Are there Health Insurance Plans with No Waiting Period?

Posted on: Dec 14, 2023 | 3 mins | Written by: HDFC ERGO Team

Are there Health Insurance Plans with No Waiting Period?

A medical emergency can happen anytime and eat up your savings if you are not prepared for it with an adequate health insurance policy. A health plan can cover your medical expenses and save you from financial setbacks. From doctor’s consultation fees and hospital bills to surgery expenses and the cost of medicines, a health plan covers them all. However, when you buy health insurance, you must wait for a specified number of days before you can avail of policy benefits. This is called the waiting period in health insurance. So, can you buy a healthcare plan with zero waiting period? Although most health insurance policies in India have an initial waiting period of 30-90 days, hospitalisations due to accidents are covered from day one. Moreover, some insurance companies have also introduced health insurance without a waiting period. Read on to understand what is waiting period in health insurance and other details.

What is Waiting Period in Health Insurance?

The waiting period in health insurance parlance denotes the duration for which you must wait before filing any claims. This simply means that your insurance provider will not entertain claims when your policy is still in the waiting period.

Types of Waiting Periods

There are different forms of waiting periods in health insurance —

1. Initial waiting period

When you buy a health plan, you must wait for about 30 to 90 days before you can file a claim. This is the initial waiting period in health insurance.

2. Waiting period for pre-existing conditionsm

Most healthcare policies have a waiting period of 1 to 4 years for pre-existing conditions. For example, if you get diagnosed with diabetes before buying health insurance, it will be considered a pre-existing condition. If your healthcare plan has a waiting period of 2 years for pre-existing conditions, the insurance company will cover diabetes-related treatments after 2 years from the date of policy purchase.

3. Disease-specific waiting period

Specific diseases, such as hernia, bariatric surgery and psychiatric health conditions, have a waiting period of 1 to 2 years.

4. Waiting period for maternity coverage

Insurance companies cover maternity expenses only after a waiting period of 9 months to 4 years.

Can I Buy Health Insurance with Zero Waiting Period?

The waiting period in health insurance can keep you from availing of the benefits of your healthcare plan. Some people delay expensive medical procedures when their policy is in the waiting period, and this worsens their health condition. Keeping this in mind, insurance companies have introduced the no waiting period clause in health insurance. The same is applicable in the following scenarios —

1. Accidental hospitalisation

Insurance companies cover hospitalisation due to accidents from day one for no extra premium.

2. Add-on cover for pre-existing conditions

Some insurance providers offer a no-waiting-period add-on for pre-existing conditions. If you opt for this add-on cover, the insurer will cover your pre-existing condition from day one. However, the add-on will increase your health insurance premium.

Why do Health Insurance Plans Have a Waiting Period?

Here are some key reasons why these insurance plans come with a waiting period:

• Improve the overall integrity of the process

In the case of health insurance without waiting period, policyholders may resort to certain unethical practices. They may buy a policy if they need coverage for their medical expenses, submit proof of their expenses, get their claims settled and quit the policy. In short, they only use their policy for their claims and nothing else. However, in the case of plans with waiting periods, this is not possible, as policyholders must wait for a specific time to avail themselves of the benefits.

• Same rules for all

All policyholders, regardless of their social status, receive equal and fair treatment in cases involving plans with waiting periods. The claims, too, are settled through a fair and just process.

• Manage Claim Settlement

Health plans come with a waiting period to give insurers enough time to settle claims submitted by policyholders. They use this time to manage the risk and ensure the financial stability of the plan.

What are the Types of Waiting Periods in Health Insurance?

The most common types of waiting periods you may come across when you buy health insurance are:

• Initial waiting period

This is the most common waiting period and starts as soon as you buy the plan. Most insurers have an initial waiting period of 30 days. This means you can submit your claim only 30 days after the policy purchase, except in cases like accidents.

• PEDs (pre-existing diseases) waiting period

If you have been diagnosed with a condition before buying medical insurance, that condition is treated as a PED. Different insurers have different terms when it comes to deciding waiting periods for these PEDs. Mostly, insurers have a waiting period of up to 4 years for pre-existing conditions. If you haven’t disclosed your PED at the time of buying your policy, your claims will be rejected.

• Waiting period for a particular ailment

Certain specific diseases, such as hernia, ortho issues (including osteoporosis and joint replacement), and problems related to ENT, come with different waiting periods based on the insurer’s terms. In most cases, these come with a waiting period of 2 to 4 years.

• Maternity and newborn waiting period

You may have to wait between 9 months and 2 years after buying your medical insurance to qualify for maternity benefits and newborn coverage. It is always a good idea to buy medical insurance quite early, so that by the time you require maternity benefits, you become eligible for the same.

How Can I Reduce the Waiting Period for a Health Insurance Plan?

Here are some ways you can try to reduce the duration of your insurance plan’s waiting period:

• Minimum waiting period

Compare the different waiting periods of various insurers under different categories (specific illnesses, maternity coverage, critical illnesses, etc.). Choose the plan that offers the shortest waiting period for a condition that’s most relevant to you so that you don’t have to wait too long to submit your claims.

• Buy early

This is the best option not only in terms of efficient financial management but also in reducing your waiting period. Ideally, you should buy medical insurance as soon as you start earning. When you require coverage (for illnesses, maternity benefits, etc.), you will have already served the waiting period.

• Add-ons

Some insurers offer a “no-waiting period add-on” that you can purchase for an additional charge. These are applicable for existing conditions, and you can qualify for coverage right from day one of the policy when you buy these.

• Opting for copayment

When you opt for a copayment, you agree to pay a part of the medical expenses in case of hospitalisations or treatments. By doing this, your waiting period can be reduced significantly, but you have to pay some expenses out of your pocket.

• Using employer-sponsored health insurance plans

Insurance plans from employers (group insurance plans) have no waiting period, and you qualify for claims right from the first day of the policy.

Conclusion

You can buy health insurance without a waiting period by paying more than you would for a standard healthcare plan. However, the best option is to buy health insurance early, i.e., when you are young and healthy. You can easily get adequate coverage for nominal annual premiums. Moreover, the waiting period of your healthcare plan will be over by the time you may want to use it to cover your medical bills.

Disclaimer: The above information is for illustrative purposes only. For more details, please refer to the policy wordings and prospectus before concluding the sales.

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