Brokerfish

Medical costs for benefits with waiting periods

Costs incurred during the waiting period are often excluded from coverage under medical insurance policies. These waiting periods apply to certain benefits such as dental benefits, pregnancy or childbirth (including complications), wellness and any other benefits with a set waiting period. The purpose of waiting periods is to ensure that policies are not purchased with a specific reason in mind. For example, if there was no waiting period for maternity coverage, many individuals would purchase or upgrade a policy immediately after becoming pregnant, leading to high claims in short periods of time and increased premiums for all members of the insurance policy/company.

Waiting periods are usually a standard time frame, usually ranging from 30 days to 12 months, that the policyholder must wait before they can claim for certain benefits. During this time, policyholders are responsible for paying the costs of any treatments or procedures themselves. This means that if a policyholder develops a dental problem, becomes pregnant, or needs treatment for a pre-existing condition during the waiting period, they will not be covered for the costs of that treatment or procedure.

It’s important to understand that waiting periods vary among insurance providers and policies, and it is essential to review the terms and conditions of an insurance policy before purchasing it. If a policyholder has an existing condition, they should also check if the policy has any waiting period for pre-existing conditions.