What is the Waiting Period for an Existing Disease in Health Insurance?

Buying health insurance is the best thing you can do to secure your savings from the financial burden of unexpected medical emergencies.

However, if the policyholder already has certain diseases, such as diabetes, hypertension, and asthma, before purchasing a policy, there is a fixed time they are required to wait to claim the coverage benefits. This period is known as the waiting period for a pre-existing disease.

How does the Waiting Period for an Existing Disease Work in Health Insurance?

To understand how the waiting period for an existing disease works, look into this example,

Mr Ajay has recently been diagnosed with diabetes, but he still decided to purchase individual health insurance. On January 1, 2026, he bought the insurance while honestly disclosing his condition to the insurance provider. His policy documents specify a 3-year waiting period for existing diseases, including diabetes. Thus, his insurer will not cover the medical expenses for the next 36 months.

In case he gets hospitalised after 2 months of purchasing this policy, the insurance company will reject his claim. Therefore, he has to pay the hospital bill out of his own pocket.

Why Do Health Insurance Policies Have Waiting Periods for an Existing Disease?

• Prevent Fraud:Policyholders can not claim immediate high-cost treatment for their existing diseases and then drop coverage.

• Risk Management: It helps insurers manage potentially costly claims of the policyholders who intentionally buy insurance during medical needs.

• Stabilising Premium: Waiting period helps the insurer to offer lower and more competitive premiums without raising prices for all

• Promote Early Enrollment: This encourages potential health insurance buyers to purchase the policy early to reduce the waiting period.

6 Ways to Buy the Best Health Insurance for Existing Diseases

• Always purchase health insurance with a low to zero waiting period.

• Try to purchase insurance while you are young and healthy.

• If your existing policy has a longer waiting period, switch to the plan with a lower waiting period.

• Opting for high-sum insured plans to maximise the coverage benefits after the waiting period ends.

• It is always ideal to check what medical conditions and illnesses have a longer waiting period.

Can a Policyholder Reduce the Waiting Period for Pre-existing Conditions?

While purchasing health insurance with a pre-existing condition, the common question that arises in a policyholder's mind is, 'Can I reduce this period?' Well, the answer is yes.

Most reputable health insurance providers offer the option of reducing waiting periods for a pre-existing disease. However, policyholders must pay an additional premium amount to reduce the time. By opting for these optional buyback pre-existing disease cover, they can minimise the period from 36 months to 12 months.

Therefore, before buying a healthcare plan, always ensure that your insurer offers this benefit.

Conclusion

Usually ranging from 12 months to 36 months, the waiting period can vary across different insurance providers. In fact, a waiting period does not apply to accident-related medical emergencies. Therefore, always get a clear understanding of it before purchasing health insurance.