Are There Health Insurance Plans With No Waiting Period?
- Author :
- TATA AIG Team
- Published on :
Buying a health insurance plan is essential to secure yourself against the rising costs of medical treatments financially. However, as an informed buyer, you must read the offer document carefully and understand every aspect in detail.
One critical aspect of medical insurance you must understand is the policy’s waiting period. A waiting period in health insurance is a standard inclusion of almost every medical insurance plan in our country.
Moreover, it significantly impacts the benefits and claims you can draw from your policy. Therefore, it is essential to understand the waiting period for health insurance in detail and know if there are zero waiting period health insurance plans.
What is a Health Insurance Waiting Period?
The waiting period of a medical insurance plan is the amount of time the insured must wait before becoming eligible to avail of the policy benefits. The waiting period in health insurance can apply to the entire policy or some particular health conditions and diseases.
The waiting period starts from the day of the commencement of the insurance policy and lasts for the duration mentioned in the policy terms for the given medical condition.
If the policyholder files for a claim before the waiting period ends for an excluded medical condition, the insurer will deny it. Moreover, every insurer has a different waiting period for various medical conditions.
Therefore, checking the waiting period for various diseases and conditions is essential when buying a health policy.
Can I Buy Health Insurance Without Waiting Period?
A health insurance waiting period can be stressful and unmanageable for people who require immediate expensive medical treatment. Moreover, people with existing medical conditions that need regular/ ongoing treatment require immediate financial support, and a waiting period may not be feasible for them.
Some people may have to delay urgent medical treatment due to the waiting period, which may result in a severe ailment in the future.
Therefore, insurance companies have come out with health insurance no waiting period clauses, where the policyholder does not have to wait to get policy benefits.
The health insurance no waiting period clause is applicable in only two conditions:
Accidental hospitalisation: There is no waiting period for health insurance in India for accidental hospitalisation. In case of a severe accident, if the insured requires hospitalisation, he can get coverage from the first day of the policy commencement.
Pre-existing add-on coverage: If you have added a health insurance pre-existing condition with no waiting period add-on to your health insurance plan, you can get the policy benefits from the first day of the policy commencement. However, an add-on increases the premium for a medical plan. Therefore, ensure the premium is within your budget before including the add-on to your medical policy.
For all other situations, you will have to pass the initial waiting period and specific waiting period for ailments under the health insurance plan to avail of the benefits.
Why do Health Insurance Plans Have a Waiting Period?
Avoid wrongful claims: The waiting period allows sufficient time for the insurers to access the genuineness of the insured. It helps identify false claims and policy buyers with wrong intentions.
Avoid unethical practices: Without a waiting period, an individual may purchase a medical policy on being diagnosed with a particular health issue, undergo treatment and get reimbursed through a health insurance plan, and then drop out of the policy.
It negatively impacts the insurers and other policyholders. A waiting period helps avoid such situations.
Fairness: A waiting period ensures all policyholders are subject to the same rules and regulations and promotes fairness in claim settlement.
What are the Types of Waiting Periods in Health Insurance?
Initial Waiting Period
The initial waiting period is the standard duration for which the insured must wait before filing a health insurance claim. The period starts on the day of policy commencement and lasts until you avail of the policy benefits. For most insurers, this period lasts for up to 30 days.
During this cooling period, you cannot file for any claim except for accidental hospitalisation.
Waiting Period for Pre-existing Diseases
If you have an existing medical condition, injury, or disease at the time of purchasing a medical plan diagnosed by a doctor 48 months before the insurance policy date, such a condition is called pre-existing condition or disease.
Kidney ailments, high blood pressure, heart disease, diabetes, and anxiety issues are all examples of possible pre-existing diseases/ conditions.
Every insurer has a different waiting period for pre-existing health conditions, usually lasting up to 4 years. You cannot file a claim for these conditions before the waiting period ends.
For a regular health plan, you must pass the defined waiting period to claim benefits for such conditions.
Moreover, if the policyholder fails to disclose a pre-existing medical condition at the time of policy purchase, the insurer may reject his claim later.
On the other hand, if you get diagnosed with a new disease during the policy term, it will not be considered a pre-existing condition and will be covered under the health insurance plan. However, it should not be a condition already diagnosed but undisclosed.
Waiting Period for a Specific Illness/ Disease
Certain specific diseases and illnesses, such as ENT disorders, hernia, osteoporosis, and joint replacement surgery, come with a predefined waiting period.
You must wait for the waiting period for the disease to end before filing for a claim. The waiting period for such conditions may last between 2 to 4 years.
Waiting Period for Maternity Benefits and Newborn Baby Add-On
Some health insurance plans come with maternity coverage that covers maternity-related expenses. There is a waiting period of 4 consecutive years for maternity benefits and newborn baby inclusion in most medical insurance plans.
Therefore, it is advisable to buy a health insurance plan in advance to allow the waiting period to pass before you will require maternity benefits from the policy.
How Can I Reduce the Waiting Period for a Health Insurance Plan?
The waiting period duration differs for various insurers. However, there are a few ways in which you can reduce the waiting period for your health insurance policy:
Buy a plan with a shorter waiting period: Check the initial waiting period and the waiting period for different ailments from several insurers. You can select the plan with the minimum waiting period for the ailments most relevant to you.
For example, if you plan to start a family in the coming years, opt for a health policy with the shortest maternity benefits waiting period.
Buy a plan early in life: A smart way to pass the health insurance plan waiting period comfortably is to buy a plan in the early life stages. You may not require much medical care in your younger days. Therefore, you can easily pass the waiting period in that duration. This way, you will be qualified to get the policy benefits by the time you need them.
No waiting period add-on: As discussed above, you can opt for a no-waiting period add-on for an existing ailment and get coverage from the first day of the health plan.
Copay clause for senior citizens: Some insurers may eliminate or reduce the waiting period for senior citizen policyholders under the copay clause. However, the insured will have to bear a part of the treatment cost under this clause, which may not be feasible for many people.
Pay additional premium: Some insurers have the option of eliminating or reducing the waiting period for an additional premium amount. However, it increases the medical policy cost and may not be suitable for everyone.
Employer-sponsored health insurance plans: If you have an employer-sponsored health insurance policy, you need not pass the waiting period and enjoy the benefits from day 1. If, in some cases, a waiting period exists for these plans, it is much shorter than individual health plans.
Moreover, if you convert your employer group medical insurance into an individual policy, there will be no waiting period for you because the waiting period clause has already been met in the group plan.
Buy health insurance online: With Tata AIG, you can buy health insurance online and ensure you do not waste time doing lengthy paperwork and visiting the insurance office physically. With an online purchase, your medical policy gets activated sooner, and you can cover the initial waiting period faster.
While a waiting period in health insurance can prevent the insured from getting the benefits from the first day of the policy, it is a common aspect of every health insurance plan in India. The waiting period ensures there are no false claims against a health plan and makes health policy rules and regulations uniform for all policyholders.
You can buy health insurance early in life to pass the waiting period in your healthy years comfortably. This way, you can enjoy health insurance tax benefits in your earning years and save significantly.
Disclaimer / TnC
Your policy is subjected to terms and conditions & inclusions and exclusions mentioned in your policy wording. Please go through the documents carefully.