Waiting Period In Health Insurance: What Is It & Why Is It Important?
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5 May 2022The waiting period in health insurance refers to the duration or period that one has to wait before claiming health insurance benefits. Insurance providers do not offer any coverage to any claims within that period.
The waiting period varies as per the different circumstances or situations of the insured. Therefore, if you know this variance of the waiting period, you can claim benefits wisely.
Table of contents
Different Types of Waiting Periods in Health Insurance
You can file a claim only after the minimum waiting period of the health insurance policy is over. However, there are different types of waiting periods for health insurance. You can avoid getting rejected by insurance providers if you make an informed claim. So, read the following to know more about the types of the waiting period in insurance.
Initial Waiting Period
The initial waiting period indicates the minimum duration that a person needs to wait to get any insurance benefit. You can claim health coverage only after this initial waiting period.
In general, a standard initial waiting period of 30 days is common among all health insurance providers.
Waiting Period for Pre-existing Disease
Before obtaining a health insurance plan, you must inform all of your pre-existing diseases to the insurer. It refers to all kinds of treatment, medical advice, diagnosis, or symptoms of diseases an individual has undergone in the last 48 months.
Usually, a person has to wait for three to four years on average to claim health insurance benefits for pre-existing diseases.
Waiting Period for Accidental Hospitalisation
There is no health insurance policy without a waiting period. However, in case of hospitalisation due to accidental injury, no pre-existing waiting period is applicable.
Maternity Benefits in Waiting Period
Policyholders can claim coverage after the completion of a specific waiting period of maternity benefits. The expenses of hospitalisation and delivery get covered by the maternity benefits.
Generally, the average period for maternity benefits ranges from one year to four years.
Waiting Period for Specific Diseases
There is a specific limit in the waiting period for health insurance for a list of specific diseases. Insurance holders need to wait for two to four years as per the guidelines of policy providers. Specific disorders include ENT disorders, cataracts, tumours, osteoporosis etc.
Also Read: Health Insurance Plans For Diabetes Patients
Reason for Waiting Period for Health Insurance
A health insurance policy works by sharing the health coverage and collecting the premiums from policyholders. However, premiums paid by policyholders are always less than the monetary coverage by insurers.
The waiting period helps insurers in preventing misuse of health insurance policies. One can manipulate health coverage of the insurance if there is no waiting period. Had there been health insurance policies with no waiting period, policyholders could claim the coverage a few days after purchasing the policy.
Possibility of Reducing Waiting Period
The length of the waiting period depends on the insurance provider. Some insurers provide the option of a lesser waiting period at the cost of a higher premium price. You can reduce your average waiting period by two to four years if the insurer allows you to do so. Thus, with a reduced waiting period, one can obtain his policy’s benefits faster.
Co-Pay Clause of Waiting Period
This clause stipulates that policy owners pay a certain share of the hospitalisation cost while the insurer would cover the other remaining amount. Some insurance providers manage to provide the health insurance of elderly persons by using a co-pay clause.
Also Read: How To Select An Affordable Health Insurance Plan?
Final Word
You should read the terms and conditions regarding the waiting period for health insurance carefully before purchasing a policy.
You can read the policy-related guidelines from the official websites of your insurer. The waiting period restricts policyholders from manipulating health insurance policies. It varies from one company to another; therefore, one should be aware of the policy guidelines.
Frequently Asked Questions
Ans. You will surely get benefits if you buy a health insurance plan at an early age. You will get to pay a lower premium price as you enter a plan at a younger age and stay in the health insurance plan for a maximum period.
Ans. You will get medical coverage for a new disease only when you claim benefits after an initial waiting period. You can file for a claim after an average initial period of 30 days. However, it depends on the policies of different insurers.
Ans. You have two options to claim health insurance coverage. First, you can get cashless treatment if you plan accordingly with your insurer beforehand. Secondly, you can provide the insurers with medical bills, medical certificates, cash memos, discharge cards, etc., to claim reimbursement.
Ans. You can buy a health insurance plan from Navi App. The best thing is that it’s completely paperless and can be availed within two minutes.
Ans. You cannot avoid the waiting period of your health insurance plan. However, you can get around the problem of the waiting period by purchasing health insurance plans early.
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Disclaimer: This article has been prepared on the basis of internal data, publicly available information and other sources believed to be reliable. The information contained in this article is for general purposes only and not a complete disclosure of every material fact. It should not be construed as investment advice to any party. The article does not warrant the completeness or accuracy of the information, and disclaims all liabilities, losses and damages arising out of the use of this information. Readers shall be fully liable/responsible for any decision taken on the basis of this article.
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