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Waiting Period in Health Insurance

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Almost everybody prefers to buy a health plan as it has many benefits attached to it and it is the only way to cover the medical expenses in a planned manner. However, access to some important benefits is available only if you fulfill certain pre-determined conditions. One such condition is waiting period.

What Waiting Period stands for?

The waiting period stands for the duration for which the Insured has to wait to avail all the services of the insurer. Different insurers have different norms and policies on the subject of waiting period

Determinants of the waiting period

Age of the insured, kind of the medical insurance Policy and Pre-existing health conditions are the major contributing factors for the determination of the waiting period. The good news is that waiting period does not apply to almost every Health Insurance benefit. Let’s see what else is considered important when discussing about the waiting period.

When does waiting period not apply?

When you acquire a health insurance policy, you do not get immediate health coverage. Instead, you may have to wait for the period of 30 days from the date of acquiring the policy. This period can stretch to even 90 days for some people. However, you get covered for a treatment that requires Hospitalization or surgery due to accidental external injury, but no Coverage would be provided if hospitalization occurs due to any sickness reason.

Conditions of waiting period

In case of pre-existing diseases:

Given that every Insurer has a different norm, waiting period for coverage on pre-existing health conditions can vary from 2 to 4 years. But again, the insured can avail the coverage on other ailments during those initial years of commencing health insurance

In case of specific disease: This specific disease or the health condition is not fixed and can differ from company to company. It depends on the insurer you choose for the coverage. Insurers ask to wait for 2 years generally, to avail the coverage of the specific disease. Diabetes, hypertension, hernia, osteoarthritis, osteoporosis, polycystic ovarian syndrome are some of the health conditions and there are many more. The insurer can put the condition of waiting period on any one of these or a set of diseases.

Why do insurers put this condition?

There are many people with deceptive mindsets who can raise large claims and after receiving the reimbursements can call off their policy. Consequently, the insurer will have to bear the loss. Therefore, the condition of waiting period has been designed purposefully, to protect the insurer’s fund.

Switching insurers by the insured was another reason to put waiting period condition. Nonetheless, IRDA has changed the policy and there would be no waiting period condition applied on porting the policy from one insurer to another as well as on changing the coverage plan from one to another.