Why Is It Important To Keep Track Of The Waiting Period In Health Insurance Plans?
Mr. Shukla (50-years-old) lives in Indore with his wife and two sons. Mr. Shukla is an entrepreneur and runs a jewellery shop. Though Mr. Shukla has some kidney problems, he didn’t purchase any health insurance policy for himself. But, when one of his close friends was diagnosed with the COVID-19; Mr.Shukla was inspired to buy health insurance for himself and his family members in 2021. Mr. Shukla purchased the best health insurance plans hastily to enhance his protection against various diseases, including the COVID-19. Just two months before, Mr. Shukla was admitted for his kidney problems to a private hospital and the hospital gave him a bill of Rs.80,000 during his discharge. Mr. Shukla paid the amount from his side and then, he initiated a reimbursement claim with his insurer. But the insurance company rejected the claim as his waiting period in the health insurance policy is not over for pre-existing conditions.
This is because Mr. Shukla completely overlooked the waiting period clause for pre-existing diseases in his health policy. If he would have gone through the policy documents properly, then he could have saved money for his operation. Thus, you see waiting period contributes a significant role in health insurance. Never buy health insurance overlooking the waiting period applied by the insurer.
Let’s discuss what is the waiting period in health insurance and why it is so imperative.
The Waiting Period in Health Insurance
The waiting period is an important term in health insurance policies. Waiting periods are different for various types of diseases that may vary from insurer to insurer. For instance, the waiting period for Star Health Insurance would be different from the waiting period for Bajaj Allianz Health Insurance.
The waiting period is a fixed period under which the policyholders can’t initiate any claim for particular diseases. The waiting period may differ from company to company. A policyholder should complete his waiting period to avail of the benefits of the policy. To avoid any fraudulent claims and misuse of any health insurance plan for pre-existing diseases (PED), insurance companies don’t offer health insurance without a waiting period.
Types of Waiting Periods
For a new health insurance policy, the minimum waiting period for health insurance is 30 days. This implies a policyholder should serve this period before enjoying the benefits of the policy. But the policyholder doesn’t need to complete the waiting period if you need hospitalization because of an accident. This type of claim can be filed right from the first day once the policy is issued to the individual.
Many insurance companies have a minimum waiting period for health insurance of 2 years for certain specified diseases such as cataracts, hernia, knee replacement, and so on. Since these types of ailments grow slowly, hence a waiting period is applied for these diseases in almost all insurance plans.
Why is there a Waiting Period for Health Insurance?
Thinking about why there is a waiting period for health insurance policies offered by a majority of insurance companies? This is because the insurer wants to overcome the risk of paying the claims without receiving a sufficient amount of premium from the policyholder. They want to secure some amount of premium paid by the policyholder before offering claims for immediate health issues.
What is the Role of the Waiting Period when Porting a Health Policy?
To port your health policy to a different insurer, if you have completed the waiting period with your existing insurer, you don’t need to serve a fresh waiting period with the new insurance company. But if you didn’t complete the full waiting period with your old insurance provider, you need to serve the remaining waiting period with your new insurer.
Waiting Periods for Pre-Existing Diseases (PED)
Most health insurance companies usually apply the waiting periods for pre-existing diseases. While purchasing a health insurance policy, a policy buyer needs to reveal his/her pre-existing conditions such as diabetes, hypertension, kidney ailments, or some other disease for which they are required to take continuous medications. The waiting periods for such conditions are generally 2-4 years from the date on which the policy was issued.
To serve their customers in a better way, most health insurance policies are offering health insurance with a minimum waiting period of 1 year for PED or pre-existing diseases. For example, Digit Insurance has started offering waiting periods of one year for pre-existing ailments and specific diseases. Similarly, the waiting period for Star health insurance policy called the red carpet is one year. Likewise, the waiting period offered by Bajaj Allianz silver health also has one year for any pre-existing ailments.
Comprehensive health insurance policies that provide maternity benefits also offer a waiting period of 12-48 months. Some specific illnesses like Hepatitis B, HIV, malignant Neoplasms, Cosmetic Surgeries, etc. belong to the category of permanent exclusion. Insurance companies never offer coverage for these diseases. These days, many health insurance plans also offer coverage for life-threatening diseases like cancer, heart-related diseases, and critical illnesses. You can purchase these plans without a long waiting period. Moreover, by paying an additional amount, a policy buyer can minimize his/her waiting period.
People who are going through common pre-existing ailments like diabetes, hypertension, high cholesterol, and asthma are not interested in purchasing health insurance due to the waiting period. But if insurance companies redesign their plans and make some customized plans that will cover pre-existing diseases, then they can minimize the health insurance penetration in India. To encourage customers in purchasing health insurance, many health insurance policies have minimized the waiting period for pre-existing conditions.
If you are having diabetes and need to take insulin to control your condition, then it would be an uphill task for you to buy a health insurance policy for your requirements. But with new customized plans, you can avail the benefits of your health coverage for your condition. These days, companies have drafted such plans that are advantageous for patients who are going through chronic diseases such as asthma, high blood pressure, high cholesterol, and diabetes.
Talking about the group health insurance waiting period. It is usually something between 30 days to 90 days from the date of policy purchase. However, it may differ from insurer to insurer. The simple alteration in the health insurance underwriting process helped insurers to engage more customers in purchasing health insurance. These days, you can conveniently purchase health insurance policies and also enjoy the coverage from the beginning if you or your family members are suffering from various pre-existing diseases.