Can You Get Health Insurance After Diagnosis? Kidney Failure, Stroke, Alzheimer’s & More

Can You Get Health Insurance After Diagnosis? Kidney Failure, Stroke, Alzheimer’s & More

Introduction

Health insurance is not just about covering minor illnesses anymore it’s a lifeline during major diagnoses like kidney failure, stroke, Alzheimer’s, or even Multiple Sclerosis. But what happens when you or a loved one is diagnosed without any prior coverage? Is it too late to get insured?

This guide helps you understand real-world insurance options that still exist post-diagnosis and how to avoid claim rejections using smart strategies.

1. Understanding the Hidden Clauses in Critical Illness Policies

Before diving into diseases, let’s decode the two most misunderstood clauses in Indian Critical Illness (CI) insurance:

🕒 90-Day Waiting Period: Most CI plans won’t cover you if the illness is diagnosed within 90 days of buying the policy.

📅 30-Day Survival Clause: Even after diagnosis, you must survive for at least 30 days to get the lump sum payout.

🛡️ Pro Tip: Always check if your policy has a shorter survival clause (0 or 15 days) especially important for older people or those with risk factors.

2. Kidney Failure (ESRD): Insurance is Still Possible

Kidney failure is one of the most expensive long-term diseases:

• Dialysis (₹2,500–₹4,000 per session)

• Transplant surgery (₹4L–₹10L)

• Post-transplant meds (₹15K–₹20K/month)

But here’s the good news:

✅ Private Insurers like ACKO, ICICI Lombard, and HDFC ERGO now offer health plans for pre-existing kidney disease.
✅ Government Schemes like PMJAY and PMNDP offer free dialysis and ₹5 lakh/year coverage.
✅ Rajasthan’s RAN Scheme gives up to ₹15L for transplant expenses.

📌 Be honest during proposal  never hide your condition.

3. Stroke & Paralysis: Read Between the Lines

Stroke is usually covered in CI policies, but with conditions:

• Must meet severity thresholds (e.g., long-term disability)

• Must wait 90 days + survive 30 days (in most plans)

• Not all rehab expenses (physiotherapy, etc.) are covered

✅ Look for Waiver of Future Premiums after first payout
✅ Pair CI with standard health insurance to cover hospitalization + ICU

⛔ Avoid: Policies that exclude neurodegenerative outcomes.

4. Alzheimer’s, Parkinson’s & Mental Illness: Now Mandated

Thanks to IRDAI’s 2020 directive, all policies must include mental & neuro illnesses:

✅ Plans like:

• ManipalCigna SecureHealth

• Niva Bupa Health Premier

• SBI General

cover Alzheimer’s, Parkinson’s, and psychiatric hospitalization.

📌 Still, most plans exclude long-term nursing care or home help.

💡 Pro Tip: Use OPD riders + top-ups to get wider protection.

5. Multiple Sclerosis: Rare but Rising

MS is progressive and treatment is expensive. The following cover MS even post-diagnosis:

• Care Health: ₹3L cover + diagnostics, OPD

• Tata AIG: MS-inclusive CI plans

• Bajaj Finserv: ₹271/year plan for ₹3L!

🎯 Always opt for:

• No sub-limits

• Short PED wait periods

• Lifetime renewability

6. Real Costs: Snapshot Table

Treatment	Average Yearly Cost
Hemodialysis	₹3L–₹5L
Peritoneal Dialysis	₹3L+
Kidney Transplant	₹6L–₹12L (1st year)
Heart Bypass Surgery	₹3L–₹5L
Alzheimer’s Therapy	₹1L–₹3L
Multiple Sclerosis	₹3L–₹6L

7. Tools That Can Help

🧠 InsureBuzz AI offers:

• Policy matching based on medical history

• Rejection flagging before submission

• Auto-fill + escalation for reimbursements

You don’t have to fight alone. Use digital tools to reduce error and get faster settlements.

Final Thoughts

Serious diagnoses feel overwhelming  but they don’t have to mean financial ruin. With the right policies, honest disclosures, and tools like InsureBuzz AI, even complex cases can be insured.

🔗 Need help selecting or checking a policy?
Visit InsureBuzz.in and explore smart, post-diagnosis insurance options.

💬 Have questions? See the FAQ section below.

Frequently Asked Questions (FAQ)

Q1. Can I buy insurance after being diagnosed with kidney failure or stroke?
Yes. Some private insurers and government schemes offer plans even after diagnosis. You must disclose your condition truthfully.

Q2. Are Alzheimer's and Parkinson's covered under normal health insurance?
Yes, post-IRDAI mandate (2020), these are included. But long-term nursing care may still not be covered.

Q3. What is the 90-day waiting period in CI policies?
If you’re diagnosed within 90 days of buying a policy, the insurer will not honor the claim.

Q4. What is the survival clause?
It’s the number of days you must survive post-diagnosis (usually 30 days) to get CI payout.

Q5. Which government schemes help with dialysis or transplant?
PMJAY, PMNDP, and state schemes like RAN in Rajasthan offer free dialysis and ₹5–₹15L transplant cover.

Q6. How does InsureBuzz AI help?
It matches your condition to relevant plans, flags exclusions, and prepares documentation for faster claim settlements.