Wednesday, June 15, 2022

Why Is There A Waiting Period For Health Insurance

Don't Miss

Am I Covered For Health Services That I Leave The Country To Obtain

Why does private health care lengthen public wait times? (HD)

Prior approval by your provincial/territorial health insurance plan may be required before coverage is extended for elective health services obtained outside Canada. Individuals who seek elective treatment out-of-country without obtaining approval from their provincial or territorial health insurance plans may be required to bear the cost of the services received.

Maternity Benefit & Newborn Baby Cover Waiting Period

As part of most health insurance policies for individuals and families, there is an option to also include a Maternity Benefit and Newborn Baby add-on for those planning a family soon and apart from just planning for the baby, it is wise to also plan financially for the expenses that arise during and post labor.

Typically, the waiting period with most health insurance policies ranges from one year to four years.

With Digits health insurance policy, the waiting period for the maternity cover is 2 years.

This means, you can only claim for maternity related expenses once youve completed two years of your policy.

Therefore, if youre planning on starting a family sometime soon and would want to ensure your health insurance policy covers for it, then take in consideration the 9-months of the pregnancy term, plus the rest 15-months to complete your two- years waiting period.

The maternity benefit add-on covers for delivery expenses and, the baby for its first 90 days; including its necessary vaccinations and any other medical care required otherwise.

Dental Insurance With No Waiting Period

We checked over 20 Australian health funds in December 2020 and our research found most health funds have a two-month waiting period for general dental.

However, we did find one that doesn’t have a waiting period! Lifestyle Extras from ahm has a $500 annual general dental limit with no waiting period and 2 no-gap check-ups.

Remember: You may be able to get no waiting period dental with more funds if you take advantage of sign-up deals or offers. Check them out here.

Recommended Reading: Who Is The Best Home Insurance Company

Is It Possible To Use Your Health Insurance Immediately

Health insurance may be used straight away if youve transferred to a new hospital or extras policy without a break in coverage provided you have already served the applicable waiting periods for the service you are looking to claim on even if youve served your waiting periods under a different provider before switching to them. Keep in mind that if youre adding to or upgrading your existing hospital or extras cover, youll still be subject to waiting periods for the additional services you are gaining.

At times some insurers will offer waiting period waivers as a joining offer on extras policys allowing you to; use extras health insurance straight away.

Examples Of How The Dental Insurance Waiting Period Works

Why is there a Waiting Period for Health Insurance?

If you decide to buy a dental benefits insurance plan because you just found out that you need a crown, the insurance waiting period could prevent you from being able to cover the procedure immediately when you purchase your dental insurance. Waiting periods can last up to a year on certain major procedures.

  • Example 1:;Joan needed a crown. She contacted her dental insurance company to see what coverage she had for the procedure. Her;insurance company;said that she did not have any coverage for the procedure since she only had her dental insurance for 3 months and any crown procedures had a 6-month dental insurance waiting period. Once the waiting period has elapsed, then dental benefits will be fully accessible.
  • Example 2: Anna wants to visit a dentist for a checkup and cleaning, but her dental plan waiting period is not over yet. She is worried that the dentist will need to take x-rays and charge her a lot for these services. She calls her dental benefits plan administrator and finds out that although she has a 1 year waiting period for “Major” work like crowns, and bridges, that all the basic coverages are included. She is delighted to find out that her x-rays will be covered, as well as her cleaning, and if they find any cavities, her plan will cover that too. Since every plan is different, she was happy she called as was able to get access to some of her benefits right away.

You May Like: What Insurance Covers Veneers

Q What Should I Do If I Need To Take My Baby To The Doctor But Haven’t Received His Or Her Health Card

The infant registration form contains a convenient tear-off record of your baby’s Ontario health number. Keep and present this record for any required medical services until you receive your child’s plastic Ontario health card.

If you do not have the tear-off record and you have paid for medical services for your child while awaiting his or her health card, your health care provider can reimburse you in full when you show the health card as proof of your child’s OHIP eligibility.

It usually takes 6 weeks from registration for ServiceOntario to process and mail your child’s health card.

What Is A Waiting Period In Health Insurance

As the name suggests, waiting period is quite literally the amount of time you need to wait. And in a health insurance, it refers to the amount of time you need to wait for, from the start of your policy, to be able to use the benefits of it.For example: One of the most common types of waiting period is the time you need to wait to be able to use special benefits such as a Maternity Cover; in this case most health insurers will include a waiting period of 2-4 years i.e. before you can actually benefit from the maternity cover, you should have your policy for at least 2 years .

You May Like: Do Parking Tickets Affect Car Insurance

Example 3 Ei Sickness Benefits

Sandeep has slipped and broken his ankle while shoveling his driveway in Gatineau, Quebec. He has a medical certificate indicating that he cannot work while he is recovering. Sandeep is eligible for EI sickness benefits and is off work for six weeks.

With a reduced waiting period, Sandeep will receive EI benefits for five of those six weeks instead of only four of those six weeks, which will help him keep up with his expenses.

Q What If I Forget To Bring My Health Card When I Go For Health Care

Why the long waits in Canadian health care?

You may be charged for a health service if you do not have a health card. The ministry requests that the provider reimburse you for the service if it was an OHIP insured service and you can later show that you were covered by OHIP at the time of the service.

Your health care provider may ask you to fill out a Health Number Release to indicate your consent to the ministry providing your health number to them.

Also Check: Is Trustage Life Insurance Any Good

When Do Waiting Periods Not Apply

If youâre considering switching health insurers, donât worry, if youâre transferring from a policy that has an equivalent cover or a lower level of benefits, you wonât have to re-serve any waiting periods1. Weâll also recognise partially served waiting periods â so even if youâve only served three months of a 12 month waiting period, the three months still counts when you transfer to us.

Can You Buy Flood Insurance During A Flood

There are no restrictions on when you can purchase a policy, only restrictions on when the policy will be able to go into effect. That means if your home is completely inundated by flooding, you can still protect it with flood insurance, it just wonât be covered for the prior flood damage .

More about

You May Like: Life Insurance Licence

Q How Do I Submit My Medical Bills

If you have purchased supplementary insurance, check with your insurance carrier about how you should submit your bills. Otherwise, it is required that you send your itemized bill to your nearest OHIP Claims office within 12 months of receiving treatment. With your bill, send;:

  • an original, detailed statement, itemized on a fee-for-service basis
  • your original receipt for payment
  • your name and current Ontario address
  • your health number
  • a completed Out of Province/Out of Country Claims Submission

To avoid delays, do not hold your bills and receipts until you return to Ontario. Mail them to your insurance carrier or the ministry as soon as you receive them.

For more information : Travelling Outside Canada

What Happens If I Go To Hospital Before I’ve Served My Waiting Period

Pregnancy Insurance

Get in touch with your insurer as soon as possible to find out if you’ll receive hospital benefits. For example, you may have served the waiting period for the digestive system, but not pre-existing conditions.

At this stage, your health insurer should give you some general advice about the pre-existing condition rule, send you forms that your doctor needs to fill out and return, then contact you within five working days with a decision.

If you need to go to hospital urgently, your insurer might not have enough time before you are admitted to decide whether your condition is pre-existing. This means that you may not know before you are admitted whether you’ll receive any benefits.

If you haven’t served the waiting period for the specific medical category, you won’t be covered by your policy. You may want to consider the public system at this point.

Recommended Reading: Do Parking Tickets Affect Car Insurance

Some More Important Points About Waiting Period

  • During the waiting period, you cannot file a claim for hospitalization or treatment expenses.;
  • If you are diagnosed with any new disease during the waiting period, it will be covered under your policy.
  • An initial waiting period of 30 days can also be considered as a cooling period.

So, if you are looking for customized health insurance plans for yourself or your family, check our wide range of health insurance products and live a stress-free life.;

*Please read the policy T & C, brochure, and prospectus to know more about our health insurance plans. We will settle the claims, subject to policy terms and conditions.

About Care Health Insurance

About Care Health Insurance

CHI is a specialized health insurer offering health insurance services to employees of corporates, individual customers, and for financial inclusion as well. With its operating philosophy being based on the principal tenet of consumer-centricity, the company has consistently invested in the effective application of technology to deliver excellence in customer servicing, product innovation, and value-for-money services.

Vision: We envision a financially secure future for our customers through the delivery of customized health insurance plans such as Family Floater Plans, Senior Citizens Health Plans, Diabetes Cover, Maternity Cover, Critical Illness Cover, and specific travel insurance plans while guaranteeing the benefits of hassle-free claims procedures.

Copyright. Care Health Insurance

What Are The Types Of Waiting Period

The range of waiting period depends on the policy, coverage, and type of diseases. Read below about the types of the waiting period.

Initial Waiting Period-;The initial waiting period starts right after you got the policy. Mostly, it is of 30 days from the date of policy issuance. During this tenure, you cannot file any claim for hospitalization due to any disease, except for accidents.

Waiting Period for Pre-Existing Diseases – Pre-Existing Diseases like diabetes and hypertension have a long waiting period, usually 2 years. During this tenure, you cannot claim for your hospitalization and treatment expenses due to such illness.

Waiting Period for Maternity Cover- The waiting period for maternity cover ranges between 9 to 24 months from the date you buy the policy. Thus, females looking for this cover can plan accordingly and opt for a maternity cover much early.

Also Check: How To Obtain A Life Insurance License

Why Do Some Provinces/territories Have Health Care Premiums

Provinces and territories have considerable leeway in determining how to finance health insurance plans. Financing can be through the payment of premiums , payroll taxes, sales taxes, other provincial or territorial revenues, or by a combination of methods. Health insurance premiums are permitted as long as residents are not denied coverage for medically necessary hospital and physician services because of an inability to pay such premiums. Provinces/territories that levy premiums also offer financial assistance based on income so that low-income residents can have their payments reduced or be entirely exempted from paying premiums.

Reasons Why Investing In A Health Insurance

Why Am I Waiting in the Emergency Department?

There are a lot of experiences that we typically associate with the twenties. It is the period of our lives when we come into our own, launch our career path and strive to become financially independent. All in all, being in ones twenties is generally correlated with various new, exciting milestones. Which is why it is unlikely for most of us to consider it a time to start preparing for emergencies.

However, becoming financially independent also entails being financially prepared for any unfavourable circumstances. That is why apart from life insurance, young adults in their twenties should also consider availing of general insurance. If you find yourself wondering what is general insurance, it is the type of insurance that helps cover for the loss or damage to ones non-life assets. There are various types of general insurance designed to protect your valuables, such as car insurance, home insurance and even travel insurance.

Hence, investing in a health insurance plan early on in life might prove to be a wise and prudent decision of your life. Here are five reasons why twenties is the right time to avail of a health insurance plan:

You May Like: Does Dental Insurance Cover Veneers

Q What Immigration Documents Must I Present To Confirm My Immigration Status As An Applicant For Permanent Residence When Applying For Ontario Health Insurance Coverage

If you are applying for Ontario health insurance coverage as an Applicant for Permanent Residence, you are required to present written confirmation from Citizenship and Immigration Canada that you are eligible to apply for permanent residence in Canada, which may be one of the following :

  • CIC Confirmation Letter letter on CIC letterhead addressed to the Applicant for Permanent Residence that confirms that the applicant is eligible to apply for permanent residency in Canada;
  • CIC Immigration document such as a Work Permit, Visitor Record, Temporary Resident Permit or Study Permit with note in the “Remarks Section” that indicates that you have applied for permanent residence and the CIC has confirmed that you meet the eligibility requirements to apply for permanent residence in Canada.

Q Do I Need To Notify The Ministry If My Baby And I Are Leaving The Province

You should contact the Ministry of Health and Long-Term Care with any change of address for both you and your baby. If you move to a location outside Ontario, you should inform the ministry of your new address and the date of the move as soon as possible. To inform the ministry of your move, you can either;:

  • Send a letter to your local ServiceOntario centre. You must include your names, health numbers, telephone number, current address, new address including postal code, and the effective date of the move for yourself and child.

You May Like: How To Obtain A Life Insurance License

Waiting Period In Health Insurance

The concept of waiting period;in a health insurance policy is defined as the period of time specified which must pass before some or all of your health care coverage can begin. Hence, this is the period during which claim is not admitted. Different conditions and coverage have different waiting periods and have different rules for the same.

The most important types of waiting period in an individual or family health insurance policy would be:

  • Initial waiting period of 30 days to 90 days – Most health insurance companies have an initial waiting period of 30 days to 90 days so that any disease contracted within that period of time will not be paid for, except accident cases. This restriction has been put so that people do not take the health insurance policy after being diagnosed a serious disease.
  • Pre-existing Condition Exclusion Waiting Period;- A;pre-existing condition;exclusion period is a type of waiting period that involves those who have a condition during the six months prior to signing up for health insurance. This type of waiting period means that your insurance coverage can be limited or excluded for any pre-existing condition. The length of this type of waiting period can vary from 12 to 48 months.;Thus pre-existing conditions will only be covered under the plan after the passage of the timeframe mentioned.
  • Q My Baby Was Born In Hospital Or At Home Attended By A Registered Midwife How Do I Get A Health Card For My Baby When He Or She Is Born

    Waiting periods â why can`t I get paid now?

    There is a special registration process for babies born in Ontario birthing hospitals and for babies born at home attended by a registered midwife.

    Immediately after the birth of your baby, hospital staff or a registered midwife will give you an Ontario Health Coverage Infant Registration form to complete. Babies born in an Ontario birthing hospital or at home and attended by a registered midwife will be provided with an infant registration form. Tourists, transients or visitors are not eligible for OHIP coverage.

    This form requests information regarding your baby such as the babys name, birth date and mailing address. Information is also requested regarding the parent/guardian who is completing the form. You will be asked to confirm that :

    • The child has a primary place of residence in Ontario.
    • The child will be physically present in Ontario for at least 153 days in any twelve-month period to retain health coverage.

    The bottom of the form is detachable and should be retained by you. It is pre-printed with a health number assigned to your baby. You should keep this record and use it until you receive the babys plastic Ontario health card.

    You May Like: Will A Parking Ticket Affect My Insurance

    More articles

    Popular Articles