What is Waiting Period in Health Insurance?

You will have basic knowledge of health insurance if you are landed here. We are sure you came to know the brief of those technical terms, like a waiting period. You’ll be aware of the waiting period once you complete this article.

If you have heard advice on health insurance, for sure, you would have got to choose a plan with a minimal waiting period! How will you be affected by a long waiting period? Let’s break the ice!

Key Takeaways

• If the holder is diagnosed with diabetes, hypertension, or any other chronic diseases after the document is set, the holder can avail of the benefits of the health insurance policy.
• Almost every insurance company has canceled or reduced the waiting period for senior citizens. 
• Try to take a health insurance policy at an early age so that you’ll lessen the chances of waiting for a longer period.
• Spend some time understanding health insurance because it not only saves you from unexpected medical expenses but it is the basic step toward your financial freedom.

What is the Waiting Period for Health Insurance:

Some features of your health insurance policy cannot be claimed immediately, but they can be accessed after a certain period. This period is the waiting period for health insurance. 

The time and terms of the waiting period vary for every company. Also, it varies according to the pre-existing diseases of the plan holder.

In a sentence, you cannot claim the benefits when your policy is in a waiting period, even if you are hospitalized.

Types of the waiting period in health insurance:

Initial Waiting Period :

It is the period from the day you complete all the processes to begin a health insurance policy to the day you can avail all the benefits.

Most insurance companies have an initial waiting period of 30 days. Except for accidental claims, you cannot apply a claim, even if it is an emergency.

Pre-existing Disease Waiting Period:

You would have undergone a medical test as a part of the health insurance process. The result of the test will be reflected in your waiting period.

Diseases like heart problems, diabetes, hypertension, or any other chronic diseases will come under this category.

The waiting period for pre-existing diseases is 2 – 4 years. If the holder needs a claim for any of the mentioned diseases, then he must have completed the waiting period.

Disease or Procedure-Specific Waiting Period:

The insurance company will have its list of diseases or procedures in the policy. For instance, hernias, tumors, ENT disorders, some surgical procedures, etc.

The disease and its waiting period will be mentioned in the document. Usually, the waiting period for disease or procedure-specific waiting period will be 1 – 2 years.

Maternity Waiting Period:

If your family is planning for a baby, then you can add maternity and newborn baby addons. The insurance policy will cover maternity benefits, delivery expenses, and expenses of the newborn for the first three months.

Usually, the maternity waiting period is nine months to 36 months, but it varies for every insurance company.

How does the waiting period work in health insurance?

It is as simple as that! When you apply for health insurance, you will undergo some process which includes a medical test.

According to some terms of the company and the result of the medical test, the document will be created. In which the waiting period, inclusive and exclusives will be mentioned. 

From day one to day 30 ( day 90 ), in some companies, is the initial waiting period. If you have any diseases, the waiting period will be mentioned in your policy document.

You cannot apply for a claim during the waiting period; in case you make a claim, it will get rejected as per the terms.

What is the need for a Waiting Period for Health Insurance?

In today’s world, burglars are technically smart enough to steal in all possible ways. Just to avoid some unwanted situations waiting period is incorporated into a health insurance policy.

Just imagine, what if a person is claiming every month for some pseudo reasons? The insurance company may run in negative.

To prevent the loss from those fraudulent situations and help people with their medical expenses, the waiting period is integrated with health insurance.

Can We Reduce the Waiting Period?

The answer is a mixed one! Some companies do not give any chances to reduce the waiting period, but some companies allow the holder to reduce the waiting period by paying an additional premium to the insurance company.

What is a Zero waiting period?

A zero waiting period is when you can avail the benefits of the health insurance policy without any waiting period. This happens in two situations.

One is when you claim for accidental hospital expenses, and another one is when you can claim for pre-existing diseases from day one.

 Of course, it will be mentioned in the document; check your document twice.

The former is applicable in all insurance companies, but the latter is available in very few insurance companies, have an eagle eye on it while taking a health insurance policy.

How do Pre-existing Diseases Affect the Waiting Period?

If the holder has pre-existing diseases like hypertension, diabetes, heart disease, or any other chronic diseases, that will be mentioned in the policy document. These diseases will have a waiting period of 2 – 4 years to make a claim. 

For instance, if the holder has a heart problem and he was affected by subsequent attacks in 3 months, the person will claim health insurance every single time. So, to avoid this, the waiting period for the mentioned diseases is regulated.

Minimum and Maximum Waiting Period:

The minimum waiting period for health insurance is 30 days, and the maximum waiting period is five years. Anyhow, these are the general terms, but every insurance company has its terms, and the minimum and maximum waiting periods differ for every company.

What is the Survival Period?

In case a policyholder is diagnosed with a critical disease like heart attack, organ failure, etc., the holder must survive for the mentioned duration of time to avail of the claim benefits. Generally, this duration will be from 15 days to 180 days, based on the disease’s condition. 

If the holder claims during this period and survives for the mentioned days, the insurance company will pay the lump sum and terminate their policy. 

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