Health Insurance

What is 'Waiting Period' in Health Insurance?

Many among us buy a medical insurance policy for the tax benefit it offers. Thankfully, it is dawning on us now that a health insurance policy is much more than tax incentives. But it is also vital to know the features and benefits of your medical insurance. Getting a grasp on the terms and conditions is equally important too. An understanding of such basic information will help you derive the maximum benefit out of the policy you have bought.

Most health insurance policies come with a ‘waiting period’ clause. Let us understand here in detail what is 'waiting period' in health insurance.

What is meant by 'waiting period' in health insurance?

The waiting period is the time span during which the insurance provider will not entertain any claim by the policy holder. This period normally varies between one year and four years. It also depends on the disease. However, some diseases are covered after a waiting period of just one month or 30 calendar days.

What is the waiting period for different diseases?

While all Health insurance plan come with a waiting period of at least one month, some plans provide cover for accidental hospitalisation from Day 1 of the insurance coverage.

For treatment of a few diseases such as tonsils, hernia and cataract, policy holders need to wait one year in some medical insurance plans. Your insurance provider would specifically mention this in policy documents.

The waiting period is usually 2-3 years for pre-existing illnesses. For example, if the insured person is a diabetic, the insurer might have put a waiting period clause. During this period, no claim on treatment cost of diabetic-related diseases will be accepted.

It is necessary to mention the pre-existing illnesses, if you have any, before you buy a policy. Your claim will be rejected if you hide such information from the insurer.

The waiting period for pre-existing illnesses for senior citizens is normally shorter. Most of the health insurance policies for senior citizens come with a co-payment clause. In such arrangements, the insurance company pays a part of the medical bill. The rest is paid by the insured.

Waiting period in SBI health insurance policies

The waiting period in SBI Health Insurance policy for pre-existing illness is four years. Illnesses and diseases contracted, or injury received, within 30 calendar days from the commencement of the policy will not be covered.

Also, joint replacement surgery that isn't caused by an accident will have a waiting period of three years.

There is no waiting period if you are covered under a group health insurance plan. You can avail of medical cover benefits even for pre-existing ailments from Day 1 of the commencement of the policy.

Disclaimer: The above information is indicative in nature. For more details on the risk factor, terms and conditions, please refer to the Sales Brochure and Policy Wordings carefully before concluding a sale.

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