Health insurance waiting periods: Why switching policies mid-year may not solve the problem
Health insurance waiting periods can leave policyholders without coverage for planned surgeries, even when they have paid premiums for years. Experts caution that switching to a “zero waiting period” policy mid-year may not guarantee immediate coverage and could affect continuity benefits.
- Aug 26, 2026,
- Updated Aug 26, 2026 2:55 AM IST
Health insurance waiting periods can leave policyholders facing unexpected gaps in coverage, particularly when they purchase a policy after already knowing that a surgery or treatment may be required. Experts advise checking the applicable waiting-period clause and securing written confirmation of coverage before considering a switch.
According to Vineet Gupta, Head – Product Development, ManipalCigna Health Insurance, such situations are not unusual because most health insurance policies include waiting periods. A planned surgery could fall under either a pre-existing disease waiting period or a specific waiting period applicable to certain listed illnesses and procedures.
Under the current regulatory framework cited by Gupta, such waiting periods cannot exceed 36 months. Policyholders should therefore ask their insurer to confirm in writing which waiting-period clause applies to their surgery and the date from which the treatment will become eligible for coverage.
Zero waiting period
Switching to a policy advertised as having a “no waiting period” or “zero waiting period” may appear to offer a straightforward solution. However, Gupta cautions that such a policy may not automatically cover a condition that was already diagnosed or a surgery that had been planned or advised before the new policy was purchased.
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A new insurer may assess the applicant’s medical reports, consultations and details of the proposed surgery before deciding whether to provide coverage. Depending on the assessment, the insurer may offer coverage subject to specific conditions, an additional premium, co-payment or another waiting period. It may also decline the proposal.
Policyholders considering a switch should therefore disclose their complete medical history and obtain written confirmation that the specific condition, planned surgery and related expenses will be covered.
Switching mid-year
Gupta advises caution when switching policies specifically to cover an upcoming surgery. Portability generally takes place at renewal, and it may allow policyholders to carry forward credit for the waiting period already completed under their existing policy.
Cancelling an existing policy and purchasing a fresh one could restart the applicable waiting period and leave the planned surgery uncovered. It could also affect continuity benefits, lead to a limited premium refund or create a temporary gap in coverage.
The new policy may additionally have different sum-insured limits, exclusions, co-payments or hospital networks, making a direct comparison important.
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Continue existing cover
For policyholders who have already completed a significant portion of their waiting period, continuing with the existing policy may be more practical, Gupta said. Near renewal, they can compare alternative plans and consider portability while retaining eligible continuity credit.
Importantly, policyholders should keep their existing policy active until the replacement policy has been issued, reviewed and confirmed in writing, particularly when coverage for a known medical procedure is the primary reason for switching.
Health insurance waiting periods can leave policyholders facing unexpected gaps in coverage, particularly when they purchase a policy after already knowing that a surgery or treatment may be required. Experts advise checking the applicable waiting-period clause and securing written confirmation of coverage before considering a switch.
According to Vineet Gupta, Head – Product Development, ManipalCigna Health Insurance, such situations are not unusual because most health insurance policies include waiting periods. A planned surgery could fall under either a pre-existing disease waiting period or a specific waiting period applicable to certain listed illnesses and procedures.
Under the current regulatory framework cited by Gupta, such waiting periods cannot exceed 36 months. Policyholders should therefore ask their insurer to confirm in writing which waiting-period clause applies to their surgery and the date from which the treatment will become eligible for coverage.
Zero waiting period
Switching to a policy advertised as having a “no waiting period” or “zero waiting period” may appear to offer a straightforward solution. However, Gupta cautions that such a policy may not automatically cover a condition that was already diagnosed or a surgery that had been planned or advised before the new policy was purchased.
MUST READ: Health insurance protection gap: 84% want extra cover, but 45% still don’t have it
A new insurer may assess the applicant’s medical reports, consultations and details of the proposed surgery before deciding whether to provide coverage. Depending on the assessment, the insurer may offer coverage subject to specific conditions, an additional premium, co-payment or another waiting period. It may also decline the proposal.
Policyholders considering a switch should therefore disclose their complete medical history and obtain written confirmation that the specific condition, planned surgery and related expenses will be covered.
Switching mid-year
Gupta advises caution when switching policies specifically to cover an upcoming surgery. Portability generally takes place at renewal, and it may allow policyholders to carry forward credit for the waiting period already completed under their existing policy.
Cancelling an existing policy and purchasing a fresh one could restart the applicable waiting period and leave the planned surgery uncovered. It could also affect continuity benefits, lead to a limited premium refund or create a temporary gap in coverage.
The new policy may additionally have different sum-insured limits, exclusions, co-payments or hospital networks, making a direct comparison important.
ALSO READ: Health insurance deductibles explained: Can this simple feature cut your premium by up to 50%?
Continue existing cover
For policyholders who have already completed a significant portion of their waiting period, continuing with the existing policy may be more practical, Gupta said. Near renewal, they can compare alternative plans and consider portability while retaining eligible continuity credit.
Importantly, policyholders should keep their existing policy active until the replacement policy has been issued, reviewed and confirmed in writing, particularly when coverage for a known medical procedure is the primary reason for switching.