Health insurance plans are often riddled with jargons. Not only the make it difficult for new buyers to comprehend what they mean, but also create confusion in selecting a plan that fits you right. Hence, it is best to understand these terms before entering in a contract of insurance.
One such term that regularly gets new policyholders confused is the waiting period—what it means, how does it impact the policy terms and the coverage are some of the concerns that needs to be addressedwhen buying a mediclaim policy.
What is waiting period in a health insurance plan?
Waiting period is the duration for which the policyholder needs to wait out before making any insurance claim. During such period, the claim raised by the policyholder is not paid owing to the terms of the insurance plan. Such period varies for every insurance plan and hence, it is essential to know the waiting period of the policy.
What are the types of waiting period to check in a health insurance policy?
Considering the different types of policies that are available, there is no one fixed duration when it comes to waiting period. Based on the type of plan and what ailments it covers, the waiting period differ across health insurance policies. Here are the different types of waiting periods to know of:
1. Initial waiting period
Initial waiting period, also known as cooling period, is the waiting period which is applicable when you buy a health insurance policy. During this initial waiting period, no claims for hospitalisation are honoured by the insurer. However, an exception where the initial waiting period is not applicable is in case of hospitalisation required due to an accident. Further, such waiting period is not applicable for subsequent policy renewal too. *
2. Waiting period for pre-existing diseases (PEDs)
Insurance policies are purchased with the intention of seeking a financial cushion for your medical treatment. However, not everyone buys a policy at an early stage in life when they are free of any and all ailments. Some buyers are late and as age catches up with them, ailments start to grip. While health insurance plans cover these ailments too, they are categorised as pre-existing diseases. The regulator, Insurance Regulatory and Development Authority of India (IRDAI) defines PEDs as any condition, ailment, or injury suffered by the insured 48 months before buying the health insurance policy. To compensate for the increased risk that the insurance company has to underwrite, a waiting period is levied for these PEDs. When buying health insurance plans for family, make sure to keep this in mind since beneficiaries of different age groups are covered under a single plan making it essential to know the waiting period of your family health cover. You can visit the official website of IRDAI for further details. *
3. Waiting period for specific diseases
A few treatments as prescribed in the policy terms are covered by the insurance plan only after a specified duration has elapsed. This is called as waiting period for specific diseases. Such waiting period is not a blanket duration, but only for the select treatments that are mentioned in the policy document. An example of such treatment would be bariatric surgery that specifically addresses the concerns around extreme weight gain. *
4. Waiting period for maternity benefits
As the title suggests, such waiting period is applicable for policies offering maternity coverage. The duration for such maternity coverage varies based on the type of policy and the insurance company, it is best to seek maternity coverage early in life in case you plan of starting a family in the near future. *
* Standard T&C Apply
With these different types of waiting periods explained, make sure to keep in mind, whether buying a reimbursement or cashless health insurance, since such terms and conditionswill apply to both types of policies.Insurance is the subject matter of solicitation. For more details on benefits, exclusions, limitations, terms and conditions, please read sales brochure/policy wording carefully before concluding a sale.