A critical term in health insurance policies is the waiting period. You might suddenly see the need for an insurance plan and buy one hoping to be covered under it for all kinds of diseases from the next day, but that’s not how it works. There are various waiting periods for different kinds of diseases, which also vary from company to company.
The waiting period is a fixed time duration that the policyholder waits for since the time of buying the policy and cannot avail certain benefits or coverage for certain diseases. For instance, with a comprehensive health insurance policy, the waiting periods for different coverages usually differ from insurer to insurer. The policyholder has to serve the waiting period to get the coverage for that specific condition. Experts say to avoid any kind of fraud and misuse of health insurance for pre-existing ailments, insurers usually apply a waiting period.
What are the types of waiting periods?
Generally, a new comprehensive health insurance plan comes with a waiting period of 30 days that the policyholder needs to serve before filing a claim, known as the initial waiting period under a health insurance policy. Having said that, a policyholder will not have to serve any waiting period in case of hospitalisation due to an accident. A claim for hospitalisation due to an accident can be filed from day one after the policy is issued to any individual.
On certain specified illnesses such as cataract, hernia and knee replacement, many insurers apply a two-year waiting period. Experts say these kinds of illnesses are slow-growing, therefore attracting a waiting period across all insurance plans.
What are the Pre-existing diseases (PED) that attract waiting periods?
The waiting period is generally applied to pre-existing diseases by all insurers. While buying a health plan, the insured will be asked about having any pre-existing condition such as hypertension, diabetes, kidney-related ailments or any other disease for which they are on continued medication. For such pre-existing conditions, most insurance companies apply a waiting period ranging from 2 to 4 years from the date of policy issuance.
To help policyholders better few insurers have started offering health insurance with a waiting period of 1 year for pre-existing diseases. For instance Digit Insurance, recently started offering waiting periods of one year for pre-existing diseases and specific illnesses. Similarly, Star health policy called red carpet and Bajaj Allianz silver health also offers a waiting period of one year for PED.
Similarly, those comprehensive health insurance plans that offer maternity benefits, also come along with a waiting period of 12-36 months. Along with that, illnesses such as HIV, hepatitis B, cosmetic surgeries, malignant Neoplasms, etc. falls under the permanent exclusion category and insurers never provide cover for those illnesses. Various insurance policies also offer specific cancer, critical illness and heart related plans, which can be opted for to avoid a long waiting period. Additionally, one can also choose to reduce their waiting period by paying a little extra.
While porting your policy to a different insurer, if you have served the waiting period with the current insurer, you will not have to serve a fresh waiting period with the new insurer. However, if you have not served the full waiting period with your old insurer, the remaining waiting period will be applied by the new insurer.