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Medical Test in Health Insurance Research Team | Posted On Wednesday, July 24,2019, 12:50 PM

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Medical Test in Health Insurance



There are chances that the insurance company will deny your claim when you undergo a surgery for a chronic disease, within a few days of availing a health insurance plan. Let’s take the case of 63 year old Gopinathan who availed a health insurance policy (for senior citizens) three months ago. He consulted a doctor for a medical check-up. The doctor identified a blockage in his heart.

Gopinathan got the angioplasty done as per the advice of the doctor. He was under the impression that he could claim the medical expenses. The insurance company refused to honor the claim on the grounds of non-disclosure of pre-existing medical conditions. Do not let this happen to you. Take medical tests before you buy a health insurance plan. At the time of renewal, make sure the medicals are done.

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Medical Test in Health Insurance

Why Waiting Period in Health Insurance?

Normally, insurers do not cover certain diseases to avoid disputes. They may not be able to ascertain whether customers are suffering from illnesses like gall bladder stones, tonsillitis and so on, when issuing policies. These types of ailments do not require immediate medical attention.

Therefore, health insurance plans do not cover critical ailments, right from the beginning. Insurers impose a waiting period of 2 years for some diseases and 4 years for critical diseases. All types of pre-existing illnesses should be brought to the notice of insurers before availing the policy. Claims are possible only after the completion of the prescribed waiting period.

See Also: Health Insurance for Parents

Procedure for Medical Test

  • The measurement of height and weight
  • The blood sample is tested for protein, blood glucose, cholesterol, HIV and so on.
  • Blood Pressure measurement
  • ECG for cardiac medical conditions
  • Urinalysis for creatinine, HIV, nicotine, glucose, drugs and so on.

Note: Based on the results of medical tests, insurance companies will offer fully personalized health insurance policies to customers.

See Also: Health Insurance for Minors

Ensure Preventive Health Checkups for Tax Benefits

Get preventive health checkups done regularly, to avoid paying higher premiums for health insurance. Policyholders enjoy tax deductions for preventive health checkups within the overall Section 80D limits.

You are not allowed to claim tax deductions for payments made on behalf of siblings and in-laws. Moreover, the tax deductions for payments made on behalf of non-financially dependent children are not allowed.

See Also: Check These Five Myths About Health Insurance

Do Not Skip Medical Tests

Insurers compute the premium amount based on the test results. Do not skip medical tests even though you are suffering from any illness. If they are fully aware of your existing health conditions, insurers may offer you a lower premium. Even though medical check-ups reduce the risk for insurers, why are medical tests not compulsory? This is because insurers have to bear the cost of medical check-ups.

Health insurance policies with no medical tests are normally low-value policies that may not serve your purpose. If you want a higher cover, you have to go for a pure protection plan with medical tests. As per experts, a healthy person has to undergo pre-insurance medical checkups for lower premiums.

Medical Check-Ups for Free

Health insurance providers offer health check-up facilities for free after a certain number of claim-free years. It means that if you have not made a claim on the health insurance policy within the specified period, you can benefit from free medical check-ups.

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