Health insurance is definitely a great thing to have as it allows you to cover the costs of medical treatments and procedures when you need it the most.

However, it’s important to understand that not all medical conditions are covered by health insurance. There are some conditions that have a waiting period before they can be covered. This waiting period is usually two years, which means the insurance policy will not cover the costs associated with the treatment or procedure within that time frame.

Covered and Non-Covered Conditions

It’s essential to understand the difference between covered and non-covered conditions to make informed decisions using your insurance plan.

Some of the most common non-covered conditions include pre-existing medical conditions, cosmetic surgery, fertility treatments, among others. The reason for these exclusions is pretty straightforward.

Insurance companies consider them to be too costly and want to make sure they don’t absorb the costs of treating these conditions.

Other health insurance plans may cover certain conditions after a specific waiting period. However, some individuals may not know about this waiting period and only discover that their condition is not covered when it is too late.

Below are common medical conditions that typically have a waiting period of two years before covering treatment or procedures by health insurance.

1. Pregnancy and Childbirth

Most insurance providers don’t cover pregnancy and childbirth for a waiting period of up to two years after taking up the policy.

This waiting period comes as a preventive measure to discourage customers who may want to take up insurance, pay off premiums for a short time, only to get pregnant and have the insurance company take care of the entire medical cost.

2. Cataract Surgery

Cataract surgery is one of the most common surgical procedures, especially among the elderly. Insurance providers also have a waiting period of two years before they cover this condition.

Some factors may affect the development of cataracts, and the insurance company may not want to cover these costs until after the waiting period elapses.

3. LASIK Surgery

LASIK surgery is a popular vision correction procedure, but insurance companies only cover it after the two-year waiting period.

This is because the chances of having possible side effects after LASIK surgery are high after the operation; hence, the insurers wait for the waiting period to elapse before they can cover this condition.

4. Hernia Surgery

Most hernia surgery procedures require repairs and may take thirty minutes to one hour. During this time, the surgeon makes an incision and repositions the herniated tissue.

The stitches get removed after a specific duration to facilitate the healing process. Some individuals may need this surgical procedure for their hernia, but the insurance companies may not cover it until after two years.

5. Obesity Surgery

Obesity surgery may be an option for those struggling with weight loss, and insurance companies recognize the health benefits of these procedures.

However, due to the high costs involved, insurance companies may have a two-year waiting period before they cover the procedure.

6. Knee and Hip Replacement Surgery

Knee and hip replacement surgery procedures require a lengthy recovery time. Before the surgery, the patient undergoes examinations and diagnostic tests to assess the suitability and reduce the risks of any complications that arise during the operation.

Knee and hip replacement surgeries pose a high risk of complications, which insurance companies may not want to cover at the beginning of policy coverage.

7. Treatments for Serious Health Conditions

Insurance coverage may also have exclusions for treating some serious conditions such as cancer and heart-related problems for the first two years.

These conditions are costly, and the insurance provider may have a waiting period before covering the associated costs or any medical treatment or procedure that arises from the health issues.

8. Routine Dental and Vision Procedures

Most insurance providers offer coverage for routine dental procedures or vision procedures after the waiting period of two years. Routine procedures may include teeth cleanings, dental fillings, eye checkups, and prescription lenses or glasses.

Conclusion

In conclusion, waiting periods are necessary for insurance companies to reduce the risks of policyholders taking up policies and only getting the expensive medical procedures or treatments while expecting the insurers to cover all the costs.

It is essential to check your insurance policy and verify what conditions are covered and excluded before subscribing to any insurance policy.