The policy will cover all the medical expenses such as in-patient hospitalization bills, pre and post-hospitalization expenses, day care procedures, etc.

Family Cover – You don’t need to worry about the medical expenses of your family when you are covered under a group health insurance plan. Because it not only provides cover to you but your spouse and children as well.

Easy to Claim – You don’t need to worry about the claim and go through a long procedure. Just submit your hospital bills and other details to the employer and they will help you get the claims settled.

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