Do you know this about waiting period in health insurance

Harjot Singh NarulaComparepolicy.comBought a health insurance policy lately or planning to buy one? It is recommended to read the fine print carefully before entering into an insurance contract. We all get excited to see the benefits offered in a proposition, but tends to overlook the nitty gritty’s of the same. The health insurance plan also offers a wide range of benefits which may include expenses related to inpatient hospitalization, pre & post hospitalization, day care procedures, domiciliary treatment, organ donor benefits. Such benefits do not come into existence from the time you purchase a health policy. Your health insurance benefits are governed by a “WAITING PERIOD” clause. The waiting period clause suggests that the insured / insureds have to wait for a specific time period as defined in the policy to avail the specific health insurance benefits mentioned in the contract. Waiting periods are not standardized for all health insurance plans which are available in the insurance industry rather the quantum of waiting period may vary from one health plan to another or from one insurer to another.The intent of the waiting period is to avoid any kind of moral hazards or planned claims from the insured’s perspective while opting for a health insurance policy. Insurance does not pay for the losses which are certain and predictable and ethically insurance is taken not to gain out of the occurrence of an event.The insurance company will not like to face the brunt of a claim arising out of the known ailments / diseases and the treatment of which is required, just after the policy issuance.This way the health insurance portfolio will turn into a loss making portfolio for the insurance companies, if the claims which are bound to occur is already known to the insured at the time of policy inception are accepted. So, the insurer has a waiting period clause to confront such claim events.It is imperative for the policyholder to read the waiting period clause before buying the health insurance policy to avoid any last minute surprises or rejection of the claim by the insurer on the grounds of the waiting period clause.There are various kinds of waiting period, which are specified in your health insurance policy contract.Initial waiting periodThe initial waiting period specifies that no claim pertaining to any treatment of any illness / disease or undergoing of surgery is not covered within first 30 days of policy inception date. The only event which is excluded from the purview of the initial waiting period is the claim for the hospitalization due to an accidental external injuries. For some health insurance plans, the initial waiting period may go upto 90 days as well. Pre-existing disease waiting periodA pre-existing disease implies to any kind of medical condition, ailment, illness or disease that the insured is suffering from before taking the health insurance policy. A pre-existing waiting period usually ranges from one year to four years of continuous policy coverage for various health insurance plans available in the market. Such diseases or medical conditions are covered post waiting period of the issuance of the first health insurance policy.For specific health plans catering to senior citizen might offer you a lower pre-existing disease waiting period which may range from a year to two years time window.Specific waiting periodThere are certain specific treatments or surgeries like Cataract, Hernia, Tumour, ENT disorders, osteoporosis,Non infective Arthiritis, Joint Replacement which are covered post completion of the specific waiting period of two years of continuous policy coverage or as specified in the policy contract.The list of such specific treatments may vary from insurer to insurer or plan to plan.So, it is suggested not to assume such specific treatments common for various plans.Maternity benefits waiting periodMaternity benefits relate to the child birth related medical expenses, pre and post natal expenses or as prescribed under the purview of the policy contract. To avail maternity benefits in your health insurance policy, the waiting period may range from 9 months to 36 months for some health plans. It is advisable to buy a plan at an early stage of planning a family to avail the maternity benefits under the policy when required.With various online comparison platforms, you may easily assess and compare the waiting period clauses under the health insurance plans before making a final decision. It is better to opt for a plan with lesser waiting period window to avail the benefits under your health plan. It is also important to assess in detail about the waiting period clause in your policy contract. As ignoring this vital insight about your health plan may result in repudiation or rejection of claim leading to paying off the claims from your pocket.