A waiting period is a specific period after a new cover has commenced during which benefits are not payable or benefits are only payable as per the entitlements of a previous cover or policy for treatment received.
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What are waiting periods?
When you join without current health cover
If you’re taking out private health cover for the first time or you’ve been without private health cover for 30 days or more, you’ll have waiting periods for all services on your selected level of cover. Most waiting periods are 2 months, but some are longer (e.g. major dental, orthodontics, pregnancy).
Extras waiting periods
After 2 months, you can start claiming benefits for all Extras on your chosen cover, except for:
|Major Dental, Endodontics & Periodontics||12 months|
|CPAP Apparatus||12 months|
|Other Aids and Appliances||12 months|
Not all benefits are available on all covers.
Hospital waiting periods
After 2 months, you can start claiming benefits for all Hospital on your chosen cover, except for:
|Accidental Injury||No waiting period|
|Pregnancy and birth and Assisted reproductive services||12 months|
|Pre-existing conditions||12 months|
|Home Nursing||12 months|
|Home Sleep Studies||12 months|
|Insulin Pumps – initial||12 months|
|Implantation of hearing devices (initial)||12 months|
|Insulin Pumps – replacements||36+ months|
|Implantation of hearing devices (replacement)||36+ months|
Not all benefits are available on all covers. Terms and Conditions Apply, see below for details.
Provided treatment is required immediately after the accident from a registered Medical Practitioner and it’s not related to a pre-existing condition. If an accident has occurred within 1 day of membership commencing, waiting periods apply. Refer to our Member Guide for full conditions.
When you transfer from another fund
If you are transferring another Australian Health Fund and you have served the waiting period for an equivalent cover, meaning a policy with the same inclusions and limits, you will not need to serve the waiting periods again.
Waiting periods will apply for:
- Any additional services, treatments, goods and any higher limits. During this time you will receive the same benefits you received on your previous cover
- If you have only partially served waiting periods with your previous fund, the remainder of the waiting period will be served with us.
Refer to our Member Guide for full conditions.
When you upgrade your cover
If you’re a current member with us and change your level of cover, waiting periods apply for any increased benefits and limits of cover. During this period you will receive the same benefits. For hospital cover you will also pay the same excess and co-payment as your previous level of cover, if applicable.
When you change your cover, we will explain to you which benefits you can claim immediately and any waiting periods that may apply.
Pregnancy and Birth
A 12 month waiting period applies for all hospital benefits for pregnancy and birth services. This means, you will need to take out Hospital cover that includes these services, before you get pregnant.
For more information about pregnancy and hospital cover, read the Having a Baby flyer.
Pre-existing condition is an ailment, illness or condition where the signs or symptoms existed at any time six months before you became insured with us. We will appoint a medical practitioner to determine if the treatment required is related to a pre-existing condition. Refer to our Member Guide for full conditions.
Your waiting periods switch with you
You won’t need to re-serve equivalent waits
30 day cooling off period
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