Why is Medical Test Important While Buying a Health Cover?

What are Pre-Medical Tests in Health Insurance?

Pre-medical tests in health insurance plans are medical check-ups done before you buy a mediclaim policy. These tests help the insurance company understand your current health status and accordingly they assess the risk & decide on the best plan options for you.

Even if the insurer does not ask you to go through the medical tests, it does not imply that you can withhold a pre-existing condition. Nothing can be more blunderous than withholding a fact concerning a pre-existing illness; it is plainly considered as a fraud. Moreover, it can straightaway lead to rejection of the claim.

When there are no medical tests, you have to submit the declaration of good health in lieu of that. Once you submit it, the insurer sets your premium.

Importance of Pre-Medical Test in Health Insurance

Here's why you should go through a pre-insurance medical test while buying a mediclaim policy:

1. Avoid Paying a Hefty Amount

   Skipping medical tests seems like a quick and easy fix. And why not, the insured saves the trouble of visiting the clinic/diagnostic centre. But a little consideration and you will realize that you might end up paying heavily later if you focus solely on such short-sighted savings. Besides, health plans offered without any pre-requisite of medical tests cost higher than the conventional health plans.

2. To Prove Your Low Risk-appetite

   If you happen to be a healthy individual, you have one more reason to go through the pre-medical tests. In case, you pass the medical tests with flying marks, you are surely going to get rewarded by the insurer with a certain discount on premium as you will then be seen as a low-risk deal from their perspective.

3. To Remain Covered Even in the Worst Condition

   Even if you have a pre-existing condition, you will get to know the specific exclusions and waiting period relevant to your condition. Though you will surely shell out slightly higher premium, but it is all worth it. Notably, it is better to incur high premium rates and getting covered rather than saving a few bucks today and getting your coverage denied altogether at a later stage.

4. It Makes You Accountable Towards Your Health

   One more reason why is it good to go through medical tests is that, at times, prospects themselves are not aware of their health condition. In such a case, their declaration of good health will not stand good anymore. But if they choose to go through the medical tests, the responsibility of being aware of an existing condition is transferred to the insurance company; thus they free themselves from the obligation of knowing the same.

   Now the question arises if it is riskier for the insurer, why do they offer such a proposition 'no medical tests required'. Well, it is because the medical examination is by no means light on the pocket. And when the customer has to incur the medical test cost, it directly hampers customer acquisition.

Common Pre-Medical Tests in Health Insurance

Pre-medical tests differ from insurer to insurer and plan to plan. However, the common pre-medical tests in health insurance are as follows:

• Physical examination
• Blood test
• Sugar level
• Urine test
• ECG
• Imaging test
• Blood pressure
• Lipid profile
• Cholesterol level

Who Pays the Pre-Medical Test Price?

According to the Insurance Regulatory and Development Authority of India (IRDAI), the insurer should pay at least 50% of the pre-medical test price. But, most of the insurance providers bear the entire cost of these tests, especially when they are done at a network diagnostic centre.

However, if you pay the cost of the pre-medical test, your insurance company will reimburse it after the policy issuance.

Is a Medical Test Compulsory While Buying a Health Insurance Policy?

No.

At present, most health insurance companies issue the policy without a medical test if you are below 45 years of age. Some insurers have extended this age limit to 60 years. However, for those aged above 45 years, a medical test is required. In fact, applicants with pre-existing conditions, regardless of their age, may need to undergo a pre-medical test before their policy is issued.

While it is not mandatory, but it is recommended to have a medical examination before purchasing health insurance to avoid claim rejections later.

Wrapping it Up!

To go through medical tests prior to getting insured, seems like a pain but it is not. On the contrary, the more stringent an insurer is while giving out the policy, the thicker will be the chances that your health insurance claims will be approved without any hassles. And, the more transparent you are while giving your information, the easier and faster will it be to realize the claim amount.