Buying A Health Policy? Know About Waiting Period

By Adhil Shetty | February 13, 2018

It is important to read the fine print before you buy a health policy to understand the terms and conditions associated with the policy.

Buying A Health Policy? Know About Waiting Period

Buying a Health Insurance Plan is important to protect yourself and your family from medical emergencies. However, one should remember that buying a health insurance policy doesn’t mean that you get covered from day one of the policy. While a good health plan secures you, but before you buy one, you should be well versed with all the terms and conditions, including a waiting period, survival period or exclusions.

In this article, we will discuss the waiting period, which is basically the time period in which you cannot claim any benefit from the insurance policy. The waiting period differs from company to company, disease and some other factors.

Why Waiting Period?

A waiting period is mandatory in every health plan to avoid situations when the policyholder makes a large claim just after buying the policy and cancel the plan post that. If there is no waiting period, then the premium will increase by a big margin as the insurance companies will look to cover themselves from the loss arising out of large claims just after the policy is sold. Hence, in other words, waiting period protects the policyholder from paying high premiums.

Types Of Waiting Period In A Health Policy

Waiting period depends on the ailments, pre-existing diseases and other causes covered under the health plan. So, what are the different types of waiting periods in a health plan?

Initial Waiting Period (One Month): A general health insurance will have a one month waiting period except in cases of accidents.

One Or Two Years Waiting Period For A Particular Ailment Or Disease: Health policy puts a waiting period of one or two years for any particular ailment or disease such as ENT disorders, hernia, and osteoporosis, among others.

Four Years For Pre-existing Diseases: What is a pre-existing disease? If any person suffers from any ailments or has declared to be suffering from health problems such as diabetes, high blood pressure and thyroid at the time of buying the policy, then it is considered as a pre-existing disease. Insurance companies insist on a medical test before they give health plan for pre-existing diseases. Usually, they put waiting period of four years before a policyholder can claim any hospitalisation or medical expenses related to these ailments. Hence, it’s always advisable to buy a health plan when you are young to cover these waiting or cooling period with ease.

Waiting Period For Maternity Benefits And New-Born Babies: Insurance companies put a waiting period of 9 months to four years before accepting a claim on maternity benefits. Some insurance companies who ask for a waiting period of 9 months charge an extremely high premium. Besides, there is a waiting period of 90 days for new-born babies as well.

Exceptions:

If you are covered under a group health plan provided by your employer, then insurance companies do no put up a waiting period clause and hence, you are free to make claim whenever the need arises.

Besides, if you insist on reducing the waiting period, then the insurance companies will ask you to pay a higher premium for the health plan.

What If You Are Diagnosed With A New Ailment During The Waiting Period?

In such a situation, the ailment will not be classified as a pre-existing disease and you will be duly covered for it.

Can I Do Away With This Waiting Period Altogether?

Few insurance companies may ask you to go for co-pay if you wish to do away with the waiting period. It means you will too have to bear the cost of the claim along with the insurance company. The ratio is usually fixed by the insurance company. This facility is advisable for aging parents or senior citizens who are already suffering from pre-existing diseases and may need medical attention soon.

Hence, it is important to read the fine prints, the waiting period, the terms and conditions carefully before you opt for a health plan.

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Adhil Shetty

About Adhil Shetty

Adhil Shetty is the Founder and serves as the Chief Executive Officer of BankBazaar.com. Adhil has a Master’s degree in International Relations with a specialization in International Finance and Business from Columbia University in the City of New York, and a Bachelor’s degree in Engineering from the College of Engineering Guindy, Anna University. Adhil is an expert in Personal Finance (Car loan/Home loan and personal loan) and he majorly consults on investment and spends rationalization for the Indian loan borrowers. His guidance is number based with real time interest rate calculations and hence useful for consumer’s real time query.

2 thoughts on “Buying A Health Policy? Know About Waiting Period

    1. Team BankBazaarTeam BankBazaar

      Hi Dev, Glad you found our article useful. Cheers, Team BankBazaar

      Reply

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