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?

Q: Can I file a claim immediately after buying health insurance?

If you have a health insurance plan with no waiting period, you can raise a claim as soon as your policy is active. Additionally, accidental hospitalisation claims are generally allowed immediately after policy activation.

Q: What does zero waiting period mean in health insurance?

Zero waiting period means you can use policy benefits from day one without any waiting. This typically applies to accidental hospitalisation; some specialised no-waiting plans may also offer immediate coverage for certain pre-existing conditions.

Q: How can I shorten the waiting period in my health insurance plan?

You can often reduce the waiting period by paying an extra premium for a waiting- period waiver or by choosing add-ons that shorten or remove waiting periods. Employer- sponsored (group) plans may also offer immediate coverage.

Q: How long do I need to wait before making a claim under my policy?

Typically you can file a claim after the initial waiting period of around 30 days. Accidental hospitalisation claims are usually payable immediately, and plans with no waiting period allow claims from day one as per policy terms.

Medical emergencies can happen anytime and quickly drain your savings if you don’t have health insurance. A health plan covers costs like doctor visits, hospitalisation, surgeries and medicines. However, most policies include a waiting period, which means you must wait for a certain time before using specific benefits. To address the need for timely care, some insurers now offer special plans that provide faster or even instant coverage. Knowing how these plans work can help you choose the right one and stay prepared. Read on to learn more about health insurance with no waiting period.

What is Waiting Period in Health Insurance?

The waiting period in a health insurance policy 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 conditions

Most healthcare policies have a waiting period of 1 to 3 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 3 years.

Health Insurance Plans with No Waiting Period for Pre-existing Diseases

Health insurance plans typically impose a waiting period for pre-existing diseases (PEDs). While the standard PED waiting period ranges from 1 to 3 years, a few insurers may offer limited options to reduce or eliminate this waiting period under specific conditions.

Key things to know:

◦ Standard waiting period still applies in most plans:

As per IRDAI regulations, insurers can impose a PED waiting period of up to 36 months (3 years). Most regular health insurance plans continue to follow this norm.

◦ Day 1 coverage is not common:

Only a limited number of health insurance plans offer immediate (Day 1) coverage for certain listed pre-existing diseases, and this is usually subject to strict terms, higher premiums, caps, or sub-limits.

◦ Optional add-ons may reduce waiting periods:

Some insurers offer waiting period reduction add-ons or riders, which allow faster coverage for PEDs (for example, reducing the waiting period from 3 years to 1 or 2 years). These are available at an additional premium.

◦ Senior citizen plans have conditions:

Certain senior citizen health insurance policies may offer immediate coverage for specified pre-existing conditions, but only for listed diseases, often with co-payments, sub-limits, or capped sum insured. Full PED coverage from Day 1 is generally not available across all conditions.

How Does Zero-Waiting Period Work?

In a standard health insurance plan, the waiting period begins on the day your policy starts, and you can file a claim only after this period ends. However, if you have health insurance without waiting periods, you can claim benefits immediately.

It is important to note that not all waiting periods are waived. For example, if you need cataract surgery, health insurance with no waiting period for pre-existing conditions may provide immediate coverage for pre-existing diseases (PED). However, because cataract is also considered a specified disease, a separate waiting period may still apply before you can claim for the surgery.

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 a 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 3 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 1 to 3 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

While some insurers offer health insurance without waiting period, it usually comes at a higher cost and may include certain terms and conditions. That’s why it is better to buy a health plan when you are young and healthy. This allows you to get good coverage at a lower premium, and by the time you need it for medical expenses, the waiting period will likely be over.

FAQs

1. Which health insurance plans offer no waiting period?

Almost all standard health insurance plans have an initial 30-day waiting period, during which claims are not accepted. However, accidental hospitalisation is covered from day one. Additionally, some insurers now offer health insurance pre-existing conditions no waiting period plans by charging an additional premium.

2. Can I file a claim immediately after buying health insurance?

If you have a health insurance no wait period plan, you can raise a claim soon after your policy is activated. Insurers also allow immediate claims for accidental hospitalisation expenses.

3. What does zero waiting period mean in health insurance?

In health insurance, a zero-waiting period means you can use your policy benefits from day one without any waiting. This applies to all accidental hospitalisation claims. Some special no waiting period health insurance plans may also offer immediate coverage for pre-existing diseases.

4. How can I shorten the waiting period in my health insurance plan?

You can reduce the waiting period in your health insurance plan by paying an extra premium, as many plans offer this option. Alternatively, you can choose a health insurance no waiting period plan for immediate coverage.

5. How long do I need to wait before making a claim under my policy?

Typically, you can file a health insurance claim after the initial waiting period of around 30 days. However, accidental hospitalisation claims can be made immediately after purchasing the policy. Also, if you have health insurance without a waiting period, you can raise a claim from day one.

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

◦ Waiting Period in Senior Citizen Health Insurance

◦ Waiting Period in Parents' Health Insurance Explained

◦ Waiting Period in Pre-Existing Disease (PED)

◦ Modern Treatment List Covered in Health Insurance

◦ Types of Waiting Periods in Health Insurance