Health Insurance: Why you need to keep track of the waiting period in insurance plans

An important term in health insurance policies is the waiting period. You may suddenly see the need for an insurance plan and buy one in the hope that it will be covered for all kinds of ailments from the next day, but that’s not how it works. There are different waiting times for different types of illnesses, which also vary from company to company.

The waiting period is a specific period of time that the policy holder waits since the time of purchasing the policy and cannot benefit from certain benefits or coverage for certain diseases. For example, with a comprehensive health insurance policy, waiting times for different coverages usually vary from insurer to insurer. The policy holder must spend the waiting period to obtain coverage for this specific case. Experts say to avoid any kind of health insurance fraud and misuse of pre-existing illnesses, insurance companies usually apply a waiting period.

What are the types of waiting periods?
Generally, the new universal health insurance plan comes with a 30-day waiting period that a policyholder needs to serve before submitting a claim, known as the initial waiting period under a health insurance policy. Having said that, the policy holder will not have to spend any waiting period in the event of hospitalization due to an accident. A claim for hospitalization due to an accident can be submitted from the first day after the policy is issued to any individual.

In certain specific diseases such as cataracts, hernias, and knee replacements, many insurance companies apply a two-year waiting period. Experts say these types of illnesses are slow growing, and therefore attract a waiting period across all insurance plans.

What pre-existing diseases (PED) attract waiting times?
The waiting period is generally applied to pre-existing illnesses by all insurance companies. While purchasing a health plan, the insured will be asked about any pre-existing condition such as high blood pressure, diabetes, kidney disease or any other disease for which they are undergoing ongoing treatment. For such pre-existing conditions, most insurance companies apply a waiting period of 2 to 4 years from the date of issue of the policy.

To better assist policyholders, a few insurance companies have begun offering health insurance with a one-year waiting period for pre-existing illnesses. For example, Digit Insurance recently began offering one-year waiting periods for pre-existing and certain illnesses. Similarly, Star Health’s so-called Red Carpet and Bajaj Allianz Silver Health Policy also provides for a one-year waiting period for PED.

Similarly, universal health insurance plans that offer maternity benefits, also come with a waiting period of 12 to 36 months. Besides, diseases like HIV, hepatitis B, plastic surgeries, malignancies, etc. fall under the category of permanent exclusion and insurance companies do not provide coverage for these diseases. Various insurance policies also offer certain plans related to cancer, critical illness and heart disease, which can be chosen to avoid a long waiting period. Additionally, one can also choose to reduce the waiting period by paying a little extra.

While transferring your policy to a different insurance company, if you have had your waiting period with your current insurance company, you will not have to spend a new waiting period with the new insurance company. However, if you have not spent the full waiting period with the old insurance company, the remaining waiting period will be applied by the new insurance company.