How Long Is the Waiting Period for Kidney Stones in India?

What Is the Waiting Period for Kidney Stone Treatment in Health Insurance? In most Indian health insurance plans, kidney stone treatment is covered, but not immediately. It usually falls under “specific illnesses” or “pre-existing diseases” and has a waiting period of up to 3 years, depending on the policy. If you buy insurance after being diagnosed with kidney stones, the insurer may impose a waiting period of up to 3 years before covering treatment. However, if kidney stones develop after buying the policy, coverage is usually included after a standard 2-year specific illness/named ailment waiting periods from purchase.

In India, kidney stone cases are rapidly increasing as a result of inadequate hydration and unhealthy eating patterns. According to several experts, cases have risen by 30–40% recently.

Worried about whether your health insurance covers kidney stones? You're not alone. Understanding waiting periods and the fine print of your policy can help you avoid unexpected medical expenses.

At Ditto, we've helped thousands navigate the complexities of kidney stone coverage, whether it's figuring out if it counts as a pre-existing condition or what happens if you're diagnosed after buying a policy. This article explains everything you need to know: waiting periods, if they can be reduced, and health insurance plans in India that offer kidney stone treatment.

Not sure about waiting period? Talk to Ditto’s expert advisors today and get unbiased, personalised guidance - absolutely free.

Did You Know? IRDAI’s latest 2025 guidelines have officially reduced the maximum waiting period for coverage of pre-existing diseases from four years to three years across all individual and family health insurance policies.

What if Kidney Stones is a pre‑existing condition?

If you've previously been diagnosed with kidney stones, whether or not you've received treatment, most insurers will classify it as a Pre-Existing Disease (PED). And that comes with some important implications.

Let's break it down in plain terms:

• 30-Day Buffer Period: After  After receiving treatment or being discharged from the hospital for kidney stones, there is typically a mandatory 30-day waiting period before you can apply for a new health insurance policy. During this period, most insurance providers will not accept a new application.
• Full Disclosure is Mandatory: Even if you're symptom-free or have used only alternative treatments (like Ayurveda or homeopathy), you must declare your kidney stone history when applying for insurance.
• Coverage is Conditional: having had Kidney stones doesn't automatically prevent you from getting health insurance. However, your eligibility and coverage can depend on a few factors, such as whether you need surgery, the size and location of the stone, and any related health issues, such as diabetes, high blood pressure, or frequent infections.
• Waiting Period of Up to 3 Years: Some health insurance plans will cover kidney stone-related treatments, but only after a waiting period of 2 to 3 years.

Did You Know? In most cases, kidney stones alone don't trigger a loading (extra premium). However, insurers may charge a slightly higher premium if there are other major health issues.

Can the Waiting Period for Kidney Stone Treatment Be Reduced?

In most health insurance policies, kidney stones fall under a "specific illness" category, which carries a standard 2-year waiting period, regardless of whether the condition is newly diagnosed or pre-existing.

If you already have kidney stones before buying the policy, it will be treated as a pre-existing disease (PED). In this case, even if you opt for a PED buy-back rider to reduce or eliminate the PED waiting period, the 2-year waiting period for specific illnesses still applies.

Some plans, like Care Supreme or ICICI Elevate with their PED Waiting period reduction add-ons, reduce waiting periods for PEDs to as low as 1 year. For example, Aditya Birla Activ One Max allows you to reduce the PED waiting period to as low as 1 year with an add-on. However, these do not override the 2-year waiting period for specific illnesses like kidney stones.

Certain health insurance plans, such as Care Supreme or ICICI Elevate, offer add-ons that can reduce the waiting period for pre-existing diseases (PEDs) to as little as one year. 

For instance, Aditya Birla Activ One Max lets you shorten the PED waiting period to one year with an add-on (Reduction in PED) . However, these add-ons do not bypass the standard two-year waiting period for specific conditions like kidney stones.

The implication? Buying an add-on solely to cover kidney stones early may not offer any real-time advantage, since the specific illness clause still applies independently.

Key Takeaway:

Buying an add-on to cover kidney stones early isn’t very useful, as the specific illness wait applies separately. Focus instead on reducing your pre-existing disease (PED) waiting period to 2 years (not 1) for more practical and broader health insurance benefits.

POINT TO BE NOTED Some insurers offer faster coverage for specific illnesses like kidney stones. ICICI Lombard Elevate and Star Health Super Star cut the 2-year wait to 1 year with add-ons. Acko Platinumand ManipalCigna Sarvah Param remove it entirely, making the right plan or add-on crucial for quicker claims.

What if Kidney Stone is Diagnosed after Buying Health Insurance?

If you're diagnosed with kidney stones after you purchase a health plan, treatment is usually covered, but with certain conditions:

1) Most health insurers list kidney stones under "Specific Diseases," which often come with a 2-year waiting period, even if the condition wasn't pre-existing. This  

A standard 2 year waiting period, even if it’s a PED. Most “specific diseases” lists typically include other slow-developing conditions as well. Take, for example, a popular plan like HDFC Optima Secure:

2) OPD-only treatment, such as managing stones with medication and fluids, without hospitalisation, is not covered unless your policy includes OPD benefits or an OPD rider.

3) Daycare procedures like lithotripsy or ureteroscopy are covered if:

• The waiting period has been serve
• All documentation is in order
• Falls Under Daycare Treatment 

Daycare treatment refers to: i) A medical or surgical procedure performed under general or local anaesthesia in a hospital or recognized day care centre, and ii) Completed in less than 24 hours due to technological advancements, even though it would normally require hospitalization for more than 24 hours.

In short, once the waiting period is over and documentation is proper, kidney stone removal procedures like lithotripsy qualify as daycare treatments and are covered.

So how do you pick a policy that actually covers kidney stones effectively?

Health Insurance Plans for Kidney Stones (2025) That Make Ditto’s Cut

Most comprehensive insurance policies offer coverage if you have mild symptoms of kidney stones. If it is a PED, there’s no clear-cut path, and after proper underwriting, you are offered a plan with adequate coverage and a 2 to 3 year waiting period. As most plans cover Day care procedures like treatment of a Kidney stone, take a quick look at Ditto’s recommended health policy for kidney stone coverage: 

Before we jump into the list, here’s how we decide what policies to feature. At Ditto, every plan goes through our six-point evaluation framework. It doesn’t mean these are the only good plans, but that they stand out after being scored across all six pillars. You can learn more about how we evaluate the plans here.

Plan Name	Features
HDFC Optima Secure	Bonus renewal: 50% PA up to 100% Restoration: 100% once a year ADD ONS such as Reduction in ped and Optima well-being 13k+ network hospitals CSR 98% and ICR 86%
Care Supreme	Bonus renewal: 50% pa, up to 100% Restoration: Up to base SI, unlimited times ADD ONS such as Reduction in ped and Instant Cover 11.4k+ network hospitals CSR 90% and ICR 59%
Aditya Birla Activ One Max	Bonus renewal: 100% pa, up to 500% (irrespective of claims) Restoration: Unlimited restoration of base cover ADD ONS such as Reduction in ped and Chronic Care 12k+ network hospitals CSR 95% and ICR 68%
Niva Bupa Aspire Titanium +	Bonus renewal: with addon, Up to unlimited Restoration: Unlimited restoration of base cover ADD ONS such as Safeguard + and Disease Management 10k+ network hospitals CSR 91% and ICR 83%
ICICI Lombard Elevate	Bonus renewal: with addon, Up to unlimited Restoration: Unlimited restoration of base cover ADD ONS such as Reduction in ped and Jumpstart 10.2k+ network hospitals CSR 85% and ICR 83%

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Kidney Stone Waiting Period in Health Insurance: Ditto’s Take

According to experts at Ditto, complete transparency is crucial when buying health insurance. Even if you’ve only had mild kidney stone symptoms, taken Ayurvedic remedies, or experienced a minor episode years ago, you must disclose it. Failing to do so, even if the condition is treated can lead to claim rejection or policy cancellation later.

Corporate health plans usually cover kidney stone treatment from day one, while personal plans at least have a 2-year waiting period. When purchasing a policy, review sub-limits, exclusions, and pre-authorization rules to avoid unexpected claim rejections.

Conclusion

Kidney stone coverage isn’t optional—it’s essential. Most health insurance plans include treatment, including daycare procedures like lithotripsy and ureteroscopy. However, if you’ve had symptoms or treatment before buying the policy, a 2-year waiting period will be applied.

To ensure hassle-free claims, buy insurance early and always disclose your complete health history—even mild or past episodes. Look for plans that cover day care treatments, have flexible terms, and clearly outline waiting periods.

Not sure which one to pick? Book a free call with Ditto’s advisors to find a policy that fits your needs.

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