Know Your Policy Better: Waiting Period in Health Insurance

Waiting period in health insurance

Health insurance policies, be it individual health insurance or group health insurance, are a rising necessity to secure one’s health interests. Rising costs of healthcare services, increasing susceptibility to lifestyle ailments, and an overall preference for cashless transactions leave us depending on our health insurance policy to cover our wellness needs.

You must, however, acquaint yourself with the clauses that come with a policy ahead of choosing one. A key component of health care plans is the waiting period associated with the policy. While you may see it as an obstacle at the outset, the benefits of holding a reliable policy far outweigh the inconvenience of a waiting period in the long run.

Types of Waiting Period

There is more than one waiting period in a policy. Take a closer look at what each of them mean:

Initial waiting period: Most insurance companies have an initial waiting period ranging between 30 – 90 days. The insurance will come into effect after the initial waiting period.  This waiting period is based on several factors such as the type of policy you hold, medical history, age, etc.

With the exception of accident cases, any disease or ailment within this period will not be covered and cannot be claimed. Look into policy terms and conditions as some policies cover disease diagnosed for the first time during the waiting period.

This feature is primarily common in health insurance policies for senior citizens. While some insurers offer a co-payment clause for senior citizen health insurance to avoid this hurdle, there are others who offer an option to reduce the waiting period by charging an additional premium. Group health insurance policies, meanwhile, secured by employers for employees do not insist on waiting periods.

Pre-existing conditions waiting period: During this waiting period, if you suffer from any pre-existing medical conditions before or at the time of availing the policy, the treatment expenses for the same will not be covered by the policy. Medical conditions like high blood pressure, diabetes, thyroid, etc., are called pre-existing diseases. In these cases, the insurer may request medical tests to assess the impact of the disease on the individual. Based on the outcome of the reports, insurers decide the viability of insuring an individual and prescribe a waiting period that could range between 2- 4 years.  This aspect of a health insurance policy makes it essential to opt for a policy early in life to avoid the waiting period when you need immediate treatment.

Disease-specific waiting period: Similar to the waiting period for pre-existing conditions, there is a disease-specific waiting period that is a clause stipulated in your policy terms and conditions. The insurance company will list specific illnesses/diseases that are not covered by the policy during this waiting period. There is also a maternity benefit waiting period, wherein the maternity benefits in the policy are not available to policyholder until the expiry of its waiting period, which is usually around 2 years or more.

Do you have any pre-existing medical conditions that will be subject to a waiting period in a health insurance policy? Find out with a health check immediately.

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