What is the Waiting Period in Health Insurance?

When you buy a health insurance policy, you may compare different plans based on the premium rate, illnesses covered, deductibles, etc., before choosing the right policy. But another critical factor you must consider is the waiting period.

What is the waiting period in health insurance?

Waiting period is the time gap in health insurance where you cannot file a claim. In other words, it is the period where the insurance company is not liable to pay for the hospitalisation expenses you incur. The waiting period can range from a few months to a few years, depending on the health insurance plan you have. 

Now that you know what a waiting period is, it would help you understand the meaning of different waiting periods in health insurance. 

Types of waiting periods in health insurance

  • Initial waiting period

After the insurance company issues the policy, you must wait for a specific period before claiming any policy benefit. This period is known as the initial waiting period. It is also commonly referred to as the cooling period. 

Most health insurance companies have an initial waiting period clause in their policies as a standard practice. The only exception to getting any benefit under the policy during the waiting period is the accidental claim; if you are involved in an accident and need hospitalisation, the insurer will pay the expenses as per the policy terms. 

  • Waiting period for pre-existing diseases

As the name suggests, pre-existing diseases are medical conditions you may have while buying the policy. If you have any such condition, you must declare the details of the same in your policy application form. 

As per the IRDAI (Insurance Regulatory and Development Authority of India) mandate, the insurance company has the right to defer the coverage for such conditions for a specific period, which is known as a pre-existing waiting period. 

Examples of the pre-existing disease include diabetes, hypertension, thyroid, etc. The waiting period for such diseases can vary based on the health condition and the health insurance plan you choose. 

  • Waiting period for maternity

The maternity benefit is available as an add-on cover in a standard health insurance policy for individuals and family floater plans. However, some insurance companies offer special healthcare policies with a built-in maternity cover. 

Irrespective of whether you have maternity cover as an add-on or built-in feature in your policy, you may be eligible to avail of the cover after a waiting period, which can range from 2-4 years or more. 

  • Waiting period for COVID-19

The COVID-19 infection threat is rising again in India due to the Omicron variant of the Coronavirus becoming rampant. In this scenario, many people are buying coronavirus specific health insurance plans to get protection against the disease. However, you must know that you must complete a waiting period of at least 30 days before getting any claim benefit. 

Importance of waiting period in health insurance

The IRDA introduced the wating period clause in health insurance mainly to prevent policyholders from misusing policy benefits and filing a wrong claim. 

Final Word

If you want to buy a health insurance policy, make sure that you know the terms and conditions relating to a waiting period. And, if you have any existing condition or think you are at risk of any specific disease, compare the plans carefully and choose the one with the shortest waiting period.