What Is a Waiting Period in Health Insurance?

Due to the increase in the host of diseases can affect our health, the variety of health insurance plans and critical illness insurance plans offered by insurance companies are also varied. Health-related policies cover several medical costs that may arise from consultations, medical check-ups, screenings, and more. Thus, it is a wise decision to purchase mediclaim.

However, before you do so, you must be aware of every aspect of an insurance policy.  One such significant aspect is a waiting period. This is defined as a specific time limit that must expire before the insurance company considers to cover any pre-existing disease of the policyholder. The standard waiting period offered by many companies is four years, but some offer a lower period as well. Thus, you can apply for a claim for medical expenses of certain diseases only once the waiting period has ended.

You should note that insurers do not emphasize on waiting periods when it comes to group health insurance plans.

What is an ideal waiting period?

The ideal waiting period is around two years or so. This helps you to reap the benefits of the insurance policy without waiting too long.

However, this differs among the types of waiting periods. A waiting period in case of a pre-existing disease is when the policyholder suffers from a disease at the time of registering for a health insurance plan. Thus, the hospital charges of declared diseases can be availed only after the waiting period expires, which is generally four years.

There is a certain list of diseases for which the waiting period is reduced to one or two years. These ailments are ear-nose-and-throat (ENT) disorders, hernia, and others. Except for cases related to accidents, the general insurance waiting period is one month. For infants, it is approximately 90 days. A few insurers provide maternity benefits as well with a nine- or 36-month waiting period.

Solution to long waiting periods

Some insurance companies allow you to shorten the waiting period if you pay a higher premium. Also, as per the Insurance Regulatory and Development Authority (IRDA) regulations, members of a group package can convert their group policy into an individual plan when leaving the company. This conversion can be done without a waiting period if the policyholder has already spent the specified tenure.

It is recommended that you compare health insurance plans to review which provider offers you the lowest waiting period at a cost-effective premium.

Louise Author