Health Insurance
Waiting Period
  • Know all about Waiting Period
  • Explore the types of waiting period
  • Reduce your waiting period
waiting period in health insurance
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Waiting Period in Health Insurance

The waiting period is a predetermined time period wherein an insured individual has to wait before receiving all or part of the benefits of their health insurance coverage. It is important to be aware that during this waiting time, you typically cannot make any claims against your policy. This waiting time may be applicable to all of your coverage or just a few health issues, depending on the insurer.

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What is Waiting Period in Health Insurance?

The waiting period is, as its name indicates, the length of time you must wait in order to avail coverage against your claims. Additionally, it refers to the length of time you must wait from the beginning of your policy before you may start using its benefits in the context of health insurance.

Types of Waiting Periods in Health Insurance

There are several types of waiting periods in health insurance plans. Read below to explore more about these.

  • Initial Waiting Period After receiving a health insurance policy, the policyholder is required to wait for a predetermined number of days before making any claims or receiving any benefits under the policy. In the context of health insurance, this time frame is known as the initial waiting period or cooling period. Mostly, health insurance policies have a waiting period of at least 30 days as a requirement in the business (may vary from insurer to insurer).
    Accidental claims are the only exception to the initial waiting time; these claims are only accepted when the insured is involved in an accident and needs to be hospitalised right away. Bear in mind that each insurer has a different initial waiting period.
  • Pre-Existing Diseases (PED) Waiting Period A unique waiting period for some pre-existing conditions that the policyholder disclosed at the time of insurance purchase. A pre-existing disease is defined by the Insurance Regulatory and Development Authority of India (IRDAI) as any condition, accident, illness, or disease that has been identified up to 48 months prior to the purchase of the insurance. Thyroid, hypertension, and diabetes are a few pre-existing conditions.
    Pre-existing waiting periods in health insurance plans typically range from one to four years. The pre-existing disease waiting period, however, varies depending on the insured's health status and the health insurance plan they select.
  • Waiting Period for Specific Diseases There are several diseases like tumors, ENT disorders, cancer, stroke, and cardiac ailments, that come with a specific waiting period. The waiting period for these plans usually ranges between 2 and 4 years. The ailments that qualify for this waiting period vary from insurer to insurer and can be found in the policy details provided by each insurer.
  • Maternity Waiting Period Maternity and newborn baby coverage are available as an add-on benefit of individual and family health insurance plans. Maternity coverage is a common inclusion in health insurance plans. In each case, the coverage is available following a 2–4 year waiting period. However, some health insurance providers offer shorter waiting periods, however, the policyholders need to pay higher health insurance premiums to take advantage of that.
  • How To Reduce Waiting Period? Many insurance providers offer health insurance plans that let covered people reduce the waiting period by availing of a rider named Reduction in Waiting Period. However, the insured must pay an additional premium in order to make use of this benefit.

Can Waiting Period be Reduced?

Many organizations offer a waiver of the waiting period, which means the waiting period can be reduced. However, this advantage or feature is provided to policyholders after paying a fixed extra premium. Multiple health insurance plans have a waiting period of 48 months for listed ailments/pre-existing ailments which can be further reduced according to the waiting period waiver which differs from policy to policy.

Importance of Waiting Period in health insurance

The Waiting period in health insurance is a valuable clause as it safeguards insurance providers from possible scams and ill-intentions of many individuals. It is a mechanism built in order to keep individuals from unethical practices such as not disclosing pre-existing diseases to the insurer. Waiting Period, as the name indicates is the amount of time an insurance holder has to wait before they are covered for specific conditions.

Health Insurance Waiting Period: FAQs

1. What is the waiting period for health insurance?

The waiting period is a predetermined time period wherein an insured individual has to wait before receiving all or part of the benefits of their health insurance coverage. It is essential to be aware that during this waiting time, you typically cannot make any claims against your policy. The waiting period differs from one health insurance plan to another.

2. If an insurance holder is diagnosed with a disease will they be covered for the same?

If an insured individual is diagnosed with an ailment during the policy period, the claim will cover it, However, the condition will be applied wherein the initial waiting period has to end before they can file a claim.

3. Why does a health insurance policy have a waiting period?

There are multiple risks involved when an insurer designs health insurance for the benefit of the customer but they are misused by some. To avoid unethical practices by certain individuals waiting periods are implemented under various health insurance plans.

4. Is there a benefit if a health insurance plan has a lesser waiting period?

Yes, a lower waiting period translates to access to health insurance policy coverage in a lesser amount of time. For example, if policy A has a 48 months waiting period for pre-existing diseases and policy B has 24 month waiting period then the user can avail coverage against pre-existing diseases earlier through policy B than from Policy A.

5. How can I check if my health insurance covers my existing health conditions?

Every health insurance policy has a different waiting period for certain illnesses and conditions, insurance buyers must thoroughly understand the terms and conditions of a health insurance policy before purchasing one to understand if their existing conditions are covered or not.

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Naval Goel

Reviewed By: Naval Goel

Naval Goel is the CEO & founder of Naval has an expertise in the insurance sector and has professional experience of more than a decade in the Industry and has worked in companies like AIG, New York doing valuation of insurance subsidiaries. He is also an Associate Member of the Indian Institute of Insurance, Pune. He has been authorized by IRDAI to act as a Principal Officer of Insurance Web Aggregator.