What Does a Health Insurance Waiting Period Mean?

The time that you, as a policyholder, must wait before you can utilise the insurance benefits is known as the waiting period in health policy in India. you are not permitted to make any claims during the waiting period. The length of the waiting period varies from insurer to insurer and begins on the first day the insurance is in effect. Make sure you do a health insurance comparison to understand the waiting periods.

Health Insurance Waiting Period Types

In health policy in India, there are several different waiting periods, including:

  1. The initial waiting period: Sometimes referred to as the cooling down period, is ordinarily 30 days after the insurance begins. This holds true for both prearranged and unplanned hospitalisations. There may be exceptions, such as accident claims, if the policyholder must be hospitalised immediately following an accident.
  • Pre-Existing disease waiting period (PED): According to the IRDAI, a pre-existing disease is any medical condition, illness, or injury that was discovered 48 months before purchasing the bestmediclaim policy. Diabetes, thyroid, and hypertension are a few examples of PEDs. The waiting period often ranges from one to four years, depending on your insurance and healthcare plans. #
  • Waiting period for specific diseases: The waiting period varies from one to two years for specific diseases and treatments such as hernia, osteoporosis, ENT issues, cataract, joint replacement surgery, and neurodegenerative disorders like Alzheimer’s and Parkinson’s disease.
  • Indemnity for maternity waiting time: Maternity benefits pay for all delivery and childbirth-related costs, but only after a waiting time of one to four years. This means that if you intend to establish a family soon and want to take advantage of maternity benefits, you should think about purchasing this plan right once. The first 90 days of the newborn’s life will be covered, including vaccines.
  • Waiting period for coverage of critical illnesses: The waiting period for critical sickness coverage is 90 days. Additionally, there is a 30-day survival requirement, which states that the insured must live for at least 30 days following a critical illness diagnosis. Because people over the age of 60 have a higher risk of developing critical illnesses, obtaining senior citizen health insurance in addition to critical illness coverage is useful.
  • Waiting period for accidental hospitalisation: The initial waiting period will be waived if an unexpected accident necessitates emergency hospitalisation. Health insurance with no waiting time is only applicable when an accident results in an instant hospitalisation.
  • Waiting period for annual health exams: Most health insurance plans provide policyholders with free annual health exams. You must, however, wait a full year before using this benefit.
  • Waiting period for bariatric surgery and psychiatric illness: The waiting period for bariatric surgery and psychiatric illness is often one to two years, during which no claims may be made.

Purchasing a Mediclaim policy alone is insufficient; you must be familiar with all of the policy’s terms and conditions, including the waiting time for health insurance.

# 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.

By Claire David White

Claire White: Claire, a consumer psychologist, offers unique insights into consumer behavior and market research in her blog.