The concept of a waiting period in the health industry is more complicated than it sounds. In simple terms, it’s a specified time period in a health insurance plan that must pass before part or all of a member’s health care coverage can begin. Beyond that simple definition, however, are the types of waiting periods and the rules that apply to each.
How long do waiting periods last?
Although waiting periods can vary depending on the health insurer, the government has set maximum waiting periods for some hospital benefits. Below are some of the predefined waiting periods for certain hospital benefits:
- 12 months for pregnancy and birth-related benefits
- 12 months for pre-existing conditions and ailments
- 2 months for psychiatric care, rehabilitation and palliative care (no matter if it’s pre-existing or not)
- 2 months for general hospitalization
Are there exemptions for waiting periods? Waiting period exemptions apply to certain types of benefits, including psychiatric care. If a new member is moving from one health fund to another, and they previously had limited psychiatric benefits, they are exempt from having to wait two months to receive the higher or extra benefits attached to their new health fund. This exemption can only be used once in a lifetime and is only available to people who have already served their initial two month waiting period for psychiatric benefits.
Choosing a private health fund
Although most health insurance plans have waiting periods, and virtually all health funds have them, if you’re searching for a health insurance no waiting period policy, you can start your search by comparing a variety of providers at iSelect, which is Australia’s leading destination for insurance comparison and purchasing.
Before you do that though, you need to think first about what your needs are. Below are some questions to ask yourself before deciding on a health care plan.
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- Do you want your plan to include maternity care? If you’re planning on starting a family, you’ll want to ensure the plan you choose has maternity care.
- How healthy are you? If you’re young, healthy, and have no pre-existing conditions, you may consider opting for a plan with less coverage for a lower premium. However, keep in mind that accidents happen, so unless you’re prepared to pay out-of-pocket for hospital stays, make sure the plan you choose has sufficient hospital coverage. Otherwise, you could end up draining your savings or going into debt from medical costs.
- Do you need easy access to specialists? If you have a condition or ailment that requires you to receive care from a specialist, make sure your plan gives you access to the type of specialist you require care from.
Why have private health insurance?
Private health insurance in Australia helps to protect people by helping them pay for treatments and services that are otherwise not covered by Medicare. By paying a premium to a health insurance company, people have more choices in health care and the doctor or specialist that provides it. People can purchase hospital insurance, general treatment (extras) or a plan that combines both.
Although Australians have access to free health care, known as Medicare, to take some pressure off the public system, people are encouraged to take out private health insurance. If you don’t, you’ll have to pay a Medicare levy surcharge fee and a Lifetime Health Cover loading fee.
Medicare pays up to 75 percent of your medical costs under the Medicare Benefits Schedule. Your private health fund then contributes about 25 percent of the MBS fee.
Private health insurance not only helps you to avoid the MLS and LHC loading fees, but it’s also an essential purchase if you have a health condition, are thinking of starting a family, have a family, or are getting to an age where you might require more medical care.
