With age, the human body also loses its shine and strength. As a result, it becomes more vulnerable to ailments. Further, if we consider today’s medical inflation rate, it’s easy to say that, falling ill has become a costly affair!
Quite expectedly, Mediclaim policy for senior citizens becomes a necessity. As such, policies cover hospitalization expenses incurred for treatment and injury, ambulance charges along with pre & post-hospitalization expenditure, therefore, it is a wise idea to purchase a mediclaim policy for senior citizens.
Every Mediclaim policy for senior citizens comes with a waiting clause. Which is a certain span of time before a selected list of diseases starts getting covered under a health insurance policy. Usually, the waiting period of 4 years is a standard clause, existing in almost all types of Mediclaim policies. This is important to understand because a health insurance company can’t deny the claim once the waiting period is over.
Let us understand the concept of the waiting period in a Mediclaim policy for senior citizens –
Meaning of Waiting Period
In the health insurance segment, the waiting period is considered a cooling period. That is, a time span before the insurance company starts covering.
Different types of the waiting period
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 the 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.
On the basis of the test reports, they decide the waiting period and premium. In most cases, pre-existing ailments have a waiting period of 4 years. It implies the claim related to any medical expenses related to the declared ailments would consider 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 don’t offer coverage in the first month of the policy, except for accident cases.
Is it possible to lower the waiting period?
Yes, you can lower your waiting period as some health insurance companies lower it if policyholders pay the extra premium. Further, in the case of corporate health insurance policies, insurance companies do not focus on the waiting periods.
As per IRDAI guidelines, an employee can convert his/her group health insurance into 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 for 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 diagnoses a disease for the first time, wouldn’t consider as a pre-existing ailment. The insurer will offer coverage for such a disease. With changing times, most health insurance companies designed such Mediclaim policies for senior citizens. And do away with the waiting periods by adding a co-payment clause.
In insurance terminology, the co-payment clause means that the policyholder bears 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 the insurer pays.
So, now that 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.