You cannot deny the fact that having health insurance is more than a necessity. A sudden illness might drain all that you’ve saved, so why not secure yourself and your savings with a comprehensive health insurance plan?
Once you buy health insurance, there’s a sense of ease in knowing that you are now protected against a multitude of health conditions, and that your policy comes with a range of benefits like in-patient hospitalization, pre-and-post hospitalization, ambulance cover, daily cash allowance, etc.
However, when the need arose to make a claim for treatment of an illness that you had before you purchased the policy, the claim request got rejected.
An instance like the above is not something you’d fathom, but it still happens. Did you check all the ‘terms and conditions’ associated with your policy? Maybe you are still in the ‘waiting period’ of your health plan.
In simple words, ‘waiting period’ in a health insurance policy is a specified period of time after which some or all of your health care coverage begins. And, during this period, any claim related to the waiting period is not admitted.
Every health plan comes with a list of inclusions and exclusions. Furthermore, there are certain clauses associated with the inclusions as well. And one of these clauses is the ‘waiting period’.
What is a waiting period?
When you a buy health insurance plan, the initial period during which no benefit is payable for certain medical procedures or services is termed as the ‘waiting period’. However, waiting periods can also apply to any additional benefits of your health plan when you change or upgrade your health insurance policy.
Why are waiting periods an essential part of a health plan?
Waiting periods play an essential role in health insurance as they encourage people to buy health insurance at the right time. If there were no waiting periods, people would buy insurance or upgrade to a comprehensive coverage only when they would require medical treatment. This practice, in totality, would lead to much higher health insurance premiums.
Types of waiting periods in a health insurance plan
Health plans do not offer complete coverage or exclude the coverage for certain conditions for a specified period during the waiting period. If you suffer from any complication due to any pre-existing disease during the waiting period, your health plan will not cover the costs of your treatment.
Here are the three main types of health insurance waiting periods: –
1.Initial waiting period
At the start of your health cover, most health insurance companies have an initial waiting period of 30 days to 90 days. During this waiting period, your health plan will not pay for any medical treatment, except in case of accident cases. This initial waiting period applies to almost all health policies. However, this waiting period does not apply to accident cases.
2.Pre-existing condition waiting period
A pre-existing condition is any health condition that you already had before buying the health plan. But, your health plan will cover these pre-existing conditions only after a waiting period. This means that all your pre-existing conditions will feature in the policy exclusions unless you go through the waiting period. The length of this waiting period can vary anywhere between 12 to 48 months depending on your health insurance provider.
3.Maternity waiting period
Most health plans do not cover maternity and related conditions. But, there are some health plans that offer maternity benefits, but these benefits are only available after a waiting period of 9 months to 48 months. So, if you are considering starting a family, you need to buy a health insurance plan much ahead of planning your family, so that all the expenses are covered.
A few things about waiting period that you should know
- Waiting period is applicable to all health plans except in group health insurance policies
- Accidental cases are covered irrespective of a waiting period
- If you are diagnosed with a health condition for the first time during the waiting period, it will not be considered as pre-existing disease
- Waiting periods can vary from one provider to another, so you must understand the waiting period clause in your health policy
Although you cannot escape the ‘waiting period’ clause in a health plan, it is important to read the fine print to understand your policy in a better manner, and avoid any surprises when you make a claim.
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