Waiting Period

What Does Waiting Period Mean?

A waiting period refers to the amount of time an insured person must wait before some or all of their coverage becomes effective. Only after this waiting period has passed can the insured file a claim and be eligible to receive benefits under the insurance policy.

In some contexts, a waiting period is also referred to as an elimination period, especially when it pertains to the time between filing a claim and receiving the payment for that claim.

Insuranceopedia Explains Waiting Period

Health insurance typically imposes three types of waiting periods:

1. Employer Waiting Period: This requires an employee to wait a certain amount of time, such as three months before they are eligible to receive covered health services. This waiting period is designed to discourage employees from filing large claims and then leaving the company shortly afterward.
2. Affiliation Periods: These are exclusion periods imposed by Health Maintenance Organizations (HMOs). The Health Insurance Portability and Accountability Act (HIPAA) regulates affiliation periods, ensuring they do not exceed three months. During this time, new enrollees are not yet eligible for coverage.
3. Pre-existing Condition (PEC) Waiting Periods: Some group plans impose waiting periods for pre-existing conditions, but these are now the only plans required to offer insurance to individuals with a PEC. However, creditable coverage from prior health insurance can help reduce or eliminate this waiting period.