Waiting period in health insurance

Yashish Dahiya

Most of us buy a health insurance plan to support us and our dependents against unexpected hospitalisation costs. A sudden illness or an accident would otherwise result in a huge financial burden if you do not have a health plan. However, for you to avail its benefits, you must be aware of its pre-determined conditions, the most important being the ‘waiting period.’

What does waiting period imply

Almost all health insurance plans include a waiting period provision and in a lot of limits — 30 days or more where certain procedures, treatments, usually specified in the waiting period provision, or elsewhere in the policy in connection with the waiting period provision, cannot be treated within this waiting period. Factors which impact your waiting period includes your age, pre-existing health conditions, and the type of plan you choose.

How are they classified

Following are the important types of waiting period that you need to be aware of:

Initial waiting period

Most insurers usually impose an initial waiting period of around 30 days at the start of your policy during which they will not be liable to pay for any hospitalisation charges. But in case of an accident-related medical emergency, they will cover you for the medical expenses you incur.

Pre-existing diseases waiting period

In case you have any pre-existing disease(s) at the time of buying the policy, they would be covered after the waiting period, which is usually between 1-4 years. However, most insurers have their own norms when it comes to imposing waiting periods for pre-existing conditions. For instance, if you already had a kidney failure prior to buying the policy, you are unlikely to be eligible for a health cover.

Therefore, your pre-existing disease(s), except for those for which your insurer has applied specific exclusion, will be covered after the mentioned timeframe.

Ailment-specific waiting period

In this category, your insurer will specify a certain timeframe during which your ailment will not be covered. However, common ailments such as diabetes, hypertension, hernia, age-related osteoarthritis and osteoporosis, are usually covered only after two years from the date of commencement of the policy. On the other hand, ENT disorders and polycystic ovarian diseases are usually covered after a one-year waiting period.

Maternity waiting period

Usually insurers impose a long waiting period for maternity which is stretched between 2-6 years.

The final word

When purchasing health insurance do ensure that you are fully aware of any waiting period you may be expected to serve. Utilise the free-look period to know your policy wordings especially the waiting period so that you are well-informed about its working and its exclusions.

The author is CEO and co-founder, Policybazaar.com. The views expressed in this article are his own