What does Waiting Period mean in Health Insurance?

As is self-explanatory, the waiting period refers to the amount of time you need to wait to avail the benefits of your health insurance policy. This time is calculated from the day when your policy starts and depends on your insurer and different diseases/health conditions as per your policy terms.

The waiting period is pre-decided for a list of health conditions, type of plan, age, and medical history.  If you file any claim before your waiting period has ended, your insurer will deny it.

What are the Different Waiting Periods?

Every health insurance policy has waiting periods that may vary considerably. Given below are the different types of waiting periods in health insurance:

• Initial Waiting Period: Usually up to 30 days
• Pre-existing Diseases Waiting Period: Ranges from one to four years
• Specific Diseases Waiting Period: Ranges from one to four years
• Waiting Period for Maternity Expenses: Ranges from one to four years

Other than these waiting periods, certain insurers may have waiting periods for special health conditions, annual health check-ups, etc.

The duration of these periods depends on many factors such as pre-existing diseases, different health conditions, type of plan opted (individual, floater or group health insurance) and any add-on cover benefits that you may have purchased.

Are There Any No Waiting Period Health Insurance Plans?

Most health insurance companies in India have a waiting period clause. There is no waiting period in health insurance only under two circumstances:

• If you need urgent hospitalisation or care due to an accident or injuries
• If you have opted for a pre-existing disease add-on that covers you from day 1

For example, if a person gets into an accident and requires an urgent organ transplant, then it will be covered by their medical insurance plan. Whereas, if they require an organ transplant due to a pre-existing condition then they will need to wait for the stipulated time.

Similarly, if you have bought a plan which offers coverage for pre-existing diseases then there will be no waiting period in that case. This feature is provided by several insurers and must be bought at an additional cost.

For all other situations, you need to wait for the standard waiting period to expire before you can file any claims related to those situations.