When you sign up to private health insurance, unfortunately you won’t be able to claim for most services straight away. Instead, you’ll have to serve waiting periods before you can be covered. However, with some strategic planning, in certain cases you might be able to get health insurance with no waiting periods so you can benefit from your plan sooner.
How do waiting periods work?
A waiting period is the set amount of time you need to hold health insurance before you can claim benefits for certain treatments or services. All health funds apply them.
Without waiting periods, people could take out cover only when they know they need treatment, claim straight away and then cancel their policy. This would increase costs for insurers, which would ultimately push premiums up for everyone.
Waiting periods vary depending on the type of treatment and your insurer, but usually range from two to 12 months, with longer waits for certain services.
If you receive treatment during a waiting period, you won’t be able to claim a benefit from your insurer and will need to pay the cost yourself, so it’s important to check your policy to understand what you’re covered for and when you can claim.
What are the typical health insurance waiting periods?
Waiting periods apply to both hospital cover and extras cover.
Hospital cover
For hospital cover, waiting periods are regulated by the government, setting maximum limits that all insurers must comply with. These include:
- 12 months for pre-existing conditions
- 12 months for pregnancy and birth-related services (obstetrics)
- 2 months for psychiatric care, rehabilitation or palliative care (even if the condition is pre-existing)
- 2 months for most other hospital services
Extras cover
Waiting periods for extras cover are not regulated and vary by insurer, but most set similar timeframes for common services. Here are typical waiting periods for some extras services:
- General dental: 2 months
- Major dental and orthodontics: 12 months
- Optical: 2 – 6 months
- Physiotherapy: 2 – 6 months
- Psychology: 2 months
- Pharmacy: 2 months
- Asthma pumps: 12 months
- Blood glucose monitors: 12 – 24 months
- Hearing aids: 12 – 36 months
The full list of waiting periods will be outlined in the insurer’s policy documents.
Can I get hospital cover with no waiting periods?
Most hospital cover has waiting periods of at least two months – but there are circumstances where you may not have to serve waiting periods:
Accidental injury
You’re usually covered for accidents as soon as your policy starts. This typically covers hospital admission as a private patient, even if the treatment isn’t included in your policy – though won’t cover emergency room visits.
Mental health waiver
If you have already served a two-month waiting period on a hospital policy with limited psychiatric benefits, you can upgrade to full psychiatric cover without serving another waiting period. This waiver can only be used once in a lifetime and applies to hospital care for mental health and drug and alcohol treatment.
Changing to a different hospital policy
If you switch to another hospital plan with the same or lower level of cover – whether that’s with the same insurer or a different one – portability rules mean you won’t have to serve waiting periods again to access benefits you already had. However, you will need to serve waiting periods for any additional benefits your new policy offers.
Do any extras services have no waiting periods?
Unlike hospital cover, extras health insurance policies allow providers to set – and waive – waiting periods as they choose. While no waiting period extras are not standard with most insurers, many offer them as part of special sign-up deals for new customers.
Commonly waived waiting periods include treatments with shorter two- and six-month wait times, such as:
- Dental check-ups
- Optical care
- Physiotherapy and chiropractic care
- Mental health support
However, longer waiting periods for more extensive treatments are not generally waived.
It’s important to check the terms and conditions of any special offers, as there are often restrictions on availability. For example, you may need to sign up for a combined hospital and extras plan to qualify.
Even if no waiting period extras cover isn’t available to you, it’s worth comparing your options as some insurers offer shorter waiting periods for certain extras services. This can make a real difference, especially if you’re after a specific service like hearing aids, where waiting times can vary greatly between providers.
Will I have to re-serve waiting times if I switch extras policies?
Unlike hospital cover, the portability rules that protect you from re-serving waiting periods when changing policies do not apply to extras cover. However, most insurers will usually allow immediate access to extras treatments if you have already served waiting periods on a previous policy.
It’s still important to check and confirm with your insurer before signing up, especially if you might need to make a claim soon after switching.
Also, be aware that any claim limits from your previous policy usually carry over, but if your new policy offers higher limits, you’ll generally need to serve waiting periods again before you can access those increased benefits.
If I have a pre-existing condition, can I access no waiting periods?
A pre-existing condition is an illness or ailment where you had signs or symptoms in the six months before you joined or upgraded your cover.
If you have a pre-existing condition, you will need to serve a 12-month waiting period before you can claim benefits for treatments related to that condition under hospital cover. You can still access treatment during this time, but you won’t be covered for it until the waiting period ends.
The one exception is for psychiatric care, rehabilitation or palliative care, which has a two-month waiting period, even if this is to treat a pre-existing condition.
Pre-existing condition rules don’t usually apply to extras cover, but waiting periods for specific services will still apply depending on your policy.
Why compare health insurance policies through Savvy?
What to watch out for with health insurance with no waiting periods
-
Only certain extras services qualify
No waiting periods usually apply only to specific, more basic extras like general dental or optical care with standard 2- or 6-month wait times. More extensive treatments, such as major dental work, often still have waiting periods.
-
May be limited to certain plans
Waived waiting periods or no waiting periods are often available only on particular plans. Cheaper or entry-level extras plans might not include waived waiting periods or cover the services you need.
-
Varies by provider
Each insurer decides which extras services have waiting periods and if they can be waived. Some will offer no waiting period deals, while others will not. Comparing policies can help you find extras plans without the waiting periods.
-
Watch for gaps when switching
To avoid re-serving waiting periods, you usually need to start your new policy within a set time frame – often around one month – after your previous cover ends. Otherwise, waiting periods may apply again.
-
Read the fine print on extras
Portability rules don’t cover extras policies, so be sure to check the details to confirm whether you’ll need to re-serve waiting periods on your new plan.
-
Be aware of pre-existing condition restrictions
If you have a pre-existing condition, hospital cover will not pay benefits for treatments related to that condition for 12 months after joining or upgrading your cover.
