Waiting Period in Health Insurance – Simplified

Not just premiums and coverage, the waiting period is an important factor to be considered for health policies too. Here’s all that you need to know.

Waiting Period in Health Insurance – Simplified

When comparing health insurance policies, one looks for the optimal coverage and lower premium rates, but the underlying procedures like the waiting period are often ignored. This causes a person to lose coverage from day one. These clauses can make your policy redundant for a set period. Familiarity with this aspect can help you to save both the time and the money.

What is the Waiting Period?

It is the time that insured individuals must wait, to avail the health insurance benefits. However, this period is not the same for all medical cases. Most health insurance policies have an average of 4 years for pre-existing conditions. If you contract any such diseases after 4 years, you will get the complete claim.

For any disease-related claim,  you will have to wait for 30 – 90 days before making any claim, depending on the insurer. This period is also called the cooling period or the exclusions.

Who Needs to Know About Waiting Periods?

Anyone applying for a health insurance policy or those having one should know the term’.

Why Is It Important to Know About the Waiting Period?

As a policyholder, you assume your coverage starts as soon as your policy is activated. But, this is not true. Consider you have a family history of some disease. As a precaution, you buy a comprehensive health insurance policy. You also get an add-on plan for that disease.

Two years down the line, if you are diagnosed with the disease, the claim would be denied since the waiting period here was 3 years.

Types of Waiting Periods

Here are some of them know you should definitely know about:

Cooling-off Period

Health insurance policies are usually active post 30 days (or even 180 days) of the policy’s purchase. So, if you fall sick before this period, you will be denied any claim. In this initial period, your policy is invalid. However, exceptions here include accidents. In such cases, you would be covered for hospitalisation or other medical expenses.

Pre-existing Conditions

Some policyholders suffer from adverse medical conditions and diseases. Something they are aware of before or when opting for the health insurance. If hospitalised due to these diseases occur, you would not be covered. Most insurance companies have an average 4-year waiting period in such cases.

Specific Disease Waiting Period

Diseases don’t come knocking on the door. But, your insurance provider would have a fixed waiting period for these. Usually, this period is 2 years, post the commencement of the policy. Some diseases under this category include ovarian diseases, hypertension, piles, hernia and diabetes.

Maternity Waiting Period

It is usually in the range of 9 months to 36 months post the policy’s commencement date. So, if you want maternity coverage, you may have to plan your baby around it.

Can You Waive Off the Waiting Period?

Some insurance providers waive off or reduce this period for higher premiums. It is in corporate health insurance plans. As per the IRDAI, the group health plan policyholders can shift to individual policies. In such cases as well, you don’t have to wait.

Conclusion

When comparing multiple health insurance policies, it is essential to know about the waiting period. This will help you to minimise the risks of not getting claims.

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