The pandemic has certainly taught us the importance of a good health insurance policy. Since then, it has become crucial for all of us to invest in a plan that provides us security in our most vulnerable moments. However, before you invest your hard-earned money into buying a policy, it is important to understand what is waiting period in health insurance and how it affects pre-existing diseases (PED) coverage.

What is Pre-existing Diseases Cover (PED) in Health Insurance?

According to the Insurance Regulatory and Development Authority of India (IRDAI), a pre-existing disease or illness is a medical condition the policyholder is diagnosed with before purchasing the insurance plan or before the health coverage begins. PEDs include conditions like diabetes, arthritis, and asthma, among others.

PED Waiting Period in Health Insurance

What is waiting period in health insurance? In simple terms, the waiting period is a specified time that the insurer asks the policyholder to serve before availing of the health insurance benefits. In the case of health insurance policies that cover pre-existing diseases in India, the waiting period is different as compared to the base cover in medical insurance. The waiting period in health insurance covering PED may also vary from insurer to insurer or the specific type of disease. Generally, it ranges between 2-4 years.

Types of Waiting Period in Health Insurance

Majorly, there are four types of waiting period in health insurance plans. These include:

• Initial Waiting Period: All health insurance policies come with an initial waiting period wherein the policyholder is required to wait for a specific number of days to be able to receive any claim under the policy. Generally, the waiting period for these plans is set at a minimum of 30 days and a maximum of 90 days.
• Pre-existing Diseases (PED) Waiting Period: This is a special waiting period for some diseases that the policyholder discloses at the time of purchasing the policy. Examples of some pre-existing diseases are thyroid, hypertension, and diabetes. Generally the waiting period in health insurance for PED is 2-4 years and may vary depending upon the health condition of the insured as well as the health insurance plan they chose.
• Waiting Period for Specific/Named, Ailments/Procedures: Several ailments and procedures like hernia, tumours, ENT disorders, cataracts, joint replacement, etc., come with a specific waiting period. The waiting period in health insurance for these plans usually ranges between 2 years and 4 years.
• Maternity Benefit Waiting Period: A lot of health insurance plans come with the built-in feature of maternity cover. If not, the policyholders can include the maternity and newborn baby cover as an add-on feature. The coverage can be availed after serving a notice period varying from 9 months to 36 months.
• Zero Waiting Period in Health Insurance: As the name suggests, zero waiting period in health insurance provides medical coverage from day 1 of the policy without having to serve any waiting period. This type of insurance coverage allows you to file a claim as soon as you buy your policy and seek financial assistance in cases of medical emergency. Almost all accidental hospitalisation claims come with zero waiting period in health insurance.

Health Insurance Without Waiting Period for Pre-existing Diseases

Generally, all health insurance plans have a waiting period, but these days’ certain insurance providers have introduced health insurance with no waiting period, specifically for pre-existing diseases. Under these special policies, pre-existing diseases are covered from day 1 of the policy. Moreover, according to IRDAI, conditions such as diabetes, cardiac conditions, hypertension, etc. should not have a waiting period exceeding 30 days.

Several insurance companies in India also offer optional cover to waive the waiting period for pre-existing diseases. You are only required to pay a little extra premium to buy this optional cover when you buy the policy.

Conclusion

If you or a family member is suffering from a pre-existing disease, then you can consider going for a health insurance plan that offers PED coverage from day 1. However, before you invest your money, ensure that you keep in mind the above-mentioned points and choose a policy that affordably meets all your requirements.

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