Starting a Family? Beware of Private Health Insurance Waiting Period Pitfalls

The reason why most of us think of investing in some of the best health insurance plans in India is because we do not want to be dependent only on the public hospital system. While buying a family health insurance plan, we all want to be treated by the best doctors, have shorter waiting periods, get a private bed rather than a general ward and the like.

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      How Health Insurance Helps?

      Buying a health insurance plan would be extremely beneficial, and those who are prone to health ailments due to age and other factors, should think about it, especially. It is important to be completely aware of the stern admission requirements/ medical history/any pre-existing ailments which are required for personal and family health insurance plans. So, if you are buying a policy, it’s important to know about the terms and conditions of waiting periods.

      What Is A Waiting Period In Health Insurance Plans?

      This is the time period for which the policy holder has to wait until the illnesses which are listed in the insurance policy are covered. You cannot claim your insurance cover during this waiting period.  Though under some policies, the health insurance company does provide a cover to some of the pre-existing illnesses, which the insured might have.

      Even if, you have some knowledge about health insurance, there can be some misconception about what waiting periods actually are. Even the best health insurance plans in India may have waiting periods. Generally, all or certain benefits and procedures become valid only after the waiting period is completed. This is also applicable on policy up-gradation or any additional benefits, if you have applied for it.

      The waiting period prevents an immediate withdrawal from health insurance policy. The insurer can back out after using the hospital treatment and quickly accessing the policy benefits and restrictions. Post the waiting period, the insured person could claim a higher amount of cover or get immediate hospital admission, when there is an emergency situation which requires hospital treatment.

      If there were ‘no waiting periods’, then the loss caused by short-term or temporary insurers would have to be borne by the long-term health insurers, and that certainly won’t be a fair deal for any customer. Waiting periods act as a catalyst to safeguard customers in such situation, as it would result in much higher premiums for all the health insurers.

      With age, the probability of chronic diseases or health ailment increases. Moreover, with the increase in the trend of unhealthy lifestyles and eating habits, hectic/ deskbound work life and chronic stress; people are becoming more prone to lifestyle diseases at an early age as well.

      Health treatments are becoming inevitable and with so many people becoming prone to chronic health conditions, the cost of health treatments is sky high. And with such splurges in medical treatments, it may burn a hole in anybody’s pocket, especially the middle class population. This is the reason people are searching for the best health insurance plans in India, which can offer them maximum cover from these illnesses. And to secure your family’s health, you can go buy a family health insurance plan.

      For an emergency situation, where you or any of your family members will require immediate health treatment (which has a huge financial cost attached to it), a health insurance policy can be a savior. You can also buy policies, which offer yearly health checkups and precautionary screening to know about your health conditions in advance.

      So, before you begin to invest in a health insurance policy, make sure you are not oblivious to the types of the waiting periods there are. You should have a fair understanding about the below mentioned points

      Different Types of Waiting Period Health Insurance Plans in India Have

      Even if you buy a general health insurance plan or a family health insurance plan, there is a pre-determined waiting period which restricts you from claiming your cover for a certain time. This time period is divided into four categories as mentioned below

      • Preliminary Waiting Period: During the initial phase, the insurance company will give you a medical or hospitalization cover which you might need, due to any unforeseen conditions or accident during this time. Please note that in case of sickness or any medical treatment which requires hospital treatment, the insurer will not provide you any cover. And you won’t be able to claim it within your waiting period.

      • Pre-existing Medical Conditions' Waiting Period: Before taking the policy, if you have some illnesses then your medical treatment for it will not be covered under your health insurance policy. This will be for some time only, till your waiting period is completed. Though, it also depends on the severity and duration of your pre-existing ailment.

      • Illness Specific Waiting Period: Certain diseases like osteoporosis, tumour are specifically mentioned in the details of the policy for which there will be defined waiting period of one or two years. These diseases generally vary from insurer to insurer. Usually, the insurer gives a list of exclusions and inclusions in your policy, which will be there, till the completion of the waiting period. Make sure, you take a note of those exclusions under the waiting period in health insurance.

      • Maternity Waiting Period: Only some health insurers provide maternity health cover in their policy. The waiting period ranges from 9 months to 3 years. These benefits are not available within the waiting period.

      Is It Possible To Make Changes In The Health Insurance Waiting Period?

      Some insurance companies give an option of decreasing the waiting period by taking a slightly higher amount as premium. Additionally, there are a few health insurance plans which have a co-payment clause especially, in the case of senior citizens. In this co-payment clause, the policy holder has to pay some percentage of the amount and the insurance company will pay the remaining.

      Usually, the insurance companies have the waiting period before the commencement of the health insurance policy. Any prior medical conditions or chronic ailments may require expensive medical treatment. In that situation you would look for a policy which has no waiting period. However, there is no policy without a waiting period, whereas you can look for a policy with minimal waiting period in comparison to others.

      In Summary

      When it comes to waiting periods, it’s vital that carefully read the details to avoid any misconceptions and so you can choose plan that is best suited for your needs. This is the reason that it is highly recommended that you purchase a health insurance while you’re still young when incidences of health problems, generally, are few and far between.

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      *₹400/month is the starting price for ₹ 5 lakh Health insurance for a 30 year old male & 29 years old female, living in Delhi with no pre-existing diseases

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