What is Disease-specific Waiting Period in Health Insurance?

When you buy health insurance it’s natural to expect all your illnesses to be covered from day one. But unfortunately, that’s not entirely true. Health insurance companies put something known as a ‘waiting period’ in your policy, which means you have to wait for a particular amount of time before you can claim the benefits of the policy. There are different types of waiting periods, but the one we will look into is called Disease-specific waiting period. We’ll break down everything you need to know - what it is, how it works, and in what way it is different from the others.

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Disease-specific Waiting Period in Health Insurance

Disease-specific waiting period in health insurance refers to the time during which your insurance policy will not cover certain medical conditions or surgeries. Many people often confuse this term with Pre-Existing Disease (PED) waiting period. Even if these conditions are pre-existing, it does not matter as they will not be covered. Depending on the insurance company, the duration is usually 1-2 years. After this period is over the policyholder can make claims for the treatment of specific diseases as long as they meet the other terms of their health insurance policy.

Every insurance company will have a slightly different list of the common conditions that fall under disease-specific waiting periods. These are generally non-emergency issues that are recurring in nature. For example, cataracts, kidney stones, hernia, gallstones, tonsillitis, joint-specific surgeries, varicose veins, piles, non-cancerous tumours, and ENT disorders, to name a few.

Types of Waiting Periods

Initial Waiting Period

After you purchase a policy there is a short waiting period of usually 30 days, in which you cannot make claims. However, in some cases, accidents are considered an exception.

Pre-Existing Disease (PED) Waiting Period

This condition is for your past health history, it applies to any illnesses you had before buying the policy and claims related to this are allowed only after 2 to 3 years, depending on the details mentioned in the policy.

Disease-specific Waiting Period

This is applied to certain medical conditions that don’t necessarily need to be pre-existing like cataracts or kidney stones.

Maternity Waiting Period

This covers pregnancy and childbirth-related expenses but only after a waiting period of 9 months to 3 years, depending on your insurance policy.

Disease-specific Waiting Period vs. the Other Types

	Initial	Pre-Existing	Disease-Specific	Maternity

What it covers	All illnesses except accidents	Illnesses you had before buying the policy	Specific conditions like kidney stones, hernia, cataract, etc.	Pregnancy, childbirth, and newborn care
Applies to	Everyone	Based on past health history	Listed diseases only	All policyholders
Duration	30 days	2 to 3 years	1 to 2 years	9 months to 3 years
Example	You cannot claim for malaria if it occurs 10 days after policy starts.	If you had asthma before buying the policy then all astha-related claims will have a waiting period.	Cataracts developed after purchase of policy will not be covered until the waiting period is over.	This claim is only allowed after the full waiting period.

Waiting Period Hacks

Read the fine print: Always check the list of diseases mentioned in your health insurance policy before purchasing it.
Start early: The younger you are, the sooner you can complete the waiting period with fewer health risks.
Look for lower waiting periods: There are some insurance companies that offer reduced disease-specific waiting periods.
Choose long-term policies: Sometimes a 2 or 3-year policy may come with benefits like shorter waiting periods.
Consider adjustability: If you’ve already completed the waiting period with one insurer, you can carry those benefits to a new policy if the transfer is approved.

Also read: Zero Waiting Period Health Insurance

Conclusion

There are different kinds of waiting periods and understanding one like Disease-specific waiting period helps you avoid any surprises when the time comes to make a claim. It becomes a reminder that buying health insurance is a long-term investment and not just a quick fix for your medical needs. Choosing the right policy at an early stage in life ensures a smooth medical journey for you and your loved ones.

Frequently Asked Questions

Can I claim for cataract during the waiting period?

No, you cannot. Even if your cataract diagnosis was pre-existing or existed at the time you purchased the policy, you still have to complete the waiting period before making a claim.

What is the minimum waiting period?

The minimum waiting period is the Initial Waiting Period which is usually for 30 days from the day you purchase the policy.

Is there a way to reduce my waiting period?

Yes, some health insurance companies allow you to reduce the waiting period by purchasing a waiting period waiver. You can also pay an extra premium at the time of purchasing the policy.

What is the Zero waiting period?

Zero waiting period in health insurance is a feature that provides medical coverage from the day you purchase the policy. Some health plans like ACKO’s Platinum Plan is a type of health insurance with no waiting period.

Is cancer part of the disease-specific waiting period list?

Yes, cancer is often included in disease-specific waiting period lists. However, keep in mind this list may vary depending on the health insurance company you choose. Make sure to check these terms before purchasing a policy.

Written by Roocha Kanade

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Reviewed by Dr. Harshita Dahiya

Health Insurance content enthusiast who turns complex topics into easy, binge-worthy reads—fueled by SEO, creativity, and way too much chai! Loves juggling multiple projects, cracking impossible deadlines, and sprinkling humor into the mix. When not geeking out over digital trends, you'll find her lurking on Quora and Reddit, planning the next getaway, or passionately decoding all things health and insurance!