Waiting Period in Health Insurance? Here’s What it Means!
Published On Nov 26, 2019 5:30 AM By Yamini Sharma
Health insurance is nothing less than a boon in today’s day and age. People from different age groups belonging to different geographical locations have finally showcased interest in purchasing the best health insurance according to their medical needs. What’s best is that nowadays buying health insurance has become extremely simple for people. All they need is an understanding of their precise medical needs and detailed information about the health insurance they find apt according to their financial limits and medical concerns.
If health insurance is new for you, know that it is significant for you to have a thorough understanding of all the concepts, including the waiting period.
What is Waiting Period in Health Insurance?
Waiting period is an important concept in health insurance field. It is a specific span of time before which a policyholder cannot claim some or all benefits from the health insurer. In other words, the policyholder has to wait for the waiting period to pass until the time they become eligible to avail the benefits.
Take note that the waiting period duration and its terms and condition differ from company to company. Moreover, in most of the cases, the policyholder is not provided reimbursement or coverage from their health insurance policy during the waiting period.
The Need of Waiting Period in Health Insurance?
The clause of waiting period was introduced in health insurance so as to avoid moral hazard or wrong intention of getting hoax claim benefit. Waiting period helps in eliminating cases where a customer purchases a health insurance policy just to claim and avail reimbursement, and that too without disclosing their disease or illness. It is because of the waiting period clause that unethical practices like such have deteriorated rapidly in the past few years.
Types of Waiting Period?
- Initial waiting period - Most of the health insurance companies come with an initial waiting period of 30 days to 90 days on purchase of a new policy. Under this waiting period, diseases contracted between the policy inception date and the last day of the waiting period are not paid for. However, there is an exception for any emergency hospitalisation occurring due to an accident.
- Pre-existing diseases waiting period - High blood pressure, diabetes, thyroid, are a few pre-existing diseases that one has to declare at the time of health insurance policy purchase. In case the health insurance company accepts the proposal, the insured has to wait for a period of 3-4 years before they can get their hospitalisation expenses related to declared pre-existing illness covered. Thus, it is advised to take health insurance early in life so as to avoid waiting period.
- Waiting period for specific diseases - Particular listed ailments such as hernia, ENT disorders, osteoporosis, and others come with a waiting period of 1 year or 2 years.
- Maternity benefits waiting period - Health insurance companies do not allow coverage of maternity expenses like pre & post natal soon after the purchase of the policy or at the time of your pregnancy. Maternity cover comes with a waiting period of 9 months to 48 months. Note that while some insurers offer maternity cover as a part of their basic health insurance policy, many others offer this as an add-on cover.
- Waiting period for infants or new born babies - The waiting period for infants and new born babies is generally 90 days in case of most health insurance companies.
- Critical illness (Survival Period) - Survival period is associated with critical illnesses. It is the time period that the insured individual must survive after they have been diagnosed with a covered critical illness. Note that the length of survival period generally differs according to insurers. Usually the survival period is of 30 days.
Can Waiting Period be Reduced?
There are health insurance companies that allow reduction of waiting period. However, to attain the same, one has to pay an extra premium.
Talking about group health insurance plans that the employers offer to their employees, insurance companies do not demand waiting period for health insurance. Keep in mind that according to the guidelines of IRDA, employees who are a member of a group health insurance plan can convert their group health insurance into a retail health insurance policy at the time of leaving the employer. When doing so, they will be provided with a policy without any waiting period. The reason behind the same is because they would have already served the waiting period in their group health insurance.
Things to Keep in Mind
When buying a health insurance, make it a point to go through the different kinds of waiting period associated with the policy.
It is significant for you to note that the waiting period in a health insurance policy is influenced by a series of factors. These vital elements include type of health insurance (individual health insurance, family floater health insurance, group health insurance, and others), medical history of the insured individual in addition to the age of the buyer.
Remember to read the fine print of the policy regarding the waiting period of a health insurance policy and choose a health insurance plan with a lesser waiting period without compromising on your other medical needs. Doing so will allow you to avail the benefits of your health insurance policy as early as possible rather than bearing medical expenses on your own because of a long waiting period clause.
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The waiting period concept in health insurance is of immense prominence. Emphasising the waiting period clause will help you avoid confusion or any kind of loss in the later stage.
Make sure you keep everything about the waiting period in mind while choosing your ideal health insurance policy.
If interested in learning more about health insurance policies or insurers, you can visit our website or also call our experts at 18001205698.