What Is the Requirement of Pre-Medical Check-Ups for Health Insurance Policies?

With the cost of medical treatment increasing each day, the need to buy health insurance is increasing, too. If you or your loved ones are ever hospitalized due to severe health issues, then financial worries should not prove to be an obstacle to getting the right treatment. A health insurance plan can ensure that to a great extent.

The process of buying health insurance includes many steps, one of which is getting medical check-ups conducted. The insurance buyer has to undergo certain medical tests before they get the policy issued in their name. Does every policyholder have to undergo these tests, and if so, then what is their relevance? Let’s understand more in this article.

What is health insurance, and how does a pre-entrance medical check-up figure in it?

Let’s first understand what is health insurance. When you have health insurance, you can make a claim on it if you or your loved ones suffer an event that is covered by the policy. The insurer provides you with financial compensation based on the expenses that you incur for the treatment. One never knows when a health condition might strike and lead to hospitalization. However, the insurer can get an understanding of how well you stand on several health matters with a health check-up.

For instance, if your test results show symptoms of diabetes, then the frequency at which you may be hospitalized later would be higher. This signals to the insurer that claims may be made more frequently by a policyholder. The insurer can, then, calculate the premium for the health insurance for family coverage accordingly.

However, pre-entrance medical check-ups are not required for all policies and for all policyholders.

When are medical check-ups required in health insurance?

  • When the insured is over a certain age threshold

If you or the people you are looking to insure when you buy health insurance are over 45-50 years of age, then a pre-entrance medical check-up may be required. Some may have a 60-year-old upper age limit. This is because older people are more likely to suffer from health complications and thus, raise more claims compared to their younger counterparts. *

  • When the insured has a turbulent past medical history

If you have been hospitalized due to this health issue or that, or if you have parents or grandparents who have had serious illnesses, then, too, a pre-entrance medical check-up is necessary for the policyholder. So, for instance, if your parents have thalassemia, which can be easily inherited, you may have to go through a medical check-up for the same. *

  • When you have opted for a high sum insured

A high sum insured implies a higher risk of illness and hospitalization for the insurer. That is why they may ask the policyholder to go for a pre-entrance medical check-up before agreeing to the sum insured and issuing the policy. *

* Standard T&C Apply

Whether you are buying an individual policy or health insurance plans for family, make sure to provide the insurer with the correct medical information. Failure to do so can lead to the rejection of your claims. Insurance is the subject matter of the solicitation. For more details on benefits, exclusions, limitations, terms, and conditions, please read the sales brochure/policy wording carefully before concluding a sale.

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