Living with a chronic medical condition, or experiencing a medical issue, can be both a physical and emotional burden. And, although there are several steps that employers can take to enhance the physical - and mental - well-being of team members with pre-existing conditions, employers should also be mindful of how these conditions impact their health insurance plan.
In this article, we explore how group health insurance works for employees with pre-existing medical conditions, and what you as an employer can do to keep your company - and your employees - covered.
How do we define a pre-existing condition?
In general, a pre-existing condition can be defined as a medical illness or injury that someone has before taking out a health insurance plan. This can include chronic conditions such as cancer, kidney disease, or diabetes. Many insurers will count any condition that you have had symptoms of, or that you have had treatment for, in the past five years.
However, it’s worth checking how your provider specifically defines a pre-existing condition, as this will determine your employees’ level of coverage. For example, we define a pre-existing condition as:
‘A medical condition, or any related conditions, for which symptom(s) have been shown at some point during the three years before the commencement of cover, irrespective of whether any medical treatment or advice was sought. Any such condition or related condition about which you or your dependants know, knew, or could reasonably have been assumed to have known, will be deemed pre-existing.’
Do insurance companies cover pre-existing conditions in group plans?
Group health insurance schemes offer a substantial advantage over individual insurance plans in this regard through their "zero" waiting period policy. This means that employees with pre-existing conditions can receive reimbursement for their specific medical needs immediately upon enrollment, without the typical 6 months to one year period of ineligibility found in nearly all individual health plans.
By eliminating the waiting period, group health insurance plans prioritize the timely and essential healthcare access for employees, providing them with the necessary support right from the start. This not only helps alleviate the physical and emotional burden experienced by individuals with pre-existing conditions but also promotes a sense of security and well-being within the workforce.
How can you ensure that you’re meeting the needs of employees with pre-existing conditions?
In addition to offering a comprehensive group health insurance plan, there are other steps that you can take to make your workplace as accommodating as possible.
It’s worth regularly reviewing your group health insurance to ensure it offers sufficient coverage for your employees and to make any necessary adjustments. This practice will also help you become familiar with the terms and conditions, enabling you to address any queries or concerns your team members may have, including proof of coverage requirements and the extent of coverage.
Additionally, it’s important to effectively communicate the healthcare services available to your employees, particularly those with pre-existing conditions. Provide information about your coverage, and its limitations, with resources that help your employees better understand what your group plan means for them. And be sure to advertise the assistance and support service available, such as an Employee Assistance Program (EAP) or Chronic Medication Scheme (CMS).
Furthermore, it is essential to maintain ongoing dialogue and foster open channels of communication with your employees. This practice not only ensures that their needs are being addressed but also enables you to receive transparent feedback on their experiences. Take the time to actively listen to their concerns and suggestions, and remain receptive to making adjustments as necessary. Providers like GulfCare that offer fully customizable plans, will allow you to adapt your healthcare plan to accommodate the changing needs of your employees.
About GulfCare
GulfCare is a leading provider of premium group health insurance plans in the UAE and across the GCC. Our plans cover pre-existing and chronic health issues and are also fully customizable. This means that we are well-suited to meet the health insurance needs of companies of any size and scale, across all industries.
To learn more about our solutions, and to receive a complimentary quote, please get in touch today.
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