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Waiting Period in Senior Citizen Health Insurance - Can it be Waived?

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Imagine one day you realise that the health insurance policy you have bought for your parents isn’t adequate. Given the health risks they are vulnerable to because of their age and low immunity, you need to increase the scope of coverage. When you go looking for a better health plan, you come across a lengthy waiting period. Now, waiting for another two or three years for an illness to be covered seems to be an impractical approach. So, you start wondering if the waiting period can be reduced or, even better, completely waived. Let’s take a closer look.

What is a Waiting Period in Health Insurance?

In health insurance, the waiting period refers to the time you must wait before claiming the benefits of a healthcare policy. In other words, you cannot immediately avail of the coverage benefits after purchasing health insurance. If you file any claims before completing the waiting period, the insurer can reject the claim. The waiting period starts from the date of policy issuance and can vary between insurers.

Types of Waiting Periods

1. Initial Waiting Period: The initial waiting period is 30 days from the policy start date. During this period, you cannot raise any claim except for accidental hospitalisation. This is also known as the cooling period.

2. Waiting Period for Pre-existing Diseases: Pre-existing diseases have a waiting period of up to 3 years. So, if you have been diagnosed with any medical condition 48 months prior to purchasing a policy, you can make a claim related to the PED after completing the waiting period. Some examples of PEDs include diabetes, hypertension, thyroid disorders, etc.

3. Waiting Period for Specific Ailments: Specific ailments or procedures like hernia, cataracts, and osteoporosis have a waiting period of 1-2 years, depending on the insurance provider.

4. Critical Illness Waiting Period: Critical illnesses are covered after a waiting period of 90 days.

5. Waiting Period for Health Check-ups: Usually, policyholders have to wait for a year before they can avail of complimentary health check-ups.

Can You Waive the Waiting Period in Senior Citizen Insurance?

It is, generally, not possible to completely waive off the waiting period in senior citizen insurance. However, some insurance providers offer the option of reducing or removing the waiting period for pre-existing diseases; it is called the pre-existing disease waiting period waiver. For this option, you have to pay a higher premium. As most senior citizens are likely to have pre-existing diseases, like hypertension, diabetes, etc., the waiting period reduction or waiver option proves beneficial for them.

Things to Consider While Purchasing Senior Citizen Health Insurance

Senior citizen health insurance is a must to protect your retirement savings. However, to ensure you get the most out of it, consider these factors before buying the policy —

• Coverage amount: Senior citizens may require regular medical attention due to their vulnerability to falling sick. So, it’s important to have adequate coverage amount to minimise out-of-pocket expenses.

• Waiting period: Look for plans with the shortest waiting periods or waiting period reduction option or waiver, as most health plans have waiting periods for pre-existing diseases.

• Comprehensive coverage: The policy must cover age-related ailments in addition to other benefits, such as hospitalisation, pre- and post-hospitalisation, daycare procedures, domiciliary care, AYUSH benefits, etc.

• Co-payment clause: Senior citizen plans have a co-pay clause that you must be aware of. In co-pay, you have to pay a portion of the claim amount while the insurer covers the rest.

• Network hospitals: Look for an insurer with network hospitals near your location for immediate access during an emergency.

• Customer support: The insurer must have round-the-clock customer support to resolve any queries related to claims and other issues.

• Brand reputation: Customer reviews and ratings will help to know the insurance company’s performance. Go for an insurer with a high claim settlement ratio and seamless claims process.

Conclusion

To sum up, you must check the waiting periods for pre-existing diseases and specific ailments and procedures before buying senior citizen insurance. Discuss with the insurer if the waiting period can be reduced or waived because most senior citizens have pre-existing diseases, and an emergency can crop up at any time. If you have not completed the waiting period and raised a claim, all expenses have to be borne by you.

Disclaimer: The above information is for illustrative purposes only. For more details, please refer to the policy wordings and prospectus before concluding the sales.

RELATED ARTICLES

Waiting Period in Critical Illness: What You Should Know

Types of Waiting Periods in Health Insurance

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Waiting Period in Pre-Existing Disease (PED)

Are there Health Insurance Plans with No Waiting Period?

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