Hi Everyone,
I’m looking for urgent advice on a health insurance policy for my father. we’ve recently hit a roadblock regarding his treatment costs.
Medical History & Context:
Initial Diagnosis: Diagnosed ~13 years ago, originally with Ocular Myasthenia Gravis.
Progression: About 5–6 years ago, it progressed to his left arms.
Current Status: He has been on long-term medication, but after a recent Neostigmine test confirmed the MG status recently, he is now undergoing Rituximab (Rituxirel) infusions. It hasn't been officially labeled as "generalized" yet, but it has clearly moved beyond just ocular.
The Financial/Insurance Problem:
Treatment: He needs 500mg Rituximab infusions twice a year.Its cost around 40k+ each including hospitalization charges in our area.
Waiting Periods: Most standard policies have a 2–4 year waiting period for Pre-Existing Diseases (PED). Given he is already starting the infusion cycle, we cannot wait years for coverage.
What I’m looking for:
Low Waiting Period: Are there specific policies or "PED Reduction Riders" that actually work for a long-term autoimmune condition like MG from atleast month 6 or year 1?
Biologics/Modern Treatment Coverage: Since Rituximab is a biologic, I need a plan that covers these infusions up to the full Sum Insured. I’ve heard many plans have "sub-limits" or caps on modern treatments—I need to avoid those.
My Questions:
Has anyone with a long-term (10+ years) chronic condition successfully used a PED reduction rider for immediate claims for autoimmune condition infusions?
Which insurers are "smooth" with the underwriting for Myasthenia Gravis? We want to declare the 13-year history 100% upfront to avoid any future claim rejections.
Has anyone successfully claimed for Rituximab specifically? Did the insurer try to label it as "experimental" or "outpatient"?
Any leads on specific plans, riders, or specialized brokers who handle high-risk/chronic underwriting would be a huge help. Thanks in advance!