Understanding The Waiting Period Of A Health Insurance Policy

Featured Image Caption: Health Insurance Benefits

India, as a country, has made massive strides in the healthcare sector. The improvement of vital healthcare statistics is a testament to that. India has gained a lot on critical health indicators like infant mortality rate and life expectancy in the past few decades.

Medical costs have gone up proportionately in the same time frame. According to leading surveys, medical inflation in India is more than double of standard inflation and touched double digits too. The high cost of availing quality medical service makes it essential for individuals to be covered by health insurance policies.

Medical insurance in India: Why is it important?

As established earlier, medical costs in India are exorbitant. Unfortunately, government expenditure on healthcare services has not been up to the mark. The Indian government currently spends just over 1% of its GDP as public expenditure on health, making affordable healthcare a distant reality. However, there are multiple initiatives in the pipeline along with an increase in the allocated budget.

It is in this context that health coverage takes critical importance. In total, it is estimated that 35 Crore Indians, which is just 27% of the total population, have a medical insurance policy in place. Recently, the Government has committed to Universal Health Coverage or UHC through schemes like Ayushman Bharat.

Insurance was liberalised as late as 2000, and since then, private firms have done reasonably well to provide health insurance coverage to millions of Indians. Currently, they are responsible for the coverage of around 21% of the total medically insured population. For instance, Bajaj Finserv offers products such as monsson cover policy, Stampede Insurance Plan and Firecracker Cover under their Pocket Insurance category.

If you have a health insurance plan in place, there are certain things that you should know about it, such as the waiting period.

Waiting period in health insurance: The what and why of it

In medical insurance terms, the waiting period is the span of time that has to pass before your plan provides coverage certain diseases/ ailments. In other words, you cannot claim any money from your health insurer for certain ailments until a certain pre-fixed period has passed since you bought the plan.

Reasons for waiting period

Although it varies from one insurer to another, there are some general inclusions in waiting period which are more or less universal.

• Pre-existing conditions

Pre-existing conditions, such as diabetes, thyroid, hypertension, etc. generally have a waiting period of 4 years. It is, therefore, advisable to avail a health insurance policy early in one’s life so that there is no waiting period when one needs coverage for the same.

• Pre-specified ailments

Depending on the type of your insurance policy, the insurer may specify certain illnesses for which there is a waiting period of one or two years. Typically, diseases such as hernia, ENT disorders and osteoporosis come under this category.

• There is a general waiting period of one month for all types of diseases. The only exclusion is cases of accidents.
• For infants, the waiting period is generally 3 months.
• Most insurers have eliminated the waiting period for senior citizens by introducing a co-pay clause. It essentially means the policyholder shall bear a certain percentage of the medical costs, while their health insurance plan will cover the rest.
• Bajaj Finserv offers Pocket Insurance plans such as monsoon cover, stampede insurance policy, dengue cover, etc. that are easy to apply.

An understanding of waiting period is central to avail the full benefits of your health insurance coverage. Ask your insurer about the waiting period in details before finalizing on your insurance policy.