PRE-EXISTING CONDITION: WHAT IT IS AND HOW IT APPLIES TO INSURANCE



ORIGINAL POST
Posted by PSR_AXP 2 yrs ago

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When it comes to health insurance, pre-existing conditions are unavoidable. Your health condition is a key factor that affects a policy’s level of coverage and cost, which is why “do you have a pre-existing health condition?” is one of the first questions that an insurance provider or broker will ask.
 
Not sure how to answer that? Fret not, our friends from Pacific Prime Hong Kong are here to discuss what pre-existing conditions are and how they apply to insurance.
 
What is a pre-existing condition?

A pre-existing condition describes any medical injury or illness that existed prior to securing health insurance. These health conditions tend to be long-term or chronic, with some of the most common including cancer, heart disease, and diabetes. However, these are just a fraction of the common chronic health conditions that a person can develop throughout their life.

Chronic health diseases are often associated with inherited and lifestyle factors. For instance, breast cancer genes can run in the family. Conversely, smoking cigarettes, an unhealthy diet, and excessive alcohol consumption are examples of poor lifestyle choices.

How pre-existing conditions affect health insurance coverage

Many people looking to secure health insurance wonder how insurers decide on coverage levels. It starts with a quick assessment that involves stating whether you have any pre-existing conditions. It’s advisable to disclose any pre-existing conditions since this information is vital to the underwriting process - a rather rigorous process that also includes factors such as age, whether you’re a smoker, and desired benefit levels, to name a few.

Remember that withholding information from the insurance provider or broker is considered insurance fraud. To avoid getting into any financial or legal trouble, be sure to answer all questions as best you can and provide official medical records when possible. Doing so will help your insurance provider or broker come up with the ideal plan for you.

Options for securing health insurance with a pre-existing condition

Insurers in Hong Kong typically exclude coverage for pre-existing conditions since such conditions virtually always require treatment, which insurers will have to reimburse. While you can get health insurance coverage that excludes pre-existing conditions, other options include:

  • Full coverage (including pre-existing conditions) - If you do find a plan that offers this, go over the terms and conditions carefully to establish what would happen when you file a claim.
  • Coverage for ​​pre-existing conditions with premium loading or extra premium - Full coverage may also be offered with premium loading or surcharge on top of the original quotation to help the insurer with reimbursement costs.
  • Coverage for ​​pre-existing conditions with a waiting period or moratorium - This indicates a specific time period before your pre-existing condition will be covered by your insurance policy (e.g. 1 to 2 years).
  • Exclusion or no coverage at all

Looking for pre-existing conditions insurance in HK? Contact us at Pacific Prime for impartial insurance advice and a free plan comparison today.


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