Health insurance top urgent question

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Health insurance top urgent question

Friends my cousin 31 single diagnosed with bicuspid arotic valve. it is by birth condition in which heart valve needs replacement. he has no health insurance. as per this website https://www.hdfcergo.com/health-insurance/heart... they are providing insurance on lumpsum payment and the insured should wait 30+90 days before the surgery. they don’t callback or don’t connect to customer care people. is there any other company which covers valve replacements for a shorter period? Please suggest.

@bikidas2060 biki 22 please tag insurance experts

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I dont think they will cover pre-existing diseases. They wont pay pre existing diseases if you dont declare in proposal form and if you declare it they wont accept to insure you for that disease. You can visit their nearby office or call nearby office if cc is not taking calls.

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igen wrote:

I dont think they will cover pre-existing diseases. They wont pay pre existing diseases if you dont declare in proposal form and if you declare it they wont accept to insure you for that disease. You can visit their nearby office or call nearby office if cc is not taking calls.

no company cover preexisting diseases?

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Pre existing diseases are covered only after 2 years afaik

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kukdookoo wrote:

no company cover preexisting diseases?

Is he working? Many large companies insure their employees for health insurance. Most of these insurance policies cover pre existing diseases without any waiting periods.

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igen wrote:

Is he working? Many large companies insure their employees for health insurance. Most of these insurance policies cover pre existing diseases without any waiting periods.

he is self employed so no corporate insurance.

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Sorry to hear about it. No company will cover PED before atleast 2-3 years. Also for such condition, many insurance company won’t issue policy itself.

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drjpatwa wrote:

Sorry to hear about it. No company will cover PED before atleast 2-3 years. Also for such condition, many insurance company won’t issue policy itself.

then on hdfc website which link i shared they provide wrong info?

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kukdookoo wrote:

then on hdfc website which link i shared they provide wrong info?

It is a Critical Illness policy not a Health Insurance cover. They both are very different. I suggest that you read the Policy wordings as it is the bible of the cover. The website front page is a marketing tool.

BTW. It is written clearly in their FAQ section.

10. What do you mean by pre-existing Diseases?

Any condition, ailment or injury or related condition(s) for which insured person had signs or symptoms and/or was diagnosed and/or received medical advice/treatment within 48 months prior to your first policy with the company.

Under Policy wordings read the below.

https://www.hdfcergo.com/documents/downloads/HE...

Section 2 – Exclusions

We will not make any payment for any claim in respect of the Insured Person caused by, arising from or attributable to any of the following unless expressly stated to the contrary in this Policy:

viii. Any treatment arising from pregnancy (including voluntary termination), miscarriage, maternity or birth (including caesarean section), congenital external defects or anomalies

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kukdookoo wrote:

no company cover preexisting diseases?

It is not even pre-existing, it is congenital. Congenital means by birth. As far as i know no policy covers congenital diseases even after 4 years i.e. they don’t cover congenital diseases ever. Had a congenital case in my family.

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As GoogleCA and harishgayatri mentioned, it is a congenital anomaly. Health insurance (hdfc or any other) is not an option in his case.
Since he is going to undergo an elective surgery (i.e. planned surgery, not an emergency surgery), so take quotes from 2-3 hospitals and/or take advice from nearest medical college.
In which city is he based?

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cm4444 wrote:

As GoogleCA and harishgayatri mentioned, it is a congenital anomaly. Health insurance (hdfc or any other) is not an option in his case.
Since he is going to undergo an elective surgery (i.e. planned surgery, not an emergency surgery), so take quotes from 2-3 hospitals and/or take advice from nearest medical college.
In which city is he based?

chandigarh

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GoogleCA wrote:

It is not even pre-existing, it is congenital. Congenital means by birth. As far as i know no policy covers congenital diseases even after 4 years i.e. they don’t cover congenital diseases ever. Had a congenital case in my family.

In majority of policy – Internal congenital diseases are covered after a waiting period while External congenital diseases are in permanent exclusion.

But in this case as now it is already known & diagnose, no company will issue policy itself, forget about the claim.

That’s why it is advisable to get good health insurance as early as possible.

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drjpatwa wrote:

In majority of policy – Internal congenital diseases are covered after a waiting period while External congenital diseases are in permanent exclusion.

But in this case as now it is already known & diagnose, no company will issue policy itself, forget about the claim.

That’s why it is advisable to get good health insurance as early as possible.

In majority of policy – Internal congenital diseases are covered after a waiting period while External congenital diseases are in permanent exclusion.

what is difference between internal and external congential disease? and which companies provide cover with waiting period for internal congential disease?

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cm4444 wrote:

22g… pgimer (preferably) ya gmc-32 ja kar dikhao ek baar

@KDJPR
Can u help?

pgimer aam admi ko no. milna bda mushkil ha

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kukdookoo wrote:

@drjpatwa @GoogleCA @cm4444 @harishgayatri @igen
sirg can any plan like this help my cousin reduce expenses
https://www.airtel.in/bank/group-hospita...sh

You can buy a Hospital Daily Cash Insurance irrespective of whether or not you are diagnosed with a disease. However, the design of the hospicash insurance policy does not provide cover for pre-existing diseases such as BP (Hypertension) or any heart, kidney, and circulatory disorders.

Copy pasted from the link you gave

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kukdookoo wrote:

@drjpatwa @GoogleCA @cm4444 @harishgayatri @igen
sirg can any plan like this help my cousin reduce expenses
https://www.airtel.in/bank/group-hospita...sh

The only cost effective option is a big Govt/Charitable hospital/medical college. PGI in chandigarh or AIIMS, safdarjung, GB Pant, etc in delhi. Visit the one nearest to his place so that multiple travel and accommodation is convenient. Usually there’s a long queue for surgeries in such hospitals. If nothing works, try bribing the clerk of the same department to get your work done earlier.

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mas143forever wrote:

The only cost effective option is a big Govt/Charitable hospital/medical college. PGI in chandigarh or AIIMS, safdarjung, GB Pant, etc in delhi. Visit the one nearest to his place so that multiple travel and accommodation is convenient. Usually there’s a long queue for surgeries in such hospitals. If nothing works, try bribing the clerk of the same department to get your work done earlier.

pgi mein addhe se bhi kam rate mein surgery available par date milna na ke brabar without connection.

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kukdookoo wrote:

@drjpatwa @GoogleCA @cm4444 @harishgayatri @igen
sirg can any plan like this help my cousin reduce expenses
https://www.airtel.in/bank/group-hospita...sh

U r wasting ur energy. Once disease occurs, no plan of any company will give claim amount without atleast 2-3 years. Else why one would buy health insurance from early age ? Every one will buy it when they actually need it…

He only have option to go to any Govt. Or trust hospital to reduce cost…

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kukdookoo wrote:

pgi mein addhe se bhi kam rate mein surgery available par date milna na ke brabar without connection.

not even half. much less compared to a private one.

thats what I said, there’s always a long queue for elective surgeries in such big govt hospitals. so go to PGI, talk to an attendant/clerk of the same dept in the hospital, talk to him, offer him bribe. he can probably get it done sooner. that is the only option.

if he can afford somewhat, try to check some charitable hospitals as well. does he have the means to travel and stay in delhi ?

what has made the matters worse is the current covid situation. its a bloodbath out there. the healthcare is in tatters.

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Hi DD team, can we create a group or topic where all covid/surgery related urgent matters can be taken up.
Not sure if there is any other thing also possible here

This can help each one of us, as covid situation is scarry in almost all states.
@drjpatwa @mas143forever @kukdookoo

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@MrKool_JJ
@admin If there is anything similar already on this platform, pls guide. This will be helpful to each one of us

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kukdookoo wrote:

pgi mein addhe se bhi kam rate mein surgery available par date milna na ke brabar without connection.

Koshish toh kar bhai. Ja kar dikhao PGIMER me.

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raman12 wrote:

Hi DD team, can we create a group or topic where all covid/surgery related urgent matters can be taken up.
Not sure if there is any other thing also possible here

This can help each one of us, as covid situation is scarry in almost all states.
@drjpatwa @mas143forever @kukdookoo

Feel free to PM me if there is an urgent health related matter

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cm4444 wrote:

Koshish toh kar bhai. Ja kar dikhao PGIMER me.

Yaar uske shehar se door hai pgi agar apka koi known hai to btado

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raman12 wrote:

@MrKool_JJ
@admin If there is anything similar already on this platform, pls guide. This will be helpful to each one of us

Dr Jay patwa knows it better I feel.
He is having a thread regarding health insurance which should cover your problem. My mom is covered with Apollo Munich health. I need to confirm if they do are covering pre existing diseases or not. Your cousin will recover soon pray

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