How does Health Insurance with a Waiting Period work?

  • Author :
  • TATA AIG Team
  • Published on :
  • 04/01/2024

If you have health insurance, not every benefit of your medical plan might be accessible right away. This is a result of the insurance policy's required waiting period.

Even though you may already be aware of it, you might not fully comprehend the significance of your health insurance policy's waiting period or how long it is.

When it comes to the waiting period in health insurance, it refers to the amount of time before a specific disease is covered. In order to obtain coverage for these illnesses, you should carefully review the terms and conditions of the policy and purchase a health insurance policy with a short waiting period.

In this blog post, we will delve into the complexities of health insurance waiting periods, looking at how they work.

Waiting Period Definition

A waiting period is the predetermined amount of time after which your health insurance policy begins to cover a certain list of illnesses. Alternatively referred to as the cooling-off period, it starts when the policy is implemented.

For example, a common provision in most health policies is a 4-year waiting period for pre-existing diseases.

If the policyholder files a claim with the health insurance company before the waiting period has expired, the insurer has the right to deny the claim. However, if the policyholder submits a claim after the waiting period has expired, the insurance company cannot deny the claim under usual circumstances.

For example, if the waiting period for diabetes is 90 days and you file a claim within 60 days, the insurer will deny your claim. However, if you file a claim after 90 days, it will not be denied.

However, those who are particularly interested in maternity or newborn coverage can also look into policies that have shorter waiting periods for maternity insurance, which guarantees prompt access to vital benefits.

Types of Waiting Period

Waiting periods for maternity insurance and other health insurance can vary, and insurers frequently impose different waiting periods for different types of coverage.

The following table summarises the various types of waiting periods and their durations:

Health Condition Waiting Period
Existing diseases (diabetes, hypertension, etc) 1-4 years
Maternity cover 9 months-3 years
Specific diseases/illnesses, psychiatric health conditions, bariatric surgery 1-2 years
Newborn inclusion 9 months-3 years
Covid-19 coverage 30 days
Initial waiting period 0-30 days
Accidental hospitalisation 0 days

Note that the waiting period for a particular disease may vary for different insurers. Therefore, it is advisable to contact your insurer for the exact duration of waiting period on your health plan.

Why Do Health Insurance Plans Have a Waiting Period?

The unethical practices to obtain insurance benefits have led to the need for a waiting period in health insurance. Purchasing health plans is a common way for people to obtain insurance coverage.

Imagine a PED waiting period where a person without health insurance is diagnosed with a serious illness. He/she was unable to pay for the costly surgery that the doctor had recommended using their regular income.

He/she then purchased health insurance in order to deal with this issue, but he kept the illness a secret. To prevent such immoral practices and prevent such things, a waiting period was added to health insurance.

Is it Possible to Reduce the Waiting Period?

Yes, reducing the waiting period under a health insurance policy is possible. Certain insurance providers provide a waiting period waiver as a way to shorten the waiting period.

However, an additional premium payment is required in order to obtain such waivers. A PED waiting period (meaning waiver), for example, is included in some health insurance plans and reduces the 4-year waiting period for certain diseases to just two years.

Most insurance companies typically do not require waiting periods in group health plans that employers provide to their staff. Additionally, if an employee converts their group health plan to an individual plan, they will be eligible for health insurance without waiting period.

Conclusion

Making educated decisions in the world of health insurance requires having a strong understanding of waiting periods. Remember that different coverages have different waiting periods when you compare health insurance plans. Understanding the rationale behind waiting periods will make it easier for future benefit

If you are looking for a comprehensive health insurance plan, consider our Tata AIG medical insurance plans that offer a balance between coverage and waiting periods, ensuring that consumers receive timely benefits when they need the most.

Health insurance has become easier and more convenient. You can now easily browse through policy details and pick a plan that best suits your needs for medical care. To protect your health and financial safety, we always advise to take time, weigh the options, and make an informed decision. Don’t wait to buy health insurance online with Tata AIG today.

FAQS

How many days do you have to wait to use your health insurance?

Typically, health insurance policies have an initial waiting period ranging from 0 to 30 days. This period may vary between insurers, and coverage for certain pre-existing conditions may have longer waiting periods.

What does a waiting period in health insurance mean?

In health insurance, the waiting period is a set period of time during which certain benefits are unavailable. It is the time between the start of the policy and the implementation of specific coverages, such as pre-existing conditions or maternity benefits.

Disclaimer / TnC

Your policy is subjected to terms and conditions & inclusions and exclusions mentioned in your policy wording. Please go through the documents carefully.

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