Waiting Period And Mutual Health

Changing or signing a new mutual seems the obstacle course! All offers on the market offer different contracts: with maximum guarantees, with or without waiting period, etc. But why is the waiting period so important? How does it work?

Reassure me gives you all the details you expect on the waiting period.

What is the waiting period?

For your mutual health, the waiting period is a latency period, during which the reimbursement of the mutual does not apply: your health Mauritius-plans expenses are not reimbursed. In general, this period applies at the beginning of the contract, after the effective date. The period and the conditions for applying the waiting period are specified in the general and specific conditions of your contract.

It often has other names, such as a waiting period or a waiting period.

Be careful, however, because this waiting period is not considered in insurance law as an exclusion of guarantees to the contract. It does not appear in bold and underlined in the general conditions.

This is a fairly common practice for mutuals, but not generalized. Mutuals with probationary periods often offer better guarantees. The waiting period covers important reimbursement items such as optics or dental for example, and the duration is usually 1 to 3 months (it can sometimes be much longer, 9 to 12 months, for equipment very expensive for example). When comparing mutuals to change or to sign a new contract, pay close attention to the waiting periods in your comparisons.

Namely: Waiting periods can be applied by mutuals but also by the Social Security, on certain benefits.

Waiting period and Social Security:

Social Security does not provide for waiting periods for reimbursement of health Mauritius-plans expenses. On the other hand, in case of sickness and if you are salaried or compensated by unemployment, your doctor can send you a work stoppage. You will then receive daily allowances: this is a compensation for your loss of salary in case of sick leave. Social Security then provides for a waiting period of 3 days. That is to say that during the first 3 days of your work stoppage, you do not receive any daily allowance from Social Security.

However, the Social Security does not apply waiting periods for the payment of daily allowances in case:

Stoppage of work caused by a long-term illness (ALD),

Resumption of activity between two work stoppages not exceeding 48 hours

Waiting period and mutual health

Mutuals may schedule deficiencies in their contracts, on one or more warranties, to limit abusive consumption and subscriptions by mutuals. For health mutuals, the waiting periods usually relate to:

Optics

Prostheses and dental equipment

Hearing aids

Hospitalizations (except in emergency cases)

Maternity care

In most cases, these are one to three months, and nine months for maternity. The insurer Mauritius-plans can sometimes increase them to one year for the most expensive dental and hearing aids.

The higher your guarantees, the greater the risk of waiting periods. And this is perfectly normal, since this device aims to limit large expenses in the short term. However, there are mutually sees latencies. If you are planning a hospitalization or significant expenses, it is therefore more advisable to go ahead to change or subscribe a new mutual, or choose a mutual without waiting period.

Why do mutuals put in place waiting periods?

Waiting periods have been put in place by insurers to limit the abuse of health care guarantees. The insurance Mauritius-plans company or the mutual insurance company offers contracts to compensate for a risk, which must be sudden and unforeseen. However, people subscribe to large guarantees mutual as they know they will face very short term health care costs. Mutual’ contributions are statistically scheduled to keep our contracts for several years (3 years on average). The fact that some people urgently subscribe to a very high guarantee for large needs in the very short term means that insurance loses money (by paying back more than paying premiums). In order to “discourage” people from quickly using large warranties,

For example, if you take out a contract with a waiting period on the 3-month Dental Benefit Guarantee, this means that you will not be reimbursed for your dental expenses during this period. If you try to be reimbursed, the mutual will send you a refusal of reimbursement by giving you the reason: presence of a waiting period on your dental guarantee.

Mutual health without waiting period:

If your mutual is without waiting period, it means that you can be supported from the date of effect of your contract, without waiting. Which represents a definite advantage and must fit into your criteria when you compare mutuals. It is therefore very important to check this point when you subscribe to a mutual. If your contract provides for waiting periods and you have not paid attention, your health expenses during the waiting period will not be reimbursed and will remain your responsibility.

Why a mutual without waiting period?

With a mutual health without waiting period, you do not wait to benefit from your reimbursements, whether for your dental expenses, optics, hearing aids or hospitalization. Plus, you do not have to worry about your repayments. You know that from the first day of the guarantee, you may need to use the services of your mutual and that your expenses will be covered. You will not have a bad surprise, no refusal of refund due to waiting time.

A mutual without waiting period, for whom?

Although the mutual health insurance without waiting period applies to all, it is very suitable for people who subscribe a mutual for the first time. Because, to repeal the waiting period, it is necessary to prove that one held a mutual of the same level of guarantees in advance. During a first subscription, it is better to choose a mutual health without waiting.

Also, it can be very useful for already pregnant women who subscribe a mutual. Because internship deadlines are very often applied the first 9 months of subscription in case of maternity.

How to find a mutual health without waiting period?

Fortunately, not all mutuals apply a waiting period. To find mutuals without waiting period, adapted to your profile and your budget, you can move towards online comparators.

With reassure me, you can choose the right mutual without waiting period, and that suits perfectly your needs and your budget. Very quickly and very easily, you access the offers of the market, and you can compare with peace of mind.

Leave a Reply

Your email address will not be published. Required fields are marked *