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What is the initial waiting period in health insurance?

Jul 2, 2025

One common question among policyholders is, ‘is there a waiting period for health insurance?’; the answer is yes. Various types of waiting periods depend on the insurer and policy. Most health insurance providers impose an initial waiting period of 30 days. It is the time after buying a policy during which no claims are accepted (except for medical emergencies due to accidents).

The purpose of this waiting period is to prevent individuals from buying health insurance only when they need urgent medical care. It promises balanced and fair coverage for all policyholders. The initial waiting period can be up to 90 days, but it varies with the insurance provider. Let’s discuss what is waiting period in health insurance, its working mechanism, features, key tips, and more.

Contents

What is the initial waiting period in health insurance?
Why is there a waiting period for health insurance?
How does the waiting period in health insurance work?
Understanding coverage and restrictions in the initial waiting period
- What’s covered?
- What’s not covered?
Initial Waiting Period vs Other Waiting Periods
Benefits of initial waiting periods in health insurance
Tips to manage the initial waiting period
Conclusion
Frequently asked questions

What is the initial waiting period in health insurance?

Many individuals willing to buy an insurance policy are unaware of what is waiting period in health insurance. It is the period after the policy purchase, during which claims for hospitalisations are not approved. For all health insurance policies, it is 30 days from the date of your policy purchase.

Note that during this period, only claims for hospitalisation due to accidents are accepted.

The waiting period meaning suggests that it is the time you need to wait from the date of policy issuance to actively begin using your health insurance policy. Most insurers use this period to make sure that policyholders fully understand their coverage before availing treatment.

This waiting period makes sure that policyholders don’t buy insurance only to cover immediate medical expenses. Moreover, it helps insurers manage risks related to fraudulent claims. Let’s now understand why is there a waiting period for health insurance.

Why is there a waiting period for health insurance?

Understanding what is waiting period in insurance is essential because it determines when policyholders can begin making claims for specific health conditions after buying a policy. Generally, health insurance plans include this period to avoid immediate claims. Here are the prominent reasons why is there a waiting period for health insurance:

Prevents fraud

One of the key reasons why is there a waiting period for health insurance is that it protects people from fraud. The period ensures people don’t buy health insurance solely when they need urgent care. If insurers don’t include this waiting period, they would face huge losses, and policyholders would incur higher premiums.

Manages risk

Waiting periods assist insurers in managing costs and financial risks associated with coverage of medical conditions. Some medical conditions or treatments can be extremely expensive. With a waiting period, insurers can diversify the risk of high claims over time. In the case of pre-existing conditions or some specific diseases, waiting periods provide enough time for insurers to better assess and manage the financial effects of these risks.

Facilitates long-term coverage

The wait period for health insurance encourages continuous coverage and deters temporary or short-term use of insurance. The insurer collects premiums over time before covering major claims. Thus, they ensure long-term care and financial stability for policyholders.

How does the waiting period in health insurance work?

The waiting period can differ based on the type of coverage and the insurer. The following points explain its work mechanism.

The waiting period begins from the date of your health insurance policy purchase.
During the wait period for health insurance, only the claims related to hospitalisation due to accidents are accepted. The claims associated with specific conditions (for example, maternity benefits or pre-existing diseases) are not accepted.
Once the wait period for health insurance ends, the policyholder can file claims to get compensated for medical expenses.
Some insurers provide add-ons or riders to decrease wait periods for certain conditions.

Understanding coverage and restrictions in the initial waiting period

Individuals who are new to health insurance may get confused about is there a waiting period for health insurance. Most policies include a waiting period. Let’s understand the coverage and exclusions during the initial waiting period.

What’s covered?

Accidental Hospitalisation: Most health insurance companies accept claims for medical expenses due to accidents.
Emergency Care: Some healthcare insurance policies may cover emergency treatments. However, it varies by insurer.

What’s not covered?

Pre-Existing Diseases: Conditions diagnosed before buying the policy are not covered.
Specific Illnesses: Conditions like cataracts, hernias, and osteoporosis might come with long waiting periods.
Non-Emergency Treatments: Planned surgeries, routine check-ups, and elective procedures are excluded.
Maternity Benefits: Expenses related to pregnancy are typically excluded.

Initial Waiting Period vs Other Waiting Periods

The following table compares the initial waiting period with other waiting periods.

Waiting Period Type	Duration	Coverage Limitations
Initial Waiting Period	30 days	No claims are allowed except for hospitalisation due to accidental injuries
Pre-Existing Disease Waiting Period	1 to 3 years	No coverage for pre-existing conditions
Maternity Benefits Waiting Period	9 months to 3 years	Pregnancy-related expenses are excluded
Specific Illness Waiting Period	1 to 3 years	Conditions like cataracts, hernias, etc.

Waiting Period Type

Duration

Coverage Limitations

Initial Waiting Period

30 days

No claims are allowed except for hospitalisation due to accidental injuries

Pre-Existing Disease Waiting Period

1 to 3 years

No coverage for pre-existing conditions

Maternity Benefits Waiting Period

9 months to 3 years

Pregnancy-related expenses are excluded

Specific Illness Waiting Period

1 to 3 years

Conditions like cataracts, hernias, etc.

Note that the initial waiting period is for all new policyholders, whereas other waiting periods depend on specific treatments or conditions. To decrease waiting durations for certain conditions, some insurers offer riders.

Benefits of initial waiting periods in health insurance

In health insurance, the initial waiting period ensures sustainability and fairness in the industry. Some key benefits are.

The wait period for health insurance prevents individuals from buying insurance only after they find that they have a disease.
It keeps insurers financially stable by managing risks.
It avoids immediate payout risks by preventing excessive early claims.
This period avoids fraudulent claims from individuals who buy the policy only after falling sick.
It keeps insurance companies financially stable as it helps them wisely manage expenses.

Tips to manage the initial waiting period

Here are effective tips to manage this period.

Purchase insurance early to prevent gaps in coverage.
Try to use workplace health benefits if available during this period.
Explore short-term health insurance plans that cover specific conditions.
Opt for a suitable rider to decrease waiting periods.
Develop healthy lifestyle habits to reduce medical costs during waiting periods.
Some insurers allow you to waive or decrease waiting periods by paying an extra premium.
Employer health plans often have shorter or no waiting periods.
Many employers provide group-coverage health plans that have little to no waiting period. You can skip waiting periods in health insurance by joining such plans from employers.

Conclusion

Many people are confused about what is waiting period in insurance because it determines when they can start utilising the policy benefits after purchase. This period encourages policyholders to plan their medical needs to ensure financial stability and fairness. It may feel restrictive, but it helps avoid fraud and encourages the responsible use of health insurance. A comprehensive understanding of the waiting period meaning simplifies your decisions when choosing a policy. So, it ensures they have enough coverage when they require it most.

Frequently asked questions

In this section, we will go over some of the most frequently asked questions about initial waiting period in health insurance

Is the initial waiting period applicable to accident cases?

No, the majority of health insurance policies accept claims for accidental hospitalisation even during the initial waiting period.

Does the waiting period reset on policy renewal?

The waiting period does not reset upon renewal. After the period is completed, the policyholder does not have to wait again.

Can I claim for fever or infections during the initial period?

No, the waiting period in health insurance does not accept claims for general illnesses like infections, fever, and viral diseases.

Is there any way to skip the initial waiting period?

Some insurers provide add-ons or riders to decrease or eliminate the waiting period for specific conditions.

How is this different from the pre-existing disease waiting period?

The initial waiting period is for all new policyholders, whereas the waiting period for pre-existing diseases only affects the conditions diagnosed before buying the policy.