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About Health Insurance With No Waiting Period

Health insurance helps many people afford quality health care that they could not otherwise afford, but often comes with waiting periods that temporarily limit payable benefits. These waiting periods represent red tape to work around before a policyholder can file a claim. Fortunately, federal law provides some protections for those who need insurance coverage as soon as possible.

  1. Waiting Periods

    • Once a health insurance company accepts an applicant for coverage, the policy may include a waiting period before the insurance company will pay benefits. This causes an inconvenience for many people who need access to immediate insurance coverage. The most common types of waiting periods include those for pre-existing conditions and those set by employers. A pre-existing-condition waiting period is the amount of time you must pay premiums to your health insurance company before you will receive benefits for medical treatment for a medical condition diagnosed prior to applying for health coverage. An employer waiting period, on the other hand, is the amount of time you must hold your job before you qualify for health insurance benefits through the employer's group insurance plan.

    Employer Plans

    • If you have group health insurance through an employer, you may have to wait before you can sign up for benefits, but once you are accepted, the Health Insurance Portability and Accountability Act, or HIPAA, restricts the waiting periods that your insurance company can impose. Under HIPAA, your insurer cannot implement a waiting period of more than 12 to 18 months before covering a pre-existing condition. However, if you had health insurance for your pre-existing condition in the 63 days prior to enrolling in your employer's group plan, the law prohibits your health insurer from imposing any waiting period before paying benefits on your policy.

    Existing Medical Conditions

    • If you have an existing medical condition, known in the insurance industry as a pre-existing condition, it is difficult to find private health insurance coverage that will cover the condition without a waiting period. In fact, you may have difficulty finding an insurer that will provide benefits for your medical condition at all. Instead, you may qualify for the federal pre-existing condition insurance pool, which provides comprehensive health benefits for individuals with pre-existing conditions who cannot find coverage elsewhere. There is no waiting period before benefits begin -- even to treat a pre-existing condition.

    Future Changes

    • Beginning in January 2014, insurance companies must pay benefits for all pre-existing conditions and will no longer impose waiting periods before you can receive benefits for any medical condition. Furthermore, beginning the same month, The Affordable Care Act will also keep employer qualification waiting periods from exceeding 90 days before an employee becomes eligible for group health insurance coverage.

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