Wellness Bites!

The fast-paced lifestyle has led us to face several health-related issues, the habits of eating junk food and lack of hygiene result in increased stress and illness. You have to get treated in case a severe ailment strikes you. It is better to have a health insurance policy in place so that your recovery is taken care of financially.

Once you are hospitalized and cured with the necessary treatments, your insurance provider pays off the medical bill through a cashless treatment or reimbursement process. Buying health insurance policies is a suitable option to overcome medical costs, but many policies come with catches.

You always need to understand that overconsumption of alcohol, drug abuse, self-harm, criminal acts, and other illegal activities are not covered under any health insurance policy. If you overlook this clause, your claim may indeed be rejected. However, not just these practices, but something else needs to be checked twice while choosing health insurance. Yes, we are talking about pre-existing diseases, which you are already suffering from before purchasing any health plan.

What Do Pre-Existing Conditions in the Exclusions of a Policy Mean?

Simply think of an illness that has already affected you when you don’t have any health insurance policy. Now, as you tend to buy one, the policy might not cover you against that specific illness. For instance, cancer, high blood pressure, acne, diabetes, etc., are illnesses that can be put under pre-existing conditions and not covered under the plan.

There’s a reason why many insurers don’t cover pre-existing diseases. They pose a possible financial risk, as you would soon require medical attention, thus requiring the insurance company to provide coverage. Bearing in mind the term ‘insurance’, it is a safety net against possible future illnesses. A pre-existing disease is a particular event that is going to happen for sure.

Common Pre-Existing Diseases

Usually, pre-existing diseases include the following conditions:

COPD

A chronic lung disease that makes breathing difficult and usually needs ongoing medication and monitoring.

Diabetes

A long-term condition that affects blood sugar levels and often requires regular medication, tests, and lifestyle management.

High Blood Pressure

A common but serious condition that puts strain on the heart and blood vessels if not managed properly.

Acne

A persistent skin condition that can require prolonged treatment, especially when severe or recurring.

Asthma

A chronic respiratory condition that causes breathing difficulties and may flare up due to allergens or environmental triggers.

Sleep Apnea

A sleep-related disorder where breathing repeatedly stops and starts, often requiring medical intervention or devices.

Extreme Obesity

A condition involving excessive body weight that increases the risk of multiple health complications.

Anxiety

A mental health condition that can affect daily functioning and may need ongoing therapy or medication.

Atherosclerosis

A condition where arteries narrow due to plaque buildup, increasing the risk of heart attack or stroke.

But the scenario is changing rapidly. Many health insurance companies are coming up with health policies that cover you against pre-existing conditions, letting you reduce the industry average of a 4-year waiting period on pre-existing diseases, of course, with certain conditions. Again, no company provides such coverage from day one.

How ManipalCigna Offers Policies Covering Pre-Existing Conditions

Below is how ManipalCigna offers policies covering pre-existing conditions

1. ManipalCigna ProHealth Insurance provides coverage for pre-existing diseases after a waiting period of just two years in ProHealth Preferred and ProHealth Premier plans.
2. Pre-existing diseases are covered after 36 months from the start of the policy in the ProHealth Accumulate plan and ProHealth Plus plan.
3. Pre-existing diseases are covered after 48 months from the start of the policy in the ProHealth Protect plan.

Eligibility Criteria

If you’re looking for a health insurance policy that covers pre-existing conditions, eligibility usually comes down to one simple thing: honesty and clarity at the time of purchase.

Insurers typically evaluate:

• Your declared medical history (conditions, treatments, medication, previous hospitalizations)
• Your age and overall health profile
• Whether you’ve had the condition for a long time or it’s newly diagnosed
• Any doctor reports or tests, if requested during underwriting

A practical tip: even if a condition feels “minor” (like long-term acidity issues, thyroid management, or recurring asthma flare-ups), it’s better to disclose it. Non-disclosure may save time today, but it can create claim trouble later.

Waiting Period Details

Pre-existing conditions are rarely covered from day one, and that’s normal in health insurance. What matters is how long you have to wait and what the plan promises after that.

Here’s how waiting period details typically work:

• The waiting period starts from your policy start date (not the date you get hospitalized).
• During this period, claims related to the declared pre-existing condition may be declined.
• Once the waiting period ends, coverage for that condition usually becomes available, as long as the policy has been continuously renewed.

Also, remember: a policy can have multiple waiting periods running at once, an initial waiting period, a specific disease/procedure waiting period, and PED waiting period. So it’s worth checking the policy wording carefully rather than assuming it’s “just one waiting period”.

Coverage Benefits

Once your waiting period is completed, coverage for pre-existing conditions can be a genuine relief, because ongoing treatment costs tend to show up in a lot of places, not just hospitalization.

Typically, coverage after the waiting period may include:

• Inpatient hospitalization expenses related to the condition
• Daycare treatments (procedures that don’t require 24-hour admission, if covered)
• Pre- and post-hospitalization expenses (within the time window specified in the policy)
• Room rent, ICU, and specialist charges, as per plan limits

But here’s the honest part: coverage can vary by plan. Some plans cover the condition broadly, while others may still have exclusions for specific complications. That’s why the plan brochure and policy document matter more than a quick summary.

How to Buy a Pre-Existing Condition Cover?

Your pre-existing condition only gets covered in your health insurance plan when you take the benefit that covers them, like a waiver of pre-existing diseases. You must disclose all your pre-existing conditions to your insurer before buying a policy with pre-existing conditions.

Also, it is important to read the fine print of the policy and know about the waiting periods for each disease.

Steps to Choose the Right Plan

Buying coverage with a pre-existing condition doesn’t have to feel confusing. If you break it into steps, it becomes far more manageable.

Here’s a simple way to shortlist the right plan:

• Start with your condition: What treatment does it usually require—medication, tests, periodic hospitalization, procedures?
• Compare PED waiting periods: A shorter waiting period is usually better, but also check the premium impact.
• Check if your condition is excluded: Some plans may permanently exclude certain illnesses. Don’t skip this.
• Review sub-limits and caps: Especially on room rent, ICU, or specific treatments.
• Look at network hospitals: If cashless care is important to you, the hospital network matters a lot.

Pro tip: If you’re buying for parents or older family members, don’t just choose the cheapest premium. In real life, convenience matters.

Documents Required

Documents can vary depending on age and health history, but typically, you may need:

• Basic KYC: ID proof and address proof
• Proposal form (with medical disclosures)
• Past medical records (if asked)
• Prescription history or doctor consultation notes
• Diagnostic reports (blood tests, ECG, HbA1c, etc., depending on condition)

If medical tests are requested, it’s usually part of underwriting to set clear terms. It’s not necessarily a “bad sign”; it just helps the insurer assess risk accurately.

Things to Consider Before Buying Health Insurance Plans that Cover Pre-Existing Conditions

While buying health insurance plans that cover pre-existing diseases, consider the following things:

Look for health insurance plans that offer a minimum waiting period before covering pre-existing diseases.

Check the Claim Settlement Ratio of your insurer 

Keep the health and age of your family members in mind while selecting the type of policy to buy. Buying cover on a family floater basis is highly beneficial.

Look for health insurance plans offering lifetime renewability benefits.

Compare Sum Insured

The sum insured isn’t just a number, it decides how relaxed you’ll feel during hospitalization.

While choosing it:

• Factor in your city’s hospital costs (metro vs non-metro can differ a lot)
• Consider the condition’s long-term cost pattern (frequent tests, recurring admissions, procedures)
• Don’t forget medical inflation—it creeps up quietly every year

A higher sum insured can look “extra” today, but it can feel absolutely necessary when real bills arrive.

Check Exclusions Carefully

This one is non-negotiable.

Before buying, check:

• If your condition is covered after waiting or is permanently excluded
• If related complications are excluded (example, diabetes may be covered later, but certain complications may have conditions)
• Whether there are sub-limits on specific procedures or room rent

If something isn’t clear, ask for it in writing. A two-minute check today can prevent a claim argument later.

Look for Network Hospitals

Network hospitals are what make cashless claims smoother—especially if you need planned admissions.

While checking the network:

• Look for reputed multi-specialty hospitals near your home
• Ensure your preferred doctor/hospital is part of the network (if that matters to you)
• Check whether the insurer has strong network coverage in your city

For someone managing a pre-existing condition, convenience isn’t a luxury, it’s part of peace of mind.

Conclusion

Ensure that you know your health insurance policy like the back of your hand before you purchase the same. Similarly, never conceal any health-related information, such as pre-existing diseases, from your insurer. It can only backfire on you, resulting in claim rejection.

Be honest and keep your insurer updated regarding any changes in your health and lifestyle.

With Manipal Cigna, you can explore plans designed with clear waiting period structures and practical coverage options, so you can explore plans designed with clear waiting period structures and practical coverage options, so you’re not left guessing when you need care the most.

FAQs

What Are Pre-Existing Conditions in Health Insurance?

Pre-existing conditions are illnesses or health issues you had before buying the policy, either diagnosed, treated, or showing symptoms.

Which Diseases Are Considered Pre-Existing?

Conditions like diabetes, high blood pressure, asthma, thyroid disorders, and heart disease are commonly considered pre-existing, along with many chronic or long-term illnesses.

Can I Get Health Insurance if I Have a Pre-Existing Condition?

Yes. Many insurers offer policies for people with pre-existing conditions, usually with a waiting period and underwriting requirements.

How Does Waiting Period Apply to Pre-Existing Conditions?

Claims related to the pre-existing condition are typically covered only after the waiting period ends. During the waiting period, claims for unrelated conditions may still be eligible, based on policy terms.

Does ManipalCigna Cover All Pre-Existing Conditions?

Manipal Cigna covers many pre-existing conditions after defined waiting periods, depending on the plan and policy terms. It’s best to check the product brochure and disclosures for condition-specific clarity.