All About Waiting Period in Health Insurance
Jan 24, 2022

Importance of Waiting Period in Health Insurance Plan

When buying a health insurance plan, you would come across a term called ‘Waiting Period’. If you are a first-time buyer, then you might not know what does waiting period means in health insurance. How long it is and what all does it include. Well, these are some of the common questions that will cross your mind. Read ahead, to know everything about the waiting period in a health insurance policy.

Understanding Waiting Period in a Health Insurance Plan

In simple words, the waiting period is the amount of time that you need to wait. In terms of a health insurance policy, it implies the time that one needs to wait for right from the commencement of the policy to utilize the benefits. Let us understand the various types of the waiting period that is present in a health insurance policy.

The Initial Waiting Period

A waiting period is sometimes also referred to as the cooling period. It means a certain time that one needs to wait from the issuance date to actively start the medical insurance and avail of the benefits. Most insurance companies have an initial waiting period of 30 days. However, the waiting period may vary from insurer to insurer.

Waiting Period for Specific Illness

Talking about a specific illness's waiting period differs from the initial waiting period. Diseases like hernia, tumor, osteoporosis mostly require long-term care, these costs are borne by the insurer when the policy is bought. Hence, insurers include a distinct waiting period for various diseases. Here, the waiting period for a specific illness ranges from a year to two years. It is advised to check with the health insurance company to understand rules related to specific diseases and the waiting period.

Pre-existing Diseases Waiting Period

While buying a health insurance plan, the insurers ask about the Pre existing diseases. Sometimes there is a chance that the insurer might ask you to undergo medical screening. A pre-existing disease refers to a health condition, injury, ailment, or disease which has been diagnosed up to 48 months afore buying the health plan. Some of the pre-existing diseases include thyroid, diabetes, hypertension, and so forth. So, when buying a mediclaim policy, if you have any pre-existing diseases you will have to wait for a certain waiting period to get over. Only after the waiting period gets over, a claim can be made for any treatment or hospitalization that is incurred because of the covered disease. The waiting period for PED is usually from 01-04 years. It may vary from insurer to insurer and depending on the chosen type of health insurance policy.

Accidental Hospitalization Waiting Period

When we think of accidents it gives unexpected injuries and various medical concerns. Considering the nature of any accidents, mostly the insurers do not have a notice period in terms of accidental hospitalizations. It means for one accidental hospitalization claim when they have just started with the health plan, an initial waiting period is not applicable.

Waiting Period for Maternity

There are health insurance policies that offer maternity benefits. It could be either a part of the plan or as an add-on. Talking about the maternity waiting period, during this tenure maternity benefits cannot be claimed. Till the time waiting period does not get over, the claim to avail of the maternity benefit will get rejected. Mostly here the waiting period differs from 01 to 04 years. So, if you are going forward with family health insurance, consider the waiting period for maternity in the health insurance plan.

Is There Any Way of Reducing the Waiting Period?

There are health insurance companies in India that permit the insurer to reduce the waiting period. However, to avail of this benefit, the insured is required to pay an additional premium. Generally, there is no waiting period in the health plan that is offered by the employers to the employees. In case even if it exists, then compared to a regular health insurance plan it is shorter. IRDAI permits the employees who have group health insurance to convert it to an individual health insurance plan when leaving the company. Here, the individuals will get the policy without a waiting period. This is so as they have spent the waiting time in the group health coverage by the employer.

The Bottom Line

Regardless of the waiting period health insurance offers, ensure that you are fully protected. It is always good to have a medical insurance plan in place while you are young. It will complete the waiting period without making any claim mostly. While you are young, you are supposed to be in the prime of health. So in later years of life, when you have to make a claim, you would have already crossed the waiting period clause. A health insurance plan works completely on the gradual premium collection and sharing risks. The insurer can only initiate paying out the claims once the insured pays the health insurance premium timely. Make an informed decision and act effectively.  

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