What is a waiting period?

A waiting period is the amount of time you have to wait before you can start to claim on your health insurance. Waiting periods apply to both hospital and extras covers and you cannot claim for procedures/services that you receive during a waiting period.

Waiting periods apply when you start a new private health insurance membership, or if you’re already covered (with Australian Unity or another health fund) and you choose to upgrade to a higher level of cover:

  • When you switch to Australian Unity within 30 days of leaving your previous health fund and you choose a similar or lower level of cover, you won’t have to re-serve waiting periods you’ve already completed.
  • When you upgrade your level of cover, waiting periods may apply to benefits not previously included under your original cover or benefits that are higher than your previous level of cover. You will still be entitled to the benefits payable under your previous level of cover while you are serving the waiting period for the higher benefits.

If you’ve got Overseas Visitors Cover, you can find out about waiting periods here.

Why do waiting periods exist?

If waiting periods didn’t exist, people could take out health insurance or upgrade to comprehensive cover only when they knew or suspected that they might need cover for a procedure/service, and then immediately make a claim. If these new members then cancelled (or downgraded) their membership after making a claim, their costs would have to be paid for by the fund’s long-term members. Not only is this unfair to existing members, it could also lead a fund having to increase premiums.

Hospital waiting periods

The Australian Government sets the maximum waiting periods that can be applied to different benefits on hospital covers, which means that most health funds have the same or similar waiting periods.

The following waiting periods apply to Australian Unity hospital covers. It is important to note that the benefits payable for these procedures can vary depending on your level of cover, and some procedures may be excluded or restricted. Check your product fact sheet for full details about your selected cover.

Hospital cover benefit Waiting period
Accidents and ambulance services No waiting period
Psychiatric, rehabilitation and palliative care (even for pre-existing conditions) 2 months
Pre-existing conditions 12 months
Pregnancy and related services 12 months
Chronic Disease Management and Hospital Substitution programs 12 months

Extras waiting periods

Even though extras waiting periods are set by individual health funds, the competitive nature of health insurance means that these waiting periods are typically very similar across the private health insurance industry.

The following waiting periods generally apply to Australian Unity extras covers. It is important to note that the benefits payable can vary depending on your level of cover, and some services may be excluded. Check your product fact sheet for full details about your selected cover.

Dental
Extras cover benefit Waiting period
Preventative treatments, which includes examinations, scale and clean, fluoride treatment, mouth guards and x-rays 0 days
General dental, which includes most fillings, teeth whitening and tooth extractions 2 months
Complex (periodontic and endodontic) dental, which includes root canals, gum disease treatments and surgical extractions 6 months
Major dental, which includes crowns, bridges and dentures 12 months
Orthodontics, which includes procedures to correct the positioning of your teeth and jaw 12 months
Other extras
Extras cover benefit Waiting period
Prescription glasses and contact lenses 6 months
Hearing aids, health aids, health devices and orthotics 12 months
Travel vaccinations (if supplied and administered in Australia) 0 days
All other services 2 months

Australian Unity will sometimes waive the 6 month optical and 2 month waiting periods as a limited time offer. If you’re thinking about joining or making other changes to your health insurance, it’s worth watching out for these offers so that you can claim sooner on popular extras.

Adding new people to your cover

When you add a new person to your cover, they will have to wait the standard waiting periods unless they are moving from another policy (either with Australian Unity or another health fund) with a similar or higher level of cover.

Find out more

To find out more about waiting periods, call us on 13 29 39 or visit the Private Health government website.