The contract that you and the insurance company sign is termed as the health insurance policy document. In this policy document, various terms are listed that clarify the coverage provided under the health insurance
plan. Under these, a clause related to the waiting period, if applicable, is also mentioned.
What is the waiting period in health insurance?
During the waiting period, you can’t raise a claim against any disease, even if your insurance policy covers it. You will have to pass the requisite waiting period, as per the insurer’s guidelines, to be able to raise a claim. Therefore, when you’re purchasing a health insurance plan, you must know the time you’re supposed to wait before raising a claim.
Here is a list of the different types of waiting periods:
- Pre-existing conditions
It is wise to purchase a health insurance policy when you’re young as the chances of you falling sick or contracting a medical condition are less compared to older people. A medical condition, which is already afflicting a person at the time of buying the health insurance policy, is known as a pre-existing disease. In this case, you will be asked by your insurer to wait for a specific period before you can raise a claim to avail treatment.
- Maternity benefits
Many health insurance companies have a waiting period before allowing maternity benefit insurance claim
. Depending on the terms and conditions of the company, this same period can range from a few months to a few years. Therefore, always purchase a health insurance plan in advance.
- Group plans
Most companies offer health coverage to their employees. For the new employee to be able to make a claim, they must wait for a specific period before claiming against the group policy. The waiting period might apply to someone who’s recently joined the company and is serving probation.
Now, let us look at some other commonly used terms in health insurance:
- Top up covers
Policyholders can purchase top up covers to increase coverage as required. At times, the usual plan may not have an adequate sum insured. This is when you require an top up health insurance plan. These plans can also be opted for as a standalone cover.
- Coverage provided
Coverage is the financial support that the insurance company provides you with upon purchase of the health plan. You can raise a claim in the case of emergencies and receive coverage for the sum insured. The amount of sum insured will then decide the premium amount.
- List of inclusions & exclusions
One must go through the policy documents carefully before purchasing the plan and peruse the list of inclusions and exclusions. If your insurance provider does not cover a certain disease and you file a claim for it, your claim will face rejection.
In order to receive payment for treatment, you will need to notify the insurance company, which is also known as raising a claim. They can be availed through the reimbursement process or via the hassle-free cashless option.
Firstly, analyze your requirements and then go ahead with purchasing a health insurance policy that meets your needs. Know and understand all the above-mentioned basic terms to gain more knowledge about your policy and choose the best one.