What does the 30 day waiting period mean?

1. What does the waiting period of 30 days mean? To put it bluntly, within 30 days after signing the policy contract, if the insured has an insured accident caused by a non-accident, the insurance company will not pay compensation, and the insurance with a 30-day waiting period is generally medical insurance. The purpose is to prevent the policyholder from deliberately defrauding the insurance while knowing the existence of the accident.

The length of the waiting period varies depending on what type of insurance you buy. For example, in the case of critical illness insurance, there is generally a waiting period of 90-180 days. However, there is no waiting period for accident insurance, and the regulations are effective from midnight the next day.

2. Will the refund of the premium be refunded during the waiting period? There is no definite answer to this, it mainly depends on how the insurance company decides. Generally speaking, if a critical illness occurs during the waiting period, then the insurance company is likely to terminate the contract and naturally refund the premium.

If you buy medical insurance and are hospitalized during the waiting period, although the insurance company will not reimburse the expenses, most of them will continue to recognize the validity of the insurance contract. Ultimately, it is up to the insurance company whether to terminate the contract or continue to underwrite or add exclusions.

Legal analysis: The waiting period for medical insurance is that if you get sick during this period, there is a disability, that is, if you are sick within these 30 days, the insurance company will not pay.

Legal basis: Social Insurance Law of the People's Republic of China

Article 2: The State shall establish social insurance systems such as basic endowment insurance, basic medical insurance, work-related injury insurance, unemployment insurance, and maternity insurance, to protect citizens' right to receive material assistance from the State and society in accordance with law in the event of old age, illness, work-related injury, unemployment, childbirth, and so forth.

Article 26 The treatment standards of basic medical insurance for employees, new rural cooperative medical care and basic medical insurance for urban residents shall be implemented in accordance with the provisions of the State.

Article 28 In line with the basic medical insurance drug list, diagnosis and treatment items, medical service facility standards and medical expenses, emergency and rescue medical expenses, in accordance with the provisions of the State from the basic medical insurance **.

Generally, the local regulations shall not exceed three months, and in principle, the waiting period shall not exceed six months.

1.For the circumstances specified in Article 11 of the Interim Measures, if the payment is interrupted for more than 3 months, the basic medical insurance treatment shall be implemented in accordance with the provisions of the overall planning area, and in principle, the waiting period for treatment shall be reduced from no more than 6 months to no more than 3 months.

2.If the insured person has participated in the basic medical insurance for more than 2 consecutive years (including 2 years), and the insurance relationship is switched between the employee medical insurance and the resident medical insurance due to changes in personal status such as employment, and it has not been interrupted, he shall enjoy the treatment normally according to the regulations.

3.If the insured person switches the insurance relationship between the employee medical insurance and the resident medical insurance due to changes in personal status such as employment, if the insured person does not meet the requirements of participating in the basic medical insurance for more than 2 consecutive years (including 2 years), it shall be dealt with according to the following principles:

1) If the employee medical insurance is switched to the resident medical insurance, the provisions of paragraph 2 of Article 11 of the Interim Measures shall apply in principle;

2) If the employee is switched from the resident medical insurance to participate in the employee medical insurance as a flexible employee, a waiting period of no more than 3 months can be set up, and during the waiting period for the treatment, if it is still within the effective period of the resident medical insurance treatment, the resident medical insurance treatment can be enjoyed.

Legal basis

Notice of the Office of the National Medical Examination and Insurance Bureau and the General Office of the Ministry of Finance on Printing and Distributing the Interim Measures for the Transfer and Continuation of the Basic Medical Insurance Relationship

Article 11 of the transfer of the continuation of the employee medical insurance personnel, before the transfer of the interruption of payment within 3 months (inclusive), can be transferred to the provisions of the basic medical insurance premiums for employees to pay the procedures, after the payment of the waiting period, the month of payment can be transferred to the place according to the provisions of the treatment, the interruption of the treatment can be retroactively enjoyed according to the regulations. If the payment is interrupted for more than 3 months, the basic medical insurance treatment shall be implemented in accordance with the provisions of the overall planning area, and in principle, the waiting period for treatment shall not exceed 6 months.

If the insured person has participated in the basic medical insurance for more than 2 consecutive years (including 2 years), due to changes in personal status such as employment, the employee medical insurance and the resident medical insurance will switch the insurance relationship, and the payment will be interrupted within 3 months (inclusive), the basic medical insurance can be transferred to the local Zhengyanding for the basic medical insurance premium payment procedures, and there is no waiting period for the treatment after the supplementary payment, and the payment can be enjoyed in the transfer place according to the provisions of the treatment, and the treatment during the interruption period can be retroactively enjoyed according to the regulations. If the payment is interrupted for more than 3 months, the basic medical insurance treatment shall be implemented in accordance with the provisions of the overall planning area, and in principle, the waiting period for treatment shall not exceed 6 months.

The waiting period for medical insurance is generally 30 days, if the waiting period is generally exempt, the insurance company will not pay, but the insurance contract is still valid, I would like to mention here that the illness during the waiting period extends beyond the waiting period, the insurance company will also choose to refuse to pay. The waiting period, also known as the observation period, is during which the insurance company will not pay for minor or critical illnesses caused by illness. There is no observation period for mild or serious illness caused by accidents.

Legal basis: Article 30 of the Social Insurance Law of the People's Republic of China The following medical expenses are not included in the scope of payment of basic medical insurance**

1) It should be paid out of work-related injury insurance**;

2) It shall be borne by a third party;

3) It should be borne by public health;

4) Seeking medical treatment outside the country.

Medical expenses shall be borne by the third party in accordance with the law, and if the third party does not pay or the third party cannot be determined, the basic medical insurance shall pay in advance. After the basic medical insurance** is paid in advance, it has the right to recover from a third party.

If you don't pay medical insurance for half a year, you can't be reimbursed

If the medical insurance is interrupted for more than three months, it can only be used again after six consecutive months of payment. Therefore, it is recommended that the medical insurance should not be interrupted, and the supplementary payment should be made in time after the interruption, so as not to affect the enjoyment of treatment.

According to the regulations, urban residents need to enjoy medical insurance after retirement for a certain number of years of medical insurance payment (30 years for men and 25 years for women), and the accumulated years of medical insurance payment cannot be interrupted.

The calculation of the waiting period for urban residents' medical insurance is related to the time of the insured to make up the premium. For example, if the insured renews the insurance premium during the medical insurance payment period, that is, September and December, the waiting period is January and March of the following year, and he will enjoy the treatment from April 1. If the insured person pays the premium during the non-payment period, the waiting period is 3 months from the month following the payment.

Medical insurance interruption payment follow-up spine insured:

1. If the unit interrupts the payment (including the failure to pay the payment in full and on time), the medical insurance will be suspended and the account will be blocked, and the medical expenses incurred during the suspension period will not be reimbursed, and the unit will reimburse the self-raised funds according to the provisions of the medical insurance policy;

2. If the insurance is renewed within one year of interrupting the payment, the hospitalization expenses incurred from the effective date of renewal can be reimbursed, and the medical insurance will not pay the hospitalization fee incurred before the renewal; There is a 6-month payment waiver period for interruption of payment for more than one year.

Extended reading: [Insurance] How to buy, which one is better, teach you to avoid these insurance"pits"

In daily life, we can use the things we buy immediately, but insurance is a little different, and many products will set a "waiting period". The insurance waiting period refers to the insurance company will not pay the insurance during the waiting period.

The reason why it is necessary to set a waiting period is mainly to prevent malicious insurance fraud and insurance with illness.

How long is the waiting period? There are slight differences between different types of insurance:

Critical Illness Insurance, Life Insurance:Generally 90 - 180 days.

Medical Insurance:It's basically 30 days.

Accident Insurance: There is no waiting period and the policy is covered when the policy is in effect.

In addition, a one-year product such as Million Medical Insurance usually has no waiting period if the policy is successfully renewed in the second year.

When we talk about the waiting period, we are relative to the disease. However, accidents cannot be made in advance, and if an accident occurs during the waiting period, it is possible to make a claim normally.

For example, if Xiao A purchases a critical illness insurance of 500,000 yuan, the waiting period is 90 days. A traffic accident on day 10 that results in both legs being amputated qualifies as a critical illness insurance"Multiple limbs are missing"Claim conditions.

Therefore, whether it is accident insurance, critical illness insurance, medical insurance, or term life insurance, you can get a claim if you are insured due to an accident during the waiting period.

Medical Insurance: Illness cannot be claimed during the waiting period, but the policy is still valid. If other illnesses occur after the waiting period, then you can make a claim.

In fact, the setting of the waiting period is not to make things difficult for us, but to eliminate some bad ones and give us the best protection for policyholders.

Buying insurance is actually a matter of getting insurance as early as possible. The sooner we can protect ourselves, the better we can benefit.

The waiting period means that the beneficiary will not be able to receive the claim even if the insured person has an accident.

1. What is the waiting period for medical insurance?

Insurance Waiting Period: Also known as the Observation Period, or Exclusion Period.

It is the time interval from the date of the first payment or interruption of the payment of the insured person to the date of the medical insurance** to fulfill the payment responsibility.

Insurance companies set up waiting periods mainly for risk: to prevent the insured from taking out insurance for personal benefit when they determine that they need to be reimbursed for medical expenses.

After all, insurance is actually a tool, a tool to combat unknown risks in the future.

2. What should I do if there is an accident during the waiting period?

There are two types of medical insurance coverage during the waiting period: due to illness or accidental injury.

Let's take a look at the provisions of Ping An e-Life Insurance 2020 (Guaranteed Renewal Version) with better renewal conditions regarding the waiting period:

Here are the answers to these two scenarios:

If the insurance is due to illness during the waiting period, the medical insurance will not reimburse the medical expenses incurred between the date of the insured's initial application and the end of the waiting period.

In the case of malignancy, the main insurance contract is terminated and the premium is refunded.

So if you buy insurance that is not suitable for you and want to surrender the policy, how can it be more cost-effective to surrender the policy? If I buy the wrong insurance, how to surrender the policy is the most cost-effective?

3. Summary

Generally speaking, the waiting period for medical insurance is 1 month, and it is best not to get sick in this month, as long as it is not a malignant tumor, the main loss is the medical expenses during this time.

Because it is recommended that you buy medical insurance as soon as possible while you are still healthy, and you can also be protected as soon as possible.

1. The insurance waiting period refers to the period specified when the insurance contract is in effect, even if the insured accident occurs, the beneficiary cannot receive insurance compensation, and this period is called the waiting period.

In general, the waiting period for critical illness insurance is 90-180 days, and the waiting period for medical insurance is 30 days. The waiting period is generally calculated from the effective date of the contract or the date of reinstatement, and is only applicable to the first year of insurance, and for renewable policies, there is generally no waiting period for the renewal year.

2. The purpose of setting the waiting period is to prevent the policyholder from taking out insurance immediately knowing that an insured event will occur.

Hello! The waiting period for medical insurance depends on what your situation is, if the unit helps you pay social security, then the payment will be paid in the current month, and it will take effect on the 15th of the next month.

If it is an individual who pays social security, it depends on whether you have broken off the payment for more than 3 months, if it does not exceed 3 months, it is also paid in the current month, and it will take effect on the 15th of the next month; If the relationship is broken for more than 3 months, there will be a waiting period of 6 months, and it can only be used after 6 months.

The waiting period for medical insurance is that if you get sick during this period, you will have a disability, which means that if you are sick during this 30 days, the insurance company will not pay for it.

Generally, medical insurance is set up with a 30-day waiting period, and if the medical insurance is exempted from liability during the waiting period, the insurance company will not pay, but the contract is still valid.