Waiting Period

Waiting Period: Definition, Types, and Examples

What is a waiting period?

A waiting period (also called an elimination period or qualifying period) is the time an insured person must wait before some or all insurance coverage becomes effective. Claims filed during the waiting period may be denied or unpaid.

Key points

• Waiting periods vary by insurer, policy, and product.
• Shorter waiting periods typically mean higher premiums; longer waits lower cost but increase out-of-pocket risk.
• Waiting periods are common in health, disability, auto, and homeowner insurance, and can apply at enrollment, for specific conditions, or for certain treatments.

How waiting periods work

Insurers use waiting periods to limit short-term risk (for example, to discourage people from buying coverage only after a problem arises) and to manage administrative risk for new hires. Waiting periods can apply:
* At hire or enrollment (an employer may require employees to wait before benefits begin).
* For plan affiliation (some network restrictions limit when new members can access provider networks).
* For pre-existing conditions (coverage for conditions present before enrollment can be limited for a set time).
* For specific services (maternity, dental, or major treatments may have separate waits).

Proof of prior, continuous coverage often reduces or eliminates pre-existing condition waits if there was no significant coverage gap (commonly 63 days or less).

Common waiting periods (examples and typical ranges)

Health insurance
* Employer enrollment: often up to several months before employer-subsidized benefits start.
* HMO/network affiliation: regulatory limits often cap affiliation waits (for example, short limits for routine enrollees and slightly longer for late enrollees).
* Pre-existing condition exclusion: commonly 1 to 18 months, depending on plan rules and prior coverage.
* Cancer or major condition coverage: can have waits up to about two years in some private plans.
* Maternity care: commonly 30–90 days, sometimes 10–12 months in plans with longer waits.
Dental
* General dental: typically 6–12 months for certain services.
* Major procedures: insurers may restrict frequency (e.g., denture replacement allowed only once every several years).
Homeowner insurance
* New policies often have 30–90 day waits before full coverage applies; some regions delay activation during named storms until the danger passes.
Auto insurance
* Some jurisdictions or insurers impose a short evaluation period (for example, 60 days) during which the insurer can assess risk and potentially cancel new policies.
Disability insurance
* Short-term disability: waits as short as a few weeks; many policies wait 30–90 days.
* Long-term disability: elimination periods commonly range from 90 days to a year.
Social Security Disability
* There is a statutory five-month waiting period for disability benefits after the onset of disability.

Choosing a waiting period

Consider:
* Financial readiness: can you cover living or medical expenses during the waiting period?
* Risk tolerance: shorter waits cost more but reduce exposure to uncovered claims.
* Employment stability: employer-provided benefits may include probationary waits; check whether prior group coverage can be credited.
* Specific needs: if you anticipate maternity care, major dental work, or treatment for a known condition, confirm any service-specific waits before enrolling.

Understanding waiting periods helps you balance premium cost against the risk of uncovered expenses and select coverage that matches your financial and health circumstances.