When you first purchase private health insurance, there may be a waiting period before certain medical expenditures are covered. The law limits waiting periods for hospital services. However, there are no legal limits on how long you will need to wait if you buy extras coverage. It is important to understand what waiting periods mean for you and to shop carefully to find a health insurance fund that offers limited or no waiting periods if you need prompt treatment.
- 1 Health Insurance Waiting Period Estimator
What are Standard Waiting Periods?
Waiting periods are a period of time after you buy cover before it kicks in to provide full benefits. Waiting periods apply when you are buying cover for the first time, or when you allow your policy to lapse and then purchase a new policy after not being covered.
For hospital services, the law imposes limits on waiting periods. If you are buying a new policy or a policy after a lapse in coverage, the waiting period for pre-existing conditions and for pregnancy or obstetrics coverage is 12 months. The waiting period for accidents and ambulance services can be fairly short and the waiting period for other hospital treatment is two months.
There are no standard waiting periods established by law for extras cover. Insurance companies have the choice to determine how long a waiting period should be before you get coverage for dental treatment, vision care, and other services covered by an extras policy.
Is No Waiting Period Health Insurance Available?
Some insurance companies will waive waiting periods. These insurance companies will specifically advertise that they offer “no waiting periods” or that waiting periods are waived.
Typically, when no waiting period health insurance is available, there are still restrictions. For example, you may be able to get coverage straight away for routine optical care or routine dental care but would not have immediate coverage for more expensive dental treatment.
Why do Waiting Periods Exist?
Waiting periods exist because insurance is supposed to protect you in case something happens. If there were no waiting periods, people could wait until they were sick or until they needed a particular medical service and could then sign up for insurance coverage. Insurers would not be able to stay in business if customers did this because insurers depend upon collecting premiums from healthy people to pay for those who end up needing medical services.
Can You Avoid Waiting Periods When Switching Policies?
The law does not allow a waiting period when you switch from one hospital policy to another. Unless you buy a higher level of cover with your new health fund, you should not have to wait and should immediately be able to access full benefits when switching to a new hospital policy.
If you buy a higher level of cover, a waiting period will apply before your additional benefits kick in. Your new health fund will provide the same level of cover you had under your old policy straight away, and you will get access to the higher level of cover after your waiting period is done.
There are no laws requiring insurers not to impose waiting periods when you switch from one extras fund to another. However, many insurers will waive waiting periods for Extras cover when you get the same level of cover. Health funds do this so that more people are encouraged to switch without having to wait months to get the same cover they had before.
How to Shop for No Waiting Periods Health Insurance
When you shop for hospital insurance and you are changing policies, you shouldn’t have to worry about whether a new waiting period will be imposed if you buy the same level of hospital coverage. You can count on immediately having the same coverage you had because of rules established in 2007 by the Private Health Insurance Act.
However, if you are buying a higher level of hospital coverage or if you are switching to a new extras policy, be sure to carefully review the policy terms to understand what the waiting periods are.
If the policy is advertised as “no waiting periods health insurance,” find out exactly what types of coverage you get immediate access to. You likely will only get immediate coverage for routine or preventative care expenses and not for more advanced treatment.
Where Can You Learn More About Waiting Periods?
This guide to private health insurance and waiting periods explains waiting periods in greater detail so you will know what to expect as you shop for policies. You can also use this calculator to determine what your waiting periods are likely to be before you become eligible for different types of coverage.
Health Insurance Waiting Period Estimator
Because waiting periods can limit your ability to get coverage right away for medical care, it is important to buy a policy early before you need medical help. Talk to an expert at Health Insurance Comparison about what policy and coverage level is right for you.