What is Waiting Period in Health Insurance

2 min read

Health insurance plans provide a comprehensive scope of coverage against medical costs. They cover you for your hospitalisation and treatment expenses and spare you any financial difficulty related to your medical costs. Moreover, health insurance plans also provide various value-added coverage features to enhance your health insurance experience. However, there are some terms and conditions and exclusions associated with the coverage available in a health insurance plan. One such term is a waiting period. Do you know what it means?

In simple terms, waiting period in a health insurance plan means a period during which coverage for a particular ailment or treatment is not available. You have to wait out the specified period before you can enjoy coverage for such treatment or illness.

There are different types of waiting periods in a health insurance plan which you should know about

Pre-existing waiting period

This is the most common and important waiting period which is applicable in all health insurance plans. Pre-existing illnesses or diseases are those illnesses which are present when you buy a health insurance plan. Since the insurance company knows that you already suffer from those diseases, cover for complications arising out of such pre-existing illnesses is delayed. The plan offers coverage after the first few years. This duration during which coverage for pre-existing illnesses is not allowed is called the pre-existing waiting period. This period ranges from 12 months in some plans to 48 months. If you receive treatments for your pre-existing illnesses during the waiting period, the cost of such treatments would not be covered by your health insurance plan. Once the waiting period would be over, your pre-existing illnesses would be covered.

Waiting period for specific treatments

Health insurance plans list specific treatments which have a waiting period of 1 year, 2 years or 4 years. For instance, joint replacement surgeries might be covered in your health insurance plan after a waiting period of 4 years. Similarly, appendicitis, cataract, piles, fistula, hernia, etc. are covered after a waiting period of 1 or 2 years.

Maternity waiting period

If your plan allows you coverage for maternity related expenses, there would be a waiting period associated with the cover. Maternity expenses incurred after the waiting period would only be covered. The waiting period for maternity cover ranges from 9 months to 6 years depending on the available plans.

Initial cooling off or waiting period

Another waiting period, which is common in health insurance plans, is the initial cooling-off period of 30 to 90 days. During this period, which starts from the policy start date, claims for illness related hospitalisation are not honoured. Accidental hospitalisation claims are, however, payable during this waiting period.

When you buy a health insurance plan you should know about these waiting period so that you would know how and for exactly what your health insurance plan offers you coverage.

Choose wisely!

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Gayatri Prabhu, Head-Digital Business at Mahindra Insurance Brokers Limited (MIBL) is one those few digital leaders who has the width and depth that is required to execute an ROI driven holistic digital strategy. She cuts through the noise, identifies the critical levers and leads her team to successful execution of the defined strategy. Her core mantra to win new and retain existing customers is: understand the consumer behavior and craft experiences around it.

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