The COVID-19 pandemic has brought about a new appreciation for the importance of financial planning. One of the most crucial aspects of financial planning is investing in a comprehensive health insurance policy. With an appropriately designed health cover, we can be equipped to handle medical emergencies without worrying about the financial burden. However, health insurance policies have certain intricacies and clauses, and it is essential to have a clear understanding of these terms. One such term is the waiting period, which is critical to know.
A waiting period is the time an individual must wait before they can avail of the benefits of their health insurance policy. This period is defined in the policy document, and it begins as soon as the policy starts. Health insurance policies typically have several types of waiting periods, and it is essential to know about each one of them.
The cooling-off period is the first type of waiting period, and it is also known as the initial waiting period. This period must be served before individuals can start availing the benefits of their health insurance policy. The standard cooling-off period is 30 days, during which individuals cannot claim any hospitalization arising out of an illness. However, claims for hospitalization due to accidents can be filed from day zero. For instance, if an individual is hospitalized due to an illness on the 10th day of the policy, the claim will not be admissible because the cooling-off period is still in effect. On the other hand, if an individual is hospitalized on the 10th day due to an accident, the claim will be admissible.
The waiting period for pre-existing diseases refers to the ailments or health conditions that an individual has before buying the health insurance policy. These conditions are known as pre-existing diseases and may include high blood pressure, diabetes, thyroid issues, and asthma. The waiting period for pre-existing diseases usually ranges from two to four years. For example, if an individual has been diagnosed with thyroid before buying the policy, they cannot claim for any hospitalization due to thyroid for the first two to four years of the policy.
Disease-specific waiting periods apply to certain ailments such as hernia, cataract, and joint replacement surgery, among others. Each insurer has a list of diseases that require a waiting period, and the waiting period for each ailment is explicitly mentioned in the policy document.
Maternity cover in a health insurance policy typically has a waiting period ranging from nine months to six years. Therefore, individuals can only file maternity-related claims after serving the waiting period. To ensure that individuals can take advantage of maternity coverage, it is wise to buy a health insurance policy that offers maternity benefits well in advance. With the rising incidence of pregnancy-related complications and medical inflation, proper financial planning is critical before planning a family.
Mental illnesses are mandatorily covered under health insurance according to regulatory guidelines. The waiting period for such illnesses is usually two years, but it may vary depending on the insurer.
To reduce the waiting period, individuals can pay an additional premium. However, the reduction amount varies from insurer to insurer and product to product. Therefore, individuals should check with their insurer to avail of the benefits of a reduced waiting period by paying an additional premium.
It is advisable to start investing in health insurance early, as it helps individuals serve waiting periods early in life. Typically, individuals do not suffer from serious health issues at a young age, and hence, they can easily file the relevant claims later in life without any worries.
When buying health insurance, individuals should have a close look at the waiting periods to avoid any surprises later. It is recommended to read the policy document thoroughly to have a clear understanding of the coverage, exclusions, and other terms and conditions. The policy document explicitly mentions these details in lucid language to avoid confusion for policyholders.
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