Waiting Period in Health Insurance | Vital

Less Waiting Period in Health Insurance

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It is important to look after our health from a young age. But as we grow older, we might be diagnosed with critical ailments and medical bills for treatments can increase. This is why you should have a health insurance policy. Health insurance policies cover the costs of treatments and reduce the financial burden. However, they come with a waiting period before the benefits can be claimed. The waiting period in health insurance will vary depending upon the conditions of the insurance company as well as the diseases you might have. 

What Is a Waiting Period in Health Insurance?

Insurance policies have a number of different benefits and cover treatments for several illnesses. However, after you buy a health insurance policy, you will have to wait for a particular period of time before you can claim those benefits. This is known as the waiting period in health insurance. Before buying a policy, you should know the following facts about waiting periods. 

  • The waiting period for most common health insurance policies is 30 days.
  • Although most policies have a standard waiting period of a month, accidents are usually covered from day one.
  • For pre-existing diseases. the standard waiting period is 4 years. However, a lot of new-age health covers like those from Vital have reduced this to 2 years for conditions like diabetes, hypertension and cardiac ailments. After 4 years, you can easily claim the policy for treatment of a pre-existing disease, and the insurance company will have to allow it. 
  • Insurance policies also have an extensive list of pre-existing medical conditions and surgeries they do not provide benefits for before a particular waiting period is over. These waiting periods range anywhere between 2 – 4 years.
  • If you are diagnosed with any of the medical conditions in the pre-existing diseases list after you have bought the policy, then you will not have to wait. The waiting period in health insurance is automatically waived and you will be able to claim the benefits. 

What Are the Different Types of Waiting Periods?

Waiting periods are categorized based on their time spans. There are 3 kinds of waiting periods and they have been discussed below.

Waiting Period for Pre-Existing Medical Conditions:

Pre-existing medical conditions usually include diabetes, thyroid, high blood pressure, and other similar ailments. If the policyholder has any of these conditions, then they will have to specify that while purchasing the policy. Health insurance companies usually run a few tests to determine how severe the conditions are. If the condition is not critical, then only do health insurance companies in India sell the policies. If you have any such pre-existing diseases but are still able to get a health insurance policy, then you will have to wait for 4 years before you can claim the benefits. All hospital charges for any of the illnesses on the list of pre-existing diseases can only be claimed after 4 years. The health insurance companies in India will not cover the cost of any treatments (for pre-existing medical conditions) before the waiting period is over. 

A Waiting Period of 1 to 2 Years:

There are certain illnesses that do not require as long a waiting period as pre-existing diseases. These illnesses include osteoporosis, ENT disorders, hernia, and other such medical conditions. Health insurance companies require policyholders to wait for about a year or 2 years before they can claim the policy benefits. 

Waiting Period for Infants:

There are several health insurance companies that offer policies for expecting mothers or maternity policies. These usually come with a waiting period of 9 months. However, these waiting periods can also extend to 36 months depending upon the terms and conditions stated by the health insurance company. For infants, the waiting period in health insurance is usually 90 days. 

As mentioned before, all health insurance policies come with a general waiting period. This is usually for 30 days. If there is an additional waiting period applicable to the policy then the general waiting period of 1 month will be extended to accommodate the rest of the waiting period in health insurance. 

When Can the Waiting Period Be Less?

Waiting periods are usually fixed for specific diseases. Most health insurance companies will not change the waiting periods for their policies, because these are regulations set by the Insurance Regulatory and Development Authority. Some insurance companies reduce the waiting period in health insurance if you”

  • Agree to pay a higher premium
  • Opt for a group health insurance plan
  • Want to convert your group health insurance policy to an individual policy

Group health insurance plans are usually offered by employers to their employees. For such health insurance plans, companies do not ask policyholders to wait. But, group health insurance plans are usually not extensive and often have a lot of stipulations. They also provide a limited range of benefits. Therefore, it is better to research each policy, before buying it even if it has a short waiting period in health insurance. 

Not all health insurance companies in India reduce the waiting period and the entire period is not waived in the case of personal health insurance plans.  If you change a group insurance plan to a personal one, then the waiting period can be waived as you have already spent that period under the group policy. 

Waiting periods can be quite difficult for people who need immediate financial assistance with medical treatments. This is why you should buy health insurance as a young person. When you are young, you are more likely to be healthy and without ailments. This is the best time to get a health insurance policy. There is less chance of having to wait for a long period and you can claim the benefits easily when needed.

Nowadays, health insurance companies are reducing the waiting periods for elderly people as well. This is done by introducing the co-pay clause. According to this clause, the waiting period in health insurance is waived if the policyholder agrees to pay for a section of the medical bills. It is very important to read and research health insurance policies before buying one. Compare the premiums and the waiting periods and buy the one most suitable for your needs. 

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