Understanding Waiting Period In Health Insurance

Based on the medical insurance policy selected by the insured individual, here's all you need to know about health insurance waiting periods in detail.

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All health insurance plans have a waiting period. Often, consumers aren’t aware of this and, therefore, face challenges while making health insurance claims. To ensure your claims are processed smoothly, let’s understand everything about waiting period for health insurance.

What Is Waiting Period?

It is a period of time when your insurance company will not cover any of your medical expenses. So, even though you have purchased a plan, you will not receive any compensation if you make a claim in the waiting period.

Initial Waiting Period

The initial waiting period starts when your policy cover begins. It could last between 15 and 90 days, depending on your insurance coverage. During this period, your insurance plan will not cover any of your medical expenses, except accidental injuries that cause you to be hospitalised for more than 24 hours.

Waiting Period for Pre-existing Conditions

Health insurance plans have a separate waiting period for conditions which are declared by the policyholder when purchasing the policy. These ailments are known as pre-existing conditions. These conditions include heart problems, high/low blood pressure, diabetes and so on. The policy holder will have to wait between one and three years, depending on the health insurance provider and the plan to get coverage for these conditions.

Illnesses-specific Waiting Periods

Some conditions such as hernia, tumors, ENT disorders have specific waiting periods that could last between one and two years. Every health insurance policy has a list of such conditions and their corresponding waiting periods. However, the list and exact waiting period changes from one insurance provider to the next.

Waiting Periods for Maternity Coverage

Most insurance companies impose a waiting period between nine months and three years before they offer to provide coverage for maternity expenses. So, it is wise to plan early for such insurance.

Can I Reduce My Waiting Period?

While it is impossible to get health insurance without waiting period, a few insurance companies allow you to reduce your waiting period, in exchange for a slightly higher premium. This is called premium loading, and it is a great way to enjoy the benefits of your health insurance policy.

What if the Policyholder is Diagnosed with a Condition during the Waiting Period?

Good news! As per IRDA regulations, any conditions that the policyholder is diagnosed with for the first time after the policy cover begins will not be considered as a pre-existing condition.

What Else do I need to know about Waiting Periods?

There’s a lot more you should know about waiting periods as they depend heavily on the type of plan you have, your age, and your medical history. If you wish to get a better understanding about waiting periods and how they might affect you and your policy, simply get in touch with the health insurance company!

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