Waiting periods are an initial period after joining or upgrading your private health cover during which you cannot claim on certain goods, treatments and services. The length of a waiting period depends on the type of service you wish to claim and whether or not you have already served waiting periods on previous cover.

When you join without current health cover

If you are taking out private health cover for the first time or you have been without private health cover for 30 days or more, you must first serve waiting periods for all services on your selected level of cover. The following waiting periods apply:

Extras

After two months you can claim benefits on all Extras services except for the following:

Loyalty benefits and lifetime limits apply for certain services (e.g. orthodontics and hearing aids). For full details please refer to the relevant Extras Cover information.

Hospital

After two months you can claim benefits for all Hospital services except for the following:

*A pre-existing condition is one where signs or symptoms of an ailment, illness or condition, in the opinion of a medical practitioner appointed by the Fund, existed at any time during the six months preceding the day on which the member purchased or upgraded their Hospital Cover. This does not apply to psychiatric conditions, palliative care and rehabilitation.

If hospitalisation is contemplated within the first 12 months of membership, we strongly recommend that you contact us so that eligibility for hospital benefits can be determined. Please note that not all private treatment is covered by private health insurance (e.g. cosmetic surgery not medically required).

When you transfer from another health fund or upgrade your cover

If you transfer from another fund with an equivalent level of cover, and have served the relevant waiting periods, you obtain immediate access to all services on your selected level of cover.

Waiting periods will apply in the following circumstances:

• If there is a lapse in cover of 30 days or more when transferring. We recommend that you keep your cover with your former health fund until the date you transfer to Health Partners.
• If you transfer to a higher level of cover, waiting periods apply to the additional benefits available on the higher level of cover. During this time you will receive the same benefits and pay the same excess and co-payment (Hospital Cover only) as the Health Partners equivalent of your previous level of cover.
• Where your previous cover had excluded benefits, waiting periods will apply for these specific services.
• If you have only partially served your waiting periods with the previous fund, including waiting periods for benefits where 'lifetime limits' apply, the remainder of the waiting period will be served with Health Partners.

Additional information for transferring members:

• When transferring from your former fund to Health Partners, your Lifetime Health Cover loading will remain the same.
• Benefits paid by your former fund will count towards yearly maximums in your first year of membership with Health Partners. Loyalty bonuses or accrued entitlements with your former fund are not transferable to Health Partners.
• The 'Right to Change' brochure produced by the PHIO is a useful guide when transferring between health funds. Please visit phio.org.au if you would like a copy.

When you upgrade your cover

For current members upgrading their cover, waiting periods only need to be served for the additional benefits on the higher level of cover. During this period you will receive the same benefits as your previous level of cover.