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Waiting Period in Health Insurance-All You Need to Know

Updated On Dec 04, 2020

Waiting period in health insurance is defined as the time period when claims are not admitted. The policyholder must pass this duration before he/she can make all or some of the health insurance claims.

The waiting period in health insurance depends on different conditions and coverage features. For instance, in health insurance, there can be a waiting period for pre-existing diseases, to avail maternity benefits or general waiting period after the commencement of the policy. 

Health insurance companies imply waiting period in health insurance so that people don’t get a policy issued after they have been diagnosed with some illness. 

Types of Waiting Period in Health Insurance 

Important waiting periods in an individual or family health insurance are mentioned below: 

1. Pre-existing condition exclusion waiting period

This is a type of waiting period that has particular ailments. It is for those who have a condition of certain illnesses like diabetes, thyroid, high blood pressure prior to 6 months of getting insured. These are known as pre-existing diseases. 

The pre-existing condition exclusion waiting period specifies that your insurance coverage can be limited or excluded for any pre-existing condition. This type of waiting period varies from 12-48 months. Therefore, the conditions mentioned above will only be covered under your health insurance after the time frame specified in your policy. 

2. An initial waiting period of 30-90 days

Majority of health insurance companies have an initial waiting period of 30 days to 90 days. Any disease diagnosed within this period will not be paid for, except for the cases involving accidents. This is implied for a clear reason that people don’t buy a policy after they are diagnosed with serious illness. 

3. Maternity waiting period/waiting period for pregnancy

There are a few health insurance companies which offer maternity benefits. But, a majority of them have a waiting period from 9 months to 48 months. This certainly means that you must plan health insurance much ahead of family planning in order to cover all the expenses involved in the same. Remember, it cannot be taken after conceiving. 

Can I Reduce My Waiting Period?     

To your surprise, yes, you can reduce the waiting period of your health insurance. Some companies give the insured this option by charging a little premium. As a smart insurer, you can include this period before providing policy benefits to the insured individual. 

As per the guidelines of IRDA, if you are a member of group health plan offered by your employer, you can convert your group cover to an individual retain health policy at the time of leaving that employer. You get an advantage here of not fulfilling the waiting period as you have already completed the same previously.  

Also read: Want to Get Your PED Conditions Covered? Here's a List of Plans with Low Waiting Period

Things to Remember

1. In case the person to be insured is diagnosed with a disease for the first time in the waiting period, it will not fall in the category of pre-existing disease. The disease will still be covered in your health insurance policy. 

2. Insurance companies with changing times have designed a plan for senior citizens. Here, the waiting periods have been done away by adding a co-pay clause. In the co-pay clause, the policyholders bear a specific percentage of the claim amount. For instance, for a co-pay of 30% in a claim of 1 Lakh, the insured has to bear INR 30,000.     

3. Pre-existing conditions and severe medical conditions demand costly treatments. It may happen that you urgently need funds to treat a pre-existing disease, and are looking for a no waiting period health insurance plan. But policies that fulfil such requirements are often not available.

The best you can do here is to find a plan on with the lowest waiting period. Our experts will help you to get insured early while you are healthy and wouldn’t be impacted by the waiting period clause. 

4. The waiting period is also known as the cooling period. By now you must have got your concepts cleared on waiting period in health insurance. So, if you have been planning to get yourself insured with a good health insurance policy, then check out the plans available with the shortest possible waiting period. 

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