What is a waiting period?
A waiting period is an initial period of your health insurance membership whereby no benefit is payable for certain procedures or services. Waiting periods apply to both hospitals and extras cover. You may have a waiting period if:
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You join a health fund for the first time you will be required to serve the applicable waits on the hospital and/or extras |
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You upgrade to a higher level of cover, you will attract new waiting periods, however benefits at the previous level will still be available whilst the new waiting periods are being served. This also includes reducing an excess |
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You transfer from another fund before completing equivalent waiting periods |
** The 2 month waiting period may be waived for psychiatric care for persons upgrading to a higher level of cover, to specifically access in-patient mental health services. The following conditions apply:
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The person must have already served the 2 month waits on policy they are upgrading from (the restricted cover) |
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This waiver is only available once in a person’s lifetime |
Hospital Cover Waiting Periods
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12 months for pre-existing conditions |
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12 months for obstetrics (pregnancy) |
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2 months for psychiatric care, rehabilitation and palliative care |
Can vary between insurers, however typical waiting periods include:
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2 months for general dental and physiotherapy |
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6 months for optical services |
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12 months for major dental |
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12 months for high cost procedures such as orthodontics & CPAP devices |
