Monday, April 22, 2024

What is Health Insurance with High-Risk Cover?


A medical emergency in the family can be hard to deal with. It not only causes emotional and physical stress, but it can also put strain on your finances. In such a situation, a health insurance policy can prove to be a blessing in keeping your savings protected and getting quality treatment without worrying about the cost.

When you buy health insurance, the insurance company underwrites the plan based on your health condition, age, lifestyle habits, and other important aspects. In other words, the insurer assesses the risk that they will cover. And, based on their assessment, they classify every policy in three categories – low risk, moderate risk, and high risk.

If you are young and healthy and live an active lifestyle, you may be considered a low risk insurance buyer. If you have any minor health conditions, the insurer may put you under the moderate risk category. If the insurance company classifies you as a high-risk buyer, because of your old age or if you are diagnosed with any life-threatening illness like cancer, then they may undertake detailed underwriting.

Let us understand more about how insurance companies classify health insurance as high risk.

  • Pre-existing illness

Pre-existing illnesses are illnesses that you may have while buying a policy. If you have conditions like diabetes, hypertension, cancer, and heart-related ailments that pose a serious threat to life, insurance companies will classify you as a high-risk insurance buyer.

Though pre-existing illnesses have a waiting period, the insurance company may completely exclude such conditions from the coverage and charge a higher premium. If the illness is severe, the possibility of the insurance company rejecting your insurance application cannot be ruled out.

  • Lifestyle habits

If you have the habit of chewing tobacco, smoking, or drinking alcohol, the insurance company will classify your application under high-risk category. This is because smoking and alcohol consumption pose high-risk to health, and you may be prone to various illnesses. For the insurance company, this means the chances of you making a claim is high.

To mitigate the risk, the insurance company charges a higher premium. Also, the potential medical contingence arising from such habits may be excluded from the policy coverage.

  • Professional risk

The insurance companies categorise the risk profile of a buyer based on their occupation. If you are engaged in a high-risk profession like working in the aviation sector or in a minefield, you may come under high-risk buyers. This is because the possibility of injuries, accidents and medical emergencies are quite high.

The premium for such buyers is usually price high and the coverage excludes the emergencies that may occur due to risk in their profession.

If you fall into the high-risk category, buying a health insurance policy can be difficult. But the following tips can help you.

The insurance companies generally consider factors like the quantity and frequency of tobacco use. So, if you quit smoking and refrain from tobacco usage in any form, the insurance company may not charge extra premium after a few years and may no longer consider you a high-risk policyholder.

Some insurance companies offer specialised health insurance policies for specific diseases like diabetes, cancer, and heart-related ailments. You can consider buying such policies rather than the regular comprehensive plans to get coverage against such conditions.

You can consider buying a top-up cover. It is an add-on coverage that pays the hospital expenses if you use the entire sum insured amount. Typically, the top-up plans have an affordable premium and it is better to get such coverage if you think the existing policy does not provide sufficient coverage.

Final Word

Now that you are aware of the health insurance with high-risk cover and how to deal with it, make sure that you do your due diligence while buying a policy and understand the risk category that the insurance company put you in.

Colt June
the authorColt June