Health insurance for autoimmune conditions

Autoimmune illnesses are caused by an anomaly in your body’s immunity system. The immune system is designed to fight and attack foreign invaders like bacteria and viruses to keep your body healthy. However, in the case of autoimmune ailments, this function of the immune system undergoes a role reversal. Then the immune system starts attacking the cells or organs of the body and impairs them. As such, you suffer from various complications and need medical assistance and health insurance.

The most common autoimmune disease is Type 1 diabetes wherein the immune system attacks the pancreas’s insulin-producing cells. This hinders and stops insulin production which, in turn, gives rise to diabetes since insulin regulates blood sugar levels. 

Another illness is rheumatoid arthritis wherein the immune system targets the joints of your body and causes redness, swelling, pain, stiffness, etc. 

The most common 10 auto-immune diseases include Type 1 diabetes, Rheumatoid arthritis, Multiple sclerosis, IBS (Inflammatory bowel disease), Hashimoto – autoimmune Thyroiditis, Vitiligo, Rheumatic Fever, Pernicious Anemia or atrophic gastritis, etc.

Dealing with autoimmune conditions

Prevention of autoimmune conditions might be a challenge. You do not control how your immune system works. As such, you have to deal with the illness. Usually, autoimmune conditions are not fatal. However, if they become severe or if you develop other medical complications; they might have serious repercussions. 

Fighting autoimmune disorders involves regular medication, doctor’s consultations and lifestyle changes. If, however, the illness becomes severe. You might need advanced medical attention which might cause hospitalisation. 

Health insurance and autoimmune ailments

Managing autoimmune conditions involves a considerable amount of money that might put a dent in your savings. As such, having a health insurance plan is recommended to bear the brunt of the medical bills.

Thankfully, health insurance plans are available for individuals suffering from autoimmune conditions. There is a waiting period for the pre-existing condition. Here are some important things about the coverage that you should know though –

  • The pre-existing waiting period starts from 12 months and can go up to 48 months depending on the policy that you buy
  • The premium would be higher because of the existing medical condition 
  • If your ailment is quite severe, the insurance company might restrict coverage altogether. The restriction would only be for the complications of the autoimmune condition. For other medical contingencies, you would be able to enjoy complete coverage
  • There are disease-specific health plans too that you can avail to exclusively cover your ailment
  • You might have to undergo pre-acceptance health check-ups before the policy is issued. These check-ups help the insurer understand the severity of the illness.

Group v/s personal health insurance plans

If you are employed, you might enjoy employer-sponsored group health insurance coverage. You might also have coverage through some other groups that you are a part of. So, you do enjoy group health cover, you can get complete health insurance coverage for your autoimmune condition. Group plans do not have member-specific restrictions. Moreover, they allow coverage from the first day itself, without any waiting period. You can, thus, get coverage for any complication from your autoimmune disease with a group plan.

That being said, a group plan is not the be-all and end-all of health insurance coverage. Though the plan offers cost-effective coverage without restrictions, it has its drawbacks too. For starters, the coverage might be low and insufficient. Moreover, the coverage is contingent on you remaining a part of the group. If you leave the group, you lose coverage. There is no scope for customisation and you do not control the plan. 

So, even if you have a group health plan, supplement it with personal health insurance coverage. The personal plan would help you enjoy a wider and more inclusive coverage. It offers lifelong coverage and continues even if your group plan is no longer available. 

Some tips for buying a personal health plan are as follows –

  • Choose a plan with a low waiting period to enjoy quicker coverage
  • Compare different plans and then buy the most comprehensive and competitive policy
  • Declare your medical condition to the insurer. Do not hide any information as it might lead to claim rejection
  • Choose an optimal sum insured for sufficient coverage 
  • Look for OPD coverage in the plan to get coverage for your medicines, doctor’s consultations and diagnostics too on an outpatient basis
  • Look for plans that offer annual health check-ups. This would help you keep a tab on your illness.

The bottom line

Autoimmune conditions, though not preventable, are surely manageable. You just need to know-how. Manage your illness with regular consultations and medications. Opt for a personal health insurance plan to manage the financial aspect of the illness. Choose a suitable policy to get the coverage you need without burning your pockets in the process. To know more check

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