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What Is a waiting period in health insurance?


Earlier, people’s health degraded with age. But in today’s world, age is not the only factor that affects an individual’s well-being. The changes in lifestyle have made us prone to diseases even at early ages. Excessive intake of junk food, a sedentary lifestyle, and no physical activities are the most prominent reasons that have reduced our immunity, increasing the chances of us falling ill. Therefore, health insurance is of utmost importance in today’s world.

Most health insurances come with a certain waiting period. You might be wondering what is a waiting period in health insurance? This article is all about it. So let’s understand the concept of a waiting period.

What is a waiting period in health insurance?

The waiting period is the time span during which you cannot file an insurance claim. It is a buffer period where the policyholder cannot make a claim even though his policy is active. The waiting period varies from insurer to insurer and policy to policy.

This concept of the waiting period was introduced to put an end to the unethical use of health insurance policies. It was also initiated to prevent the policyholders from filing hoax claims.

Types of waiting period

There are various types of waiting periods that differ from one health insurance policy to another. Out of these, the three major categories are discussed here:

1. Initial waiting period

In case, the policyholder gets hospitalized in the first 30-90 days after taking up the policy, he will not be able to avail of any claim benefits. To enjoy the benefits of the insurance policy this initial waiting period has to get over.

Note: Accidental hospitalization is covered from the first day itself.

2. Pre-existing disease waiting period

If a person declares that he or she is suffering from any diseases at the time of taking up the policy, the illnesses are then given the term of pre-existing diseases. Diabetes, blood pressure, thyroid, etc are a few common examples of pre-existing diseases. In such cases, a medical test is conducted to determine the impact of these diseases. Usually, a waiting period of 4 years is prescribed in these circumstances. This implies that any medical costs will be covered after the completion of 4 successful years of the policy.

3. Maternity benefits waiting period

The waiting period for availing of maternity benefits usually varies from 9 months to 36 months depending on the insurance company. A few insurance policies also offer protection to infants, but they have a waiting period too which usually lasts for 90 days.

4. Disease-specific waiting period

There is a specific waiting period that is prescribed for a few particular ailments like, tumors, ENT disorders, hernia, osteoporosis, etc. It depends upon one company to the other, but mostly the waiting period for these diseases varies from 1 to 2 years.

Other than the type of insurance policy opted and the insurance provider, there are various other factors that affect the waiting period too. The medical history of the insured, the age of the buyer, the number of people covered under the insurance policy, etc are few such factors. It is advisable to take up health insurance at an early age to avoid the chaos that might be caused during the waiting period.

Are you looking for a new insurance policy or a policy renewal? Reach out to us and let us assist you.

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