Health insurance

Medicare: Why You Should Keep Track of the Waiting Period in Insurance Plans


The elimination period is generally applied to pre-existing illnesses by all insurers. To better help policyholders, few insurers have started offering health insurance with a waiting period of 1 year for pre-existing illnesses.

A critical term in health insurance policies is the waiting period. You might suddenly feel the need for an insurance plan and buy one in the hopes of being covered for all kinds of illnesses the very next day, but that’s not how it works. There are different waiting periods for different types of illnesses, which also vary from company to company.

The waiting period is a fixed period that the policyholder waits from the moment of purchasing the policy and cannot avail himself of certain benefits or cover for certain illnesses. For example, with a comprehensive health insurance policy, the waiting times for different coverages usually differ from insurer to insurer. The policyholder must serve the waiting period to obtain coverage for that specific condition. Experts say that to prevent any kind of fraud and misuse of health insurance for pre-existing conditions, insurers typically apply a waiting period.

What are the types of waiting times?
Typically, a new comprehensive health insurance plan comes with a 30-day waiting period that the policyholder must meet before filing a claim, known as the initial waiting period under a health insurance policy. That said, an insured will not have to serve any waiting period in the event of hospitalization following an accident. A request for hospitalization due to an accident can be made from the first day after the policy is issued to any person.

For certain specified conditions such as cataracts, hernias and knee replacement surgery, many insurers apply a two-year waiting period. Experts say these types of illnesses progress slowly, resulting in a waiting period in all insurance plans.

What are the pre-existing conditions (PED) that cause waiting times?
The elimination period is generally applied to pre-existing illnesses by all insurers. When purchasing a health plan, the insured will be asked about any pre-existing condition such as hypertension, diabetes, kidney disease or any other disease for which they are under continuous treatment. For such pre-existing conditions, most insurance companies apply a waiting period ranging from 2 to 4 years from the date of issue of the policy.

To better help policyholders, few insurers have started offering health insurance with a waiting period of 1 year for pre-existing illnesses. For example, Digit Insurance, recently began offering one-year waiting periods for pre-existing illnesses and specific illnesses. Likewise, the Star Health Policy called the Red Carpet and the Bajaj Allianz Silver Health also offer a one-year waiting period for the PED.

Likewise, comprehensive health insurance plans that provide maternity benefits also come with a waiting period of 12 to 36 months. Along with this, diseases such as HIV, hepatitis B, cosmetic surgeries, malignant tumors, etc. fall under the permanent exclusion category and insurers never cover these illnesses. Various insurance policies also offer specific cancer, critical illness and heart plans, which can be chosen to avoid a long waiting period. In addition, you can also choose to reduce your waiting time by paying a small supplement.

When transferring your policy to another insurer, if you have served the elimination period with the current insurer, you will not have to complete a new elimination period with the new insurer. However, if you have not served the entire elimination period with your old insurer, the remaining elimination period will be applied by the new insurer.

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