How Soon After Taking Out Health Insurance Can I Claim?

Claim Waiting Periods for New Health Insurance Policies

One of the best ways to get financially protected in the case of any medical emergencies is health insurance. However, insurance cannot be claimed the day a policy is purchased. Insurers impose waiting periods for claims. The idea is to prevent fraudulent misuse and ascertain that only valid claims are made for events that take place after purchasing a policy.

Thus, it is very important to know about such waiting periods to plan out health coverage appropriately and not to be surprised when making a claim.

Types of Waiting Periods in Health Insurance

1.First Waiting Period
●Days: Within 15 to 30 days from the date of the policy purchase.
●This is when claims for most illnesses and treatments are not entertained except those resulting from accidental injuries.
●For instance, you could have a waiting period on the insurance policy that is 30 days, and you may get sick with a fever in the second week. In this case, your claim is denied. However, if you suffer an injury through an accident within that period, you can reap the coverage benefits.

2.Pre-existing Disease Waiting Period
●Duration: 1 to 4 years, depending on the insurer and policy.
●Pre-existing conditions are those diseases, conditions, or injuries that have been diagnosed, treated, or known to exist within 48 months preceding the date of purchase of the policy. They generally include medical issues like diabetes, hypertension, and asthma.
●Any claim for the treatment of pre-existing conditions is only accepted after the prescribed waiting period is completed.
●For instance, your policy has a waiting period of 3 years on pre-existing conditions, and you are diagnosed with hypertension. Then, claims regarding hospitalization because of hypertension will not be accepted before the end of three years without any break in coverage.

3.Waiting Period Due to Disease
●Duration: 1-2 years for conditions or procedures specific to a disease, like hernia, cataract, or even joint replacement.
●Usually, the terms and conditions of the policy outline conditions, along with waiting periods.
●For example, if a waiting period of 2 years is provided for cataract surgery, this means that all the claims to be made towards this medical condition shall be entertained only after two consecutive years of policy coverage.

4.Maternity Waiting Period
●Duration: 9 months to 4 years, depending on the cover provider and plan.
●This waiting period is applicable in the case of maternity benefits policies, which provide reimbursement based on the expense related to conception and births.
●For example, choosing maternity health insurance while planning to have a child in advance is a very important decision to avoid unnecessary out-of-pocket expenses.

How to Handle Waiting Periods in Health Insurance?

1.Plan in Advance
If you anticipate that you might require pre-existing conditions coverage, maternity coverage, or any other special treatment, buy health insurance well in advance.
2.Opt for Portability
If you shift to a new insurer, you can take all the benefits like waiting periods already served. Ensure that the new policy honors this benefit.
3.Shorter Waiting Periods
Some of the other insurers also provide insurance for reduced waiting periods, which can be availed for some extra premium. Compare before you buy.
4.Choose Policies That Cater to Your Requirement
Carefully read the terms and conditions of the policy to ensure that the applicable waiting period aligns with your health coverage needs.

When Can You File Health Insurance Claims Without Waiting?

Claims can be raised immediately on the following grounds, irrespective of the waiting period:

●Accidental Injuries: Most insurance companies permit claims of accidents from day one of the policy.
●Renewed Policies: In case you renew your policy in time without any lapse, the waiting periods for pre-existing conditions and specific treatments will carry forward from where they were left.

To ensure that the waiting period does not affect your medical insurance coverage requirements, Star Health offers a plethora of plans with varying waiting periods. Thus, based on your needs, you can opt for a policy and get assured coverage when needed. Also, we offer a buy-back cover for pre-existing diseases that lets you reduce the waiting period to receive coverage for such medical issues.  

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