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What is the Waiting Period in Health Insurance?

Updated On Mar 14, 2022

The waiting period, as the name implies, is a period of time during which a policyholder must wait to be eligible for specified benefits under a health insurance policy. During the waiting time for health insurance, you will not be able to use any of the stated advantages. The minimal health insurance waiting period varies from company to company. However, you must be aware of the Mediclaim policy's waiting time, as well as its terms and other essential exclusions.

Waiting Period In Health Insurance

The waiting period in health insurance refers to the amount of time the insured must wait from the date of the policy's issuance before being able to use the policy's benefits. A waiting period's rules and conditions differ from one insurance company to the next. Even throughout the policy term of a particular health insurance policy, the covered individual is not entitled to receive coverage benefits for some mentioned conditions due to a waiting period in health insurance. For example, most health insurance policies include a waiting period for pre-existing conditions. This means that after completing a four-year waiting period, which begins on the policy's start date, any covered person will be eligible for coverage benefits for pre-existing conditions.

Types of Waiting Period In Health Insurance

1. Initial Waiting Period

The policyholder must wait a specific number of days after getting a health insurance policy before collecting any claim benefits under the policy. In health insurance, this period is known as the initial waiting period or cooling period. All health insurance policies come with a waiting period of at least one month and up to ninety days as typical in the industry. Accidental claims are the only exception to the initial waiting period, as they are only accepted when the insured is engaged in an accident and requires rapid hospitalization. It is worth noting that the initial waiting period differs greatly amongst insurers.

2. Pre-Existing Diseases Waiting Period

It is a particular waiting period for pre-existing diseases that the policyholder discloses at the time of policy purchase. A pre-existing disease, according to the Insurance Regulatory and Development Authority of India (IRDAI), is any condition, accident, ailment, or disease that is diagnosed within 48 months of the policy purchase. Thyroid, hypertension, and diabetes are examples of pre-existing disorders. In most health insurance policies, there is a 1-4 year waiting period for pre-existing conditions. The pre-existing disease waiting period, on the other hand, varies depending on the insured's health and the health insurance plan they choose.

3. Waiting Period for Specific Diseases

Several conditions, such as hernias, tumors, ENT disorders, cancer, strokes, and cardiac problems, have a specified waiting period. These programmes often have a two-year to four-year waiting period. The illnesses that qualify for this waiting time differ from insurer to insurer and can be discovered in each insurer's policy terms.

4. Maternity Waiting Period

Individuals and families with health insurance plans have the option of adding pregnancy and newborn baby coverage as an add-on benefit. Many health insurance plans include maternity coverage as a standard feature. In either case, the coverage can be obtained after a two- to four-year waiting time. Some health insurance firms, on the other hand, provide shorter waiting periods, but policyholders must pay higher health insurance rates to qualify.

5. Waiting Period for Coronavirus

Because of the rising prevalence of coronavirus in India, many people are purchasing coronavirus-specific health insurance for themselves and their family. However, in order to receive coverage benefits such as hospitalization and treatment under these policies, the insured must wait up to 30 days.

Importance of Waiting Period in Health Insurance

A waiting period in health insurance is implemented to prevent individuals from claiming benefits under a health insurance policy with the improper motive. Customers without health insurance policies have purchased health insurance policies after being diagnosed with a specific ailment without reporting the diagnosis to the insurance provider in some situations. To avoid unethical acts like these, health insurance policies include the concept of a waiting period.

Take Away

It is advisable to purchase health insurance as soon as possible. This is because when you acquire health insurance early, your health is at its best. This implies you can easily get through the waiting time without having to rely on insurance benefits. When you reach retirement age, you will have completed the waiting period and will be entitled for all policy benefits.

Also Read: Understanding Health Insurance Policies in General

Disclaimer: This article is issued in the general public interest and meant for general information purposes only. Readers are advised not to rely on the contents of the article as conclusive in nature and should research further or consult an expert in this regard.

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