Modern living requires that you purchase health insurance. Many people do not know the details of various health insurance plans. The waiting period for health insurance is one such feature.
People might say they can’t get insurance benefits due to the waiting period. You may be familiar with the waiting period for health insurance and its importance. Let’s dig deeper.
Waiting Period Definition
Simply put, the waiting period in health insurance plans refers to the time you have to wait before receiving insurance benefits. The policy date is the beginning of the waiting period. The insured cannot claim any health insurance benefits while this time. There may be a waiting period for certain types of health insurance plans. This can vary from one company to the next.
This example will help you understand the waiting period for mediclaim policies better.
Mumbai resident, Mr. Dubey recently bought a health insurance policy with a Rs. 4 Lakhs. He was happy to make the decision, given his family history and lifestyle. He didn’t know that there was a waiting period for health insurance.
He suffered a heart attack ten days after purchasing the policy. He was shocked to learn that the waiting period for his health insurance was only 30 days. His claim was denied, and he had to pay the medical bills out of his own pocket.
Many people buy insurance for health purposes without understanding the terms, just like Mr. Dubey. It is important to know that purchasing health insurance does not guarantee you will be able to get coverage. Instead, you must pass the waiting period for health insurance before you can make any claims. To learn more about the waiting period for health insurance, make sure to read the policy’s inclusion and exclusion terms.
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Types of waiting periods in health insurance
There are many types of waiting periods in insurance policies that cover health insurance. Each one relates to a different condition.
- Initial Waiting Period
This is also known as the “cooling period” in insurance. It refers to the first period after the purchase date of the health plan to begin using it. You are not eligible to claim from the insurer for hospitalization, whether planned or emergency.
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Different insurers may have different waiting periods for health insurance. There may be exceptions to the waiting period for health insurance such as accidental hospitalization claims. The minimum initial waiting period for health insurance is generally at least 30 days.
- Waiting period for pre-existing diseases
You will be asked questions about any pre-existing conditions or illnesses. Then, certain tests will be performed to confirm these answers. This information also affects the waiting period for health insurance. According to IRDAI, any condition or disease that was diagnosed within the last forty-eight month of purchasing the insurance policy is considered pre-existing. These diseases include thyroid disease, hypertension, and diabetes to name a few.
This waiting period for health insurance is only applicable to those who have been diagnosed with a pre-existing condition. This means that if you have a pre-existing condition, you must wait for the waiting period to expire before you can receive any benefits. This waiting period can take up to four years for some diseases.
- Waiting period for specific diseases
The waiting period for a specific disease in health insurance is different to the initial waiting period. Many diseases, such as tumors, hernias, and osteoporosis require long-term care. The cost of this is covered by the insurance company, if the policy is purchased. For different diseases, most insurance companies include a waiting period in their health insurance plans.
The waiting period for health insurance can be anywhere from one to two years. In the plan document, the exact details about diseases and the waiting period for health insurance are clearly stated. Different insurers might have different waiting periods for specific diseases.
- Maternity waiting period
Many policies provide maternity benefits as an option, either as part of the plan itself or as an add-on. This is for people who are looking to expand their family while keeping the financial aspect in check. You cannot claim maturity benefits during the maternity waiting period. During this waiting period, any claim will be rejected by health insurance.
The waiting period for mediclaim policies typically ranges from one to four years. This clearly indicates that you should consider the waiting period for health insurance if your plans include having a family and receiving maternity benefits. Also, if you want to be able to pay for the expenses in two years’ time, get a plan today.
- Waiting period for accidental hospitalization
Life-threatening injuries often require hospitalization and treatment immediately. Due to the nature of injuries, any waiting period for health insurance could result in death. There is generally no waiting period for hospitalization following an unfortunate accident. In such cases, neither the waiting period for initial coverage nor the waiting period for renewals of health insurance are applicable.
Even if you are not enrolled in health insurance, it is possible to file a claim for accidental hospitalization. It would be helpful to ask your chosen insurance company for these details.
- Waiting period for health checks
You might have noticed that many health plans offer free health checks for the insured. This is something that every person would love to have. These benefits come with a waiting period. These benefits are offered by insurers that require a waiting period of at least one year. This means that you will not be able to claim this benefit until you have completed the one-year waiting time in your health insurance policy, which is the second year.
- Waiting period for COVID-19 coverage
The global fear of the Coronavirus infection is causing panic. India has seen its cases rise steadily since its inception. COVID insurance policies are being purchased by many people to protect themselves against financial hardship if they get the virus. There is still a chance of losing your benefits if you don’t know about the waiting period for health insurance for this condition. COVID-19 disease insurance policies have a waiting period of up to 30 days.