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What are Waiting Periods?

A waiting period is the time-frame you have to wait before you can start claiming benefits on your policy, and it applies to both Hospital and Extras cover. Typically waiting periods are applied when:

  • You first take out private health insurance;
  • You switch to a higher level of cover (either with your current health fund or to a new one); 
  • You have not fully served waiting periods on your previous cover (the balance of the waiting period will still apply when you switch); and
  • You have pre-existing conditions. 

When you take out private health insurance for the first time, you will need to serve the applicable waiting periods for the level of cover you choose. Each service that’s covered within the different Hospital and Extras covers will have a waiting period. These generally range from 1 day to 12 months, with a couple of items having a wait of 36 months.

If you’re switching to a similar or lower level of cover (either with your current health fund or a new one) the waiting periods you’ve already served on comparable services will be recognised so you don’t need to re-serve them*. That means you can start claiming straight away for those services where you’ve already served the waiting periods.

If you’re switching to a higher level of cover, with higher limits or new services (either with your current fund or to a new one), you’ll need to wait before you can claim for those new treatments or limits. 

Any unserved waiting periods from your previous cover will also need to be served when you switch cover.

* Applies only where there is a break in cover of 59 days or less. Waiting periods will apply for services not currently covered, services with higher benefits or where waiting periods haven’t been fully served. Where the excess on the new product is lower than the excess on the previous cover, the excess on the previous cover will apply until the unexpired waiting period has been served.

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