My mother, aged 55, was recently diagnosed with rheumatoid arthritis. We are now looking for a good health insurance policy for her, but we’re worried that no one will cover her. What are the options for buying health insurance for someone who already has RA? Will the treatment be covered immediately?
Getting health insurance after a rheumatoid arthritis diagnosis is challenging but possible in India. Insurers will treat RA as a pre-existing disease (PED), which means any policy you get will come with specific conditions. These typically include a waiting period before RA-related treatments are covered and a higher premium. The key is to find a plan that offers the most favorable terms for your situation.
credits : Health Insurance for Rheumatoid Arthritis
Health Insurance Waiting Period for Rheumatoid Arthritis
A friend of mine was trying to get insurance for his father, who has RA. Almost every standard health insurance policy he looked at imposed a 2 to 4-year waiting period for pre-existing diseases. This meant that for the first few years of the policy, any hospitalization or treatment directly related to his father’s rheumatoid arthritis would not be covered. This is the most important condition you need to be aware of; immediate coverage is extremely rare.
Aditya Birla Activ Health for Rheumatoid Arthritis Patients
I was reading on a patient support group forum where someone with RA recommended the Aditya Birla Activ Health plan. They mentioned that this plan is specifically designed for people living with chronic conditions. While it still had a waiting period for their RA, the company’s underwriting process was more understanding of their condition. The plan also offered health coaching and rewards for managing the illness well, which was a unique and supportive benefit.
Policy Conditions for Rheumatoid Arthritis Health Insurance
A colleague managed to get a good policy for his mother, who also has RA. The insurance company accepted her proposal but with two common conditions for high-risk applicants. First, they applied a 30% “loading” fee, so the annual premium was significantly higher than for a healthy person of the same age. Second, the policy included a 10% co-payment clause, meaning the family has to pay 10% of every hospital bill themselves.
Disclosing Rheumatoid Arthritis for Health Insurance
The most critical piece of advice I received from an insurance agent was about disclosure. He told me about a case where a person didn’t mention their mild RA symptoms when buying a policy. A few years later, they needed a major joint surgery. The insurance company investigated their past medical records, found the prior diagnosis, and rejected the entire multi-lakh claim based on non-disclosure. This is a crucial lesson that you must declare RA upfront, no matter how mild it seems.
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