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Waiting period in health insurance is the amount of time you have to wait (as the insured person) before you can reap all or some of the benefits of your health insurance coverage. It’s crucial to know that usually, you cannot raise any claim against your policy during this waiting period. This waiting period may be applicable to either some health conditions or your entire coverage, and it can vary from one insurer to another.
The high likelihood of being affected by lifestyle diseases such as hypertension and diabetes has led to increased acceptance of health insurance. When you opt for a health insurance plan, you must understand that there are various aspects of the policy that needs your attention.
For example: Some health insurance plans may include Maternity Cover that may have a 2-year waiting period. And, in some plans it can be 9 months to 3 years before you can enjoy the policy’s benefits on maternity coverage.
Are there health insurance plans with no waiting period in India? The answer is a big YES!
ACKO offers zero waiting period for pre-existing diseases** in the ACKO 1 Cr. Health Insurance Policy. Additionally, our health insurance plan also comes with the feature of zero deductions at claim.
Under our Rs.1 Cr plan, we will cover the cost of hospitalisation due to any pre-existing health conditions** from day 1. The only requirement is that you must inform us about the pre-existing condition** while purchasing the policy.
We don’t have limitations on room rent, and you can choose any hospital room you prefer and we will cover the full cost. Besides, we also do not consider other deductions, such as deductibles, sub-limits, copay, etc., while determining the claim amount. With ACKO Health Insurance Policy, you get the full claim amount.
There are multiple reasons why health insurance plans have a waiting period.
To make sure there are no malpractices by policyholders.
To protect the insurer from any medical risk previously unaccounted for.
To ensure that the insured does not use health insurance for regular medical expenses.
Here are the waiting periods in most conventional health insurance plans for different health conditions.
|Health conditions||Waiting period|
|Pre-existing diseases (diabetes, hypertension, etc.)||1 to 4 years|
|Psychiatric health conditions, Bariatric surgery, Specific diseases/illnesses||1 to 2 years|
|Maternity cover||9 months to 3 years|
|Newborn baby inclusion||9 months to 3 years|
|Initial waiting period||0 to 30 days|
|Accidental hospitalisation||0 days|
Let’s understand these different types of waiting periods in detail.
Waiting period for pre-existing diseases: At the time of buying a health insurance policy, if you or other insured members of the policy have existing ailments such as hypertension (high blood pressure), diabetes, thyroid, etc., then these ailments are referred to as pre-existing disease/conditions. Most traditional health insurance plans cover pre-existing conditions after the completion of the minimum waiting period. Group health insurance waiting periods may have different terms and conditions. Please check with the respective insurance provider for more information. However, you don’t have to wait for coverage of pre-existing diseases with ACKO. With ACKO 1 Cr. Health Insurance Policy, we will cover the cost of hospitalisation due to a pre-existing disease** from day 1.
Waiting period for specific illnesses/diseases: Certain diseases or medical conditions and procedures may come with a specific waiting period. These may include cataracts, ENT disorders, osteoporosis, hernia, joint replacement surgery, etc. The waiting period for such illnesses can vary from 2 to 4 years, depending on the policy’s terms and conditions.
Waiting period for maternity and newborn baby add-on: Most health insurance plans cover maternity-related expenses and include a newborn baby only after the specified waiting period. It can range from 9 months to 3 years. The maternity benefit covers the delivery expenses and the newborn baby for the first 3 months. However, there are plans that do not cover maternity expenses. Make sure you confirm the coverage details before you purchase the plan.
Initial waiting period: The initial waiting period in health insurance is the duration from the date of policy commencement to the date from when you can start using the policy’s benefits. Except for accidental hospitalisation, no other medical expenses are covered during this initial waiting period in health insurance.
Waiting period for accidental hospitalisation: As stated in the previous section, only accidental hospitalisation does not have a waiting period in health insurance. All health insurance plans cover accidental hospitalisation from day 1 of your policy commencement date.
While it may not be possible to reduce the waiting period in health insurance, you can opt for ACKO Health Insurance Policy which has a zero waiting period for pre-existing diseases.
Here are some important points to keep in mind about waiting periods in health insurance.
If the insured is diagnosed with a disease during the waiting period, then it will not be considered a pre-existing disease and will be covered under the policy.
Some of the health insurance plans for senior citizens have removed or reduced the waiting period by including a copay clause. In this case, the insured must bear a certain portion of the claim amount.
Opt for a health insurance plan that offers a zero waiting period or the shortest possible waiting period.
The survival period in health insurance refers to the specified time duration the policyholder needs to survive after being diagnosed with a critical illness (cancer, heart or kidney failure, etc.). This period can be anywhere between 14 days to 180 days, depending upon the type of plan and the illness. Note that the survival time period is in addition to the waiting period of a policy. The survival period in health insurance is an important part of critical illness plans. If a policyholder has a critical illness and raises a claim, the insurer will pay a pre-defined lump sum amount. However, this amount will only be paid if the policyholder survives through the specified survival period. Once this lump sum amount is paid for the surviving policyholder, the policy is terminated.
Refer to the below table to understand the differences between survival and waiting period in health insurance.
|Criterion||Survival period||Waiting period|
|Applicable for||Critical illness policies.||All types of health insurance policies (excluding ACKO Health Insurance Policy).|
|What is it?||The specified time period during which the policyholder needs to survive after being diagnosed with a critical illness to get the claim amount (lump sum)||The specified time period before the policyholder can start raising claims against the policy|
|What’s the time period?||14 - 180 days||0 - 30 days of initial waiting period, 0 - 3 years for pre-existing disease(ACKO has zero waiting period)|
|Factors affecting the time period||Depends on the critical illness and the insurance provider||Depends on the disease and the insurance provider|
|Continuity of the coverage||Terminates after the one-time lump sum payment of the sum insured||Exists post the waiting period with continued premium payments|
Both the survival and waiting periods are associated with health insurance to make sure that genuine customers get adequate health insurance coverage during their time of need. However, they are not the same.
Now that you understand the definition of the waiting period in health insurance, it’s time to choose a plan that suits your requirements. However, you need not worry much about the waiting period in medical insurance if you buy a health insurance plan at an early stage of your life.
Health insurance plans with zero waiting periods are ideal for coverage from day 1. Take advantage of ACKO’s Rs.1 Crore plan with zero waiting period and zero deductions at claims for optimum coverage.
Here are some common questions and answers about the waiting period in health insurance.
Except for accidental hospitalisation, you cannot file a claim during the waiting period of most conventional health insurance plans. However, you can raise a claim from day 1 with ACKO.
The most significant advantage of a lower waiting period in health insurance is that the lower the waiting period, the sooner you can avail of the policy’s coverage. Before purchasing the plan, make sure to read the terms and conditions of the health insurance policy.
The reason for the waiting period in health insurance is to avoid malpractices by policyholders.
For example: If the policy buyer has a pre-existing disease and needs treatment for the same, the buyer may not disclose the same while purchasing the policy to avoid rejection of the claim. Insurers have included the waiting period in their health insurance plans to prevent such manipulation.
If you are looking for health insurance without a waiting period, then look no further. We offer Rs.1 Crore health insurance with zero waiting period if you disclose any pre-existing disease in case the pre-existing disease surfaces after a policy is issued. However at the time of claim, if it is found that the policyholder did not disclose any known pre-existing diseases while buying the policy, the claim may get rejected.
No. Most insurers do not return the premium if the insured does not survive during the survival period in health insurance.
Please check and understand the terms and conditions of the policy to know the inclusions and exclusions of the coverage.
The waiting period for mediclaim policy can range anywhere from 2 years to 4 years. However, this can vary from insurer to insurer. Make sure you read and understand the terms and conditions of the policy before purchasing a health insurance plan.
*Except for exclusions like maternity benefits, undisclosed diseases, etc. Please check policy wordings for more details.
**In case the pre-existing disease surfaces after a policy is issued. However at the time of claim, if it is found that the policyholder did not disclose any known pre-existing diseases while buying the policy, the claim may get rejected.