Updated on 7 Jan 2026
Health insurance is meant to protect you from unexpected medical expenses. However, when it comes to pre-existing diseases (PED), most policies don’t start covering them immediately. There is usually a waiting period before such conditions are included in your coverage. This article explains what pre-existing disease coverage is, the types of waiting periods in health insurance and how the waiting period works.
What is pre-existing diseases cover (PED) in health insurance?
A pre-existing disease is any illness, injury or medical condition that you had before purchasing your health insurance policy. This could include conditions like diabetes, high blood pressure, thyroid issues, asthma or heart problems if diagnosed before the start of your policy.
Health insurance companies usually ask about your medical history while buying a policy. If any condition existed before, it is marked as a pre-existing disease. The PED cover refers to the part of your health plan that starts covering the cost of treatment for these conditions, but only after the waiting period is over.
Types of waiting periods in health insurance plans
Here are the different types of waiting periods in a health insurance policy:
- Initial waiting period: This is usually the first 30 days from the date your policy starts. During this time, you can’t claim for any illness (except accidents).
- Pre-existing disease (PED) waiting period: This usually ranges from 1 to 4 years. After this period, the policy will start covering pre-existing diseases.
- Waiting period for specific illnesses: Some illnesses like hernia, ENT disorders or joint replacements have their own waiting period, often between 2 to 4 years, even if they are not pre-existing.
- Maternity waiting period: Maternity and childbirth-related claims are usually covered after a waiting period of 9 months to 3 years, depending on the policy.
How pre-existing disease work in health insurance?
Health insurance policies do cover pre-existing diseases, but only after a waiting period, which usually ranges from 1 to 4 years. During this time, expenses related to any illness you had before buying the policy won’t be covered. To ensure you get this cover later, it’s important to declare all your existing health conditions honestly when applying.
Insurers may ask for medical tests to understand your health status before finalising your policy. Based on your condition, they may charge a higher premium. After the waiting period is over and if you have regularly renewed your policy, the insurer will start covering treatment costs related to your declared pre-existing conditions. However, hiding any illness can lead to claim rejection, even after the waiting period.
What is the waiting period for pre-existing diseases in health insurance?
The waiting period for pre-existing illnesses in medical insurance policies may vary between insurance companies, but it generally falls within the 1-4 years bracket. The waiting period comprises the following parameters:
- The waiting period for pre-existing diseases can differ depending on the disease type. Some diseases, such as hypertension or diabetes, are considered chronic conditions. Therefore, the waiting period for these diseases may be longer than other conditions.
- The waiting period may also depend on the severity of the pre-existing condition. The waiting period may be longer if the ailment is severe and requires significant medical treatment.
- The policyholder’s age is also essential in determining the waiting period. The waiting period for pre-existing diseases is typically longer for older policyholders as they are more likely to have such health issues.
Conclusion
Understanding the waiting period for pre-existing diseases is essential when choosing a health insurance policy. It helps you plan your medical expenses better and avoid surprises during emergencies. If you have an existing health condition, look for policies that offer a shorter waiting period or the option to reduce it by paying a higher premium.
This is especially important when buying senior citizen health insurance, as older adults are more likely to have pre-existing illnesses. Choosing a plan with clear terms, manageable waiting periods and comprehensive coverage ensures they receive the right care without financial stress. Always read the policy details carefully and make sure to disclose all health conditions honestly for a smooth claim experience.
Disclaimer: The information provided in this blog is for educational and informational purposes only. It is not intended as a substitute for professional advice, diagnosis, or treatment. Please consult your general physician or another certified medical professional for any questions regarding a medical condition. Relying on any information provided in this blog is solely at your own risk, and ICICI Lombard is not responsible for any effects or consequences resulting from the use of the information shared.