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How Long Is The Waiting Time For Health Insurance Cover In Australia? May 15

By Frank Wall

Starting a health insurance plan with no waiting period can be a problem but not impossible if you know what to look for. It just takes some persistance and luck.

What is a waiting period for private health insurance cover? Is the time you have to wait between joining the Fund and when you’re entitled to receive benefits and private hospital cover. For example, most private health insurance funds make you wait 12 months before you can be covered before you can claim for having a baby.

Waiting periods often apply when you:

– Become a new member

– Rejoin a Fund after taking a break

– Change to a different level of cover with your Health Insurance Fund


– Transfer your insurance from one company to another, especially if there is a difference between the benefits under your old cover and your new cover.

How long is the waiting period?

This really depends on what you need to claim on with your fund. The waiting period varies depending on the type of claim and the cost of the claim.

As a general example the following apply,but may vary depending on each Fund. That is why it is really important to properly compare funds before you join, it can really make a difference to your waiting period.

Minimum: Two months wait

You are covered for everything except the following that have even LONGER waits!

Six months

Before you can replace your glasses, contact lenses or “optical items” so optical you need to wait for 6 months before you can get a refund on your medical expenses.

Twelve months

If you have “pre-existing illnesses” you usually have to wait a full 12 months to be covered. An example of this might be if you have hurt you knee doing sport and you need an operation. You cannot join a private health fund and then have an operation in a private hospital straight away, you must have been a member of the fund for 12 months. This saves them a lot of money as you cannot join and claim straight away.

Obstetrics-related services (i.e. having a baby)

Some private health insurance funds will cover you in a private hospital if your baby is born early or you have complications from the pregnancy. You need a special letter from your doctor to say the baby was not expected to be born until after the waiting period. Other than that, you usually have to be a member for 12 months.

Major dental services also require a 12 month waiting period before you are covered. This includes waiting for endodontic services (eg root canal or other complicated dental procedures), dental surgical procedures and surgical extractions (eg wisdom teeth)- ouch, 12 months is a long time to wait!

The best way to get private health insurance without waiting periods is to grab a bargain when they are advertised by the Health Insurance Funds. They regularly advertise “no waiting periods” on television or in newspapers. Keep an eye out and check out their websites to work out what is being covered. Who knows, you might save a long wait?

About the Author: Frank Wall is a student of Private Health Insurance in Australia. He helps people

compare private health insurance cover

find the

cheapest private health insurance


best extras or anciliary cover


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Category: Dentistry
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