Check Waiting Period Clause in a Health Plan for These 4 Reasons

If you do not know how to choose health insurance, you should start the process by researching. It is highly advisable to purchase a health insurance plan.


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One aspect that is considered nothing less than a boon today is having your medical needs met. To ensure that, there are numerous health insurance plans available in the market. Especially when you have any pre-existing ailment, having a health insurance policy is a must. But before you opt for any policy, it is essential to know about the waiting period clause of the insurance companies. This period where you have to wait to make a claim can also vary from one plan to another.

Health Insurance Plan

health insurance

Moreover, there are a few other reasons why you should check the waiting period clause:

1. To Know Policy Details

If you do not know how to choose health insurance, you should start the process by researching. You can talk to an agent offline or go online to read about and understand various available plans. When you opt for the online route, you get the comfort of choosing the plan from your home itself.

You must know the terms and conditions of the plan in detail. It would help if you researched the inclusions and exclusions, the waiting period for pre-existing illnesses, and the premium to pay. Understanding each of the plans in thorough detail will help you evaluate your requirement and choose the most suitable health insurance plan accordingly.

2. To Avoid Claim Rejection

Next to the details, it is extremely vital to understand the claim rejection of health insurance plans. A legitimate cause of claim rejection by health insurance providers is the non-disclosure of a pre-existing medical condition when purchasing the health insurance policy. Many insurers also reject the claim if the medical treatment is taken during the waiting period.

It is essential to understand that health insurance companies generally cover certain diseases and ailments only after the completion of the waiting period. Usually, the waiting period ranges from a few months to a few years, depending on the policy.

3. Different Kinds of Waiting Period

Before you opt for a health insurance plan, you should note different types of waiting periods. These are:

  • Preliminary Waiting Period

Generally, the insurers will give you a medical cover, which you may need due to any unforeseen condition or accident during the initial phase. However, do note that in cases of sickness or any medical treatment which requires hospital treatment, the insurer may not offer any cover. Thus you won’t be able to claim it within this waiting period.

  • Pre-Existing Illness Waiting Period

It will help if you note that you cannot file a claim for the treatment related to pre-existing ailments before completing the disease-specific waiting period. As mentioned above, you might have to wait for at least 3 to 4 years till your waiting period is completed.

  • Waiting Period for Specific Ailments

Many health insurance providers offer a waiting period for 1 or 2 years for specific ailments. These include hernias, osteoporosis, and others.

  • Maternity Benefit Waiting Period

Generally, health insurance companies have maternity covers, which come with a waiting period of 9 months to 48 months. This benefit can be a part of the general health insurance policy or a rider.

4. Reduction of Waiting Period

Some health insurance providers can decrease the waiting period by taking a slightly higher amount as a premium. Also, some plans have a co-payment clause, especially in the case of senior citizens with which you will have to pay a certain percentage of the medical bills while the health insurance company pays the rest.

It would be best to look for a health insurance policy that offers a minimal waiting period.

Irrespective of the policy you buy, it is crucial for you to read the details to avoid misconceptions about waiting periods. Also, it will ensure that you choose a plan that is best suited for your needs. It is highly advisable to purchase a health insurance plan while you are still young when incidences of health problems generally are few and far between. You can opt for reliable insurers like Tata AIG that offer comprehensive health plans. Explore their website and read the policy wording thoroughly before you make a choice.


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