You may have heard someone claim that because the waiting period has not ended, they are not eligible for health insurance benefits. You may be familiar with waiting periods in health insurance and their significance, just like many others. Let us understand this further.
Definition of a waiting period
Simply put, the waiting period is the amount of time you must wait before receiving insurance benefits, therefore, the term in health insurance policies. The insured cannot make any claims for health insurance benefits during this time, which starts on the day the coverage starts. Health insurance waiting periods can range in length depending on the insurance company.
To better comprehend the waiting period in the mediclaim policy, think about the following example:
Mumbai resident Mr. Kumar recently bought a health insurance policy with a Rs. 4 Lakhs insured value. He was delighted to have made this choice, given his lifestyle and family background. He was unaware that health insurance has a waiting period, though.
He experienced a heart attack just ten days after purchasing the coverage and was subsequently hospitalised. He was astonished to learn that the health insurance he purchased had a 30-day waiting period. As a result, his claim wasn’t approved, forcing him to cover the medical costs out of pocket.
A health insurance premium calculator is a tool you may use online to determine the amount of coverage required based on your needs.
Many of us get health insurance without understanding such critical terms, just like Mr. Kumar. You should be aware that buying health insurance does not automatically entitle you to coverage starting on the initial date. To learn about a policy’s inclusion and exclusion clauses and the waiting period for health insurance, make sure you read them.
Health insurance waiting period types
- Initial waiting period
This kind of waiting period in health insurance also referred to as a “cooling off period,” covers the initial time after the health plan’s purchase date when it might be used. You are not eligible to receive a claim from the insurance for scheduled or unplanned hospitalisation during this time.
- Waiting period for hospitalisation due to accident
The injuries that result from severe incidents in life frequently need to be treated and hospitalised right away. Considering any waiting period in health insurance could result in a life being lost due to the nature of accidents. In general, hospitalisation following an unfortunate accident is covered by health insurance without a waiting period.
- The Time Frame for Pre-Existing Conditions
You are questioned about any pre-existing conditions when purchasing a health plan and subsequently given medical tests to verify them. The corresponding waiting period for health insurance is likewise established by this. Pre-existing conditions are those that were identified forty-eight months or more before the purchase of the health insurance policy, according to IRDAI. These illnesses include, among others, thyroid, diabetes, and hypertension.
- Maternity waiting period
Maternity benefits are provided by a number of health insurance plans, either as a standard benefit or as an add-on. It is intended for individuals who want to expand their family while considering their financial situation. You cannot claim maturity benefits during the waiting period for maternity in health insurance.
- The waiting period associated with specific diseases
In health insurance, the initial waiting period is distinct from the disease-specific waiting period. Long-term care is necessary for a number of illnesses, including tumours, hernias, and osteoporosis; if a policy is obtained, the health insurance provider will cover the expense. Because of this, the majority of insurers incorporate a varying waiting period in their health insurance plans for certain ailments.
Make sure you compare health insurance plans before buying one.
Visit the official website of IRDAI for further details.
Insurance is the subject matter of solicitation. For more details on benefits, exclusions, limitations, terms, and conditions, please read the sales brochure/policy wording carefully before concluding a sale.
