All About Waiting Period In Health Insurance


You’re probably here because you realised there’s a waiting period for health insurance, and like many first-time buyers, you need clarification on what it means, how long it lasts, and what it covers.

What is the meaning of a Health Insurance Waiting Period?

A waiting period in health insurance refers to the time you must wait from the beginning of your policy before you can utilise its benefits.

Different types of insurance waiting periods:

Let’s examine what each type implies, the industry average, and approximate waiting periods concerning these factors, so you can plan which is the best medical insurance for you.

  • Initial Waiting Period

Health insurance policies have an initial waiting period, often known as a cooling period, before you can use them. The industry standard for initial waiting periods is 30 days for all health insurance policies.

  • Waiting Period For Maternity Benefits And Newborn Baby Coverage

Most health insurance policies offer a Maternity Benefit and Newborn Baby add-on for those expecting a family soon. However, it is wise to plan financially for labour and postpartum costs.

Your medical coverage must be in place for two years before you can claim maternity expenses.

Thus, if you plan to start a family soon and want your health insurance to cover it, you must account for the 9-month pregnancy term and the remaining 15 months to finish your two-year waiting period. The maternity benefit supplement covers delivery, vaccines, and medical treatment for the first 90 days of the baby’s life.*

  • Precautionary Period for Certain Diseases

Waiting periods for specific conditions means you must wait before submitting a claim for treatment and hospitalisation for a list of ailments.

Typically, the waiting period for these circumstances ranges between one and four years.

  • Pre-Existing Diseases (PED) Waiting Period

When buying medical coverage, you may be asked about pre-existing conditions and requested to undertake a few medical tests that may confirm them. The IRDAI defines a pre-existing ailment as any condition, sickness, accident, or disease identified within 48 months of acquiring the health insurance plan. Pre-existing condition waiting periods vary by insurer and plan. #

  • Pre-hospitalisation Delay for Accidental Hospitalisation

Accidents might cause unexpected medical complications. Accident-related hospitalisations are exempt from waiting periods by all health insurers. This means new health insurance policies allow hospitalisation claims from day one. No initial waiting period applies here, either.*

  • Psychiatric Illness

Insurers now cover mental health because everyone understands its importance. This covers mental illness-related hospitalisation and inpatient treatment.

  • Preoperative Delay for Bariatric Surgery

Health insurance covers bariatric surgery. Extreme obesity can be treated by stomach and/or intestinal surgery. Only individuals with a BMI over 40 and obesity-related health conditions should consider it.

  • Annual Physical Exam

You may have noticed that some health insurance plans provide annual health examinations as part of the coverage.* Nonetheless, there is a waiting period for this as well.

When picking your plan, remember that the waiting period in health insurance depends on several factors, as mentioned above.

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* Standard T&C Apply.

# 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.

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