Does a Group Health Insurance Policy Cover Congenital Diseases?

 

What are Congenital Diseases?

Diseases that exist since the time of birth are called Congenital diseases. A Congenital Disorder or a Congenital Disease is a birth defect caused by genetic or environmental factors.

Internal Congenital Diseases

Congenital Anomalies which are not in the visible and accessible parts of the body are known as Internal Congenital Diseases. As per IRDAI, a Group Health Insurance Policy for employees usually covers Internal Congenital Diseases.

External Congenital Diseases

Congenital Anomalies which are in the visible and accessible parts of the body are known as External Congenital Diseases. If a person is suffering from an External Congenital Disease, it is usually not covered under a Group Health Insurance Plan. However, some Group Health Insurance Plans for employees can provide coverage for congenital diseases if the employer pays extra premium.

Does Group Health Insurance Cover Congenital Diseases?

Yes, a Group Health Insurance Policy covers Internal Congenital Diseases while External Congenital Diseases are not covered. Some Group Health Insurance Providers might need employers to pay extra premium to avail coverage for Congenital Diseases.A Group Health Insurance Plan might provide coverage for diagnostic tests, Hospitalisation, Treatment etc for Congenital Diseases.

What is the Waiting Period for Congenital Diseases under a Group Health Insurance Policy?

A Group Health Insurance Policy does not have any waiting period for coverage for Internal Congenital Diseases. Congenital Diseases can be covered from Day 1 under a Group Medical Insurance Policy. This is a big advantage of Group Health Insurance Policy over an Individual Health Insurance Policy as Individual Health Insurance Policies usually have a waiting period of 24 months for internal congenital diseases after the inception of the policy.

What is the treatment for Congenital Diseases?

The type and diagnosis of the Congenital Disease determines the course of treatment. Some congenital diseases require surgery while other can be cured by means of medications.

Which Group Health Insurance Companies in India covers Congenital Defects?

A Group Health Insurance Policy covers Congenital Diseases without any waiting period. Some Group Health Insurance Companies which offer cover for Internal Congenital Diseases are as follows: SBI General Group Health Insurance Policy, Tata AIG Group Health Insurance Policy, ICICI Lombard Group Health Insurance Policy, New India Assurance Group Health Insurance Policy, The Oriental Insurance Group Health Insurance Policy, Iffco Tokyo Group Health Insurance Policy, GoDigit Group Health Insurance Policy.