Health Insurance

What is Waiting Period in Health Insurance?

Let us look at the case of Mr.Sharma, a man with regular health problems. Considering his poor health, he buys an insurance policy to feel secure about the finances for his hospital visits and…

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Let us look at the case of Mr.Sharma, a man with regular health problems. Considering his poor health, he buys an insurance policy to feel secure about the finances for his hospital visits and treatments. He knew if he doesn’t buy one, it could lead him to spend way too much money at once when his physical health worsens.

A month passes by and Mr.Sharma receives shocking news. He is diagnosed with testicular cancer and was advised to go for serious treatment as soon as possible. He gets admitted to the hospital and was further met with another big shock – that his health insurance policy was not valid as he hadn’t completed the ‘waiting period.’ This means that he would have to pay all the expenses himself. If only he had carefully read the complete health plan, this could’ve been avoided.

It is a very common scenario. People often don’t like going over the details while selecting their health insurance plans. But this story illustrates the need to understand the terms and conditions of every policy before signing up. It is essential to make sense of the waiting period clause in your health insurance policy. Let us learn more about it.

What is a ‘waiting period’ in health insurance and why is it included in the policy?

It is the time period mentioned in the health insurance plan during which a person cannot claim the benefits from the insurance company. The terms and conditions of this waiting period differ across various companies and depend on a variety of factors.

The reason for the inclusion of waiting period in health insurance is to avoid moral implications and unethical methods to claim benefits from the company. An example could be a person buying a health insurance policy just before having an expensive procedure, like dental operation.

The Different Types of Waiting Period in Health Insurance

  1. Initial waiting period

In this time period, a person cannot claim the benefits from their health insurance policy in the case of sickness, except for accidents. Generally, the initial waiting period is for 30 days.

  1. PED (Pre-Existing Diseases)

If a person already suffers from a disease before availing the policy, he/she will not get any benefits for those disease for a specified amount of time. Generally, the waiting period for Pre-existing diseases vary from 2 to 4 years. The lesser the waiting period, the better the policy for the customers.

  1. Disease-specific waiting period

In this scenario, the company does not cover expenses of hospitalization and medical expenses for a pre-specified illness or disease. This is also a type of short waiting period policy. The waiting period generally 2 years for problems like ENT problems, Cataract, tumor, hernia, osteoporosis etc. These are mentioned in the policy details.

  1. Maternity benefits waiting period

Some health insurance companies give maternity cover in their policy with a waiting period ranging from 9 months to 36 months, so mothers can avail benefits under this time.

Health Insurance Without Waiting Period

In certain situations, the insurance company could have no waiting periods to cover for accidents. Besides this scenario, they generally don’t adjust their waiting period policy for hospital expenditure. A person can choose among a number of health insurance policies that provide short or in some cases health insurance with no waiting period at all.

A group health insurance policy provides the benefit of no waiting period or a mere 30 days waiting period. Companies have differing policies under this plan but generally, it is a good option for people who want their expenses covered in a short period of time.

Additional Information About Waiting Period

  • The waiting period clause must be read carefully and thoroughly before buying insurance. Make sure to read the fine print in the document attentively.
  • If a person is diagnosed with a disease during the waiting period, then it will not be considered as ‘pre-existing disease.’
  • The waiting period is affected by certain factors like type of health insurance as well as medical history and age of the person.
  • In some cases, the waiting period can be reduced by paying a higher premium. It is advisable to check with the policies of every company.

Hope you have understood about what is waiting period in health insurance. It is essential to buy a health insurance plan suitable to your needs. It will aid you and your family in times of need or emergency. Advisable is to take professional advice from different companies to land into a hassle-free and convenient health insurance policy.