What is Waiting Period in Mediclaim Policy for Senior Citizens?

With age, the human body also loses its shine and strength, and as a result, it becomes more vulnerable to ailments. Further, if we consider the today’s medical inflation rate, it is easy to say that, falling ill has become a costly affair!

Quite expectedly, Mediclaim policy for senior citizens become a necessity. As such, policies cover hospitalisation expenses incurred for treatment and injury, ambulance charges along with pre & post hospitalisation expenditure, therefore, it is a wise idea to purchase a mediclaim policy for senior citizens.

Every Mediclaim policy for senior citizens come with a waiting clause which is a certain span of time before a selected list of diseases start getting covered under a health insurance policy. Usually, the waiting period of 4 years is a standard clause which is existed in almost all types of Mediclaim policies. This is important to understand that because a health insurance company can’t deny the claim once the waiting period is over.

Let us understand the concept of waiting period in a Mediclaim policy for senior citizens –

Meaning of Waiting Period

In the health insurance segment, waiting period is considered as a cooling period, i.e., a time-span before the insurance company starts covering.

Different types of waiting period

Pre-existing ailments

Pre-existing diseases are those health conditions from which a policyholder has been already suffering much before buying the policy. At the time of buying a Mediclaim policy for senior citizens, if the policyholder declares that he/she has some specific diseases like hypertension, thyroid, diabetes, etc.; these are known as pre-existing diseases. In case of pre-existing diseases, health insurance underwriters may insist upon medical tests for screening the level of impact of the ailments of the policyholder.

Read More: How to buy a separate mediclaim plan for senior citizen in the family

On the basis of the test reports, they decide the waiting period and premium. In most of the cases, pre-existing ailments have a waiting period of 4 years, which implies that the claim related to any medical expenses related to the declared ailments would be considered only when the insured completes the four years of the waiting period.

One/Two Years Waiting Periods for Particular Diseases
There are certain diseases like a hernia, ENT disorders, etc. for which Mediclaim policies for senior citizens come with a waiting period of one or two years.

Initial Waiting Period

Usually, Mediclaim policies for senior citizens do not offer coverage in the first month of the policy, except for accident cases.

Is it possible to lower waiting period?

Yes, you can lower your waiting period as some health insurance companies lower the waiting period if policyholders pay the extra premium. Further, in case of corporate health insurance policies, insurance companies do not focus on waiting period.

As per IRDAI guidelines, an employee can convert his/her group health insurance in an individual policy at the time of leaving their employer. In case, of conversion, their waiting period would also be adjusted accordingly.

For instance, if the waiting period of ENT disorders is two years, and the employee converts the corporate health insurance into an individual policy after three years, the insurer will waive off the entire waiting period on ENT disorders.

Some crucial points to note=

If during the waiting period, the policyholder is diagnosed with a disease for the first time, it would not be considered as the pre-existing ailment. The insurer will offer coverage for such disease. With changing times, most of the health insurance companies have designed such Mediclaim policies for senior citizens in which waiting periods have been done away by adding a co-payment clause.

In the insurance terminology, the co-payment clause means that the policyholder would have to bear a certain portion of the claim amount. For instance, for a co-pay of 20%, in a claim of Rs 2 lakh, the policyholder would have to pay Rs 40,000 and the remaining Rs 1,60,000 would be paid by the insurer.

So, now when you have understood the concept of the waiting period, do consider it while buying a Mediclaim policy for yourself or your parents. Choose the plan which comes with the shortest waiting period.

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