How long are health insurance waiting periods? 

Taking out a health insurance policy is a great way to cover yourself in the event of illness or an injury. But to claim on that policy, you have to take it out well before you need or get treatment, due to health insurance waiting periods.  

A waiting period is the amount of time you have to wait before you can claim on your policy for healthcare services and treatments. In short: you can’t claim on your Hospital Cover or Extras Cover right away. Health insurers have waiting periods to stop people taking out policies and claiming immediately then cancelling their policies, which would cost insurers a lot of money (and that would mean higher premiums for everyone).  

Waiting periods usually apply when you’re starting a new health insurance policy, upgrading to a higher level of cover or, in some cases, reducing your excess. 

So, what is the waiting period for your health insurance policy? Here’s what you can expect. 

How long is the waiting period for Hospital Cover? 

The waiting period when claiming on hospital treatments depends on your policy, the type of treatment and whether you have a pre-existing condition. Most insurers set their waiting periods in line with the maximum waiting periods imposed by the government. So as a general rule, the waiting period for Hospital Cover will be 2 months, except for in these circumstances: 

• pre-existing condition – maximum waiting period: 12 months  

• pregnancy and birth claim – maximum waiting period: 12 months 

• psychiatric care or treatment (including rehabilitation and palliative care) – maximum waiting period: 2 months. (Read more about the mental health waiting period exemption below.) 

Find out more about pre-existing conditions. 

How long is the waiting period for Extras Cover? 

There are no government regulations for Extras Cover waiting periods, which means it’s up to your insurer to set their own. They could be as little as 2 months, or as long as 3 years. For example, Qantas health insurance waiting periods on the top level of Extras Cover are 2 months for psychology but 36 months for hearing aids. 

Pre-existing conditions do not impact waiting periods for Extras Cover. 

Sometimes insurers waive waiting periods on Extras Cover as part of a promotion to entice new customers. Even if this option isn’t advertised, it could be worth asking your new insurer if they’re willing to waive Extras Cover waiting periods. 

How long are waiting periods when switching health insurance? 

If you change your Hospital Cover to a different insurer, you won’t have to serve any waiting periods as long as you’re staying at the same level of cover. But if you’re upgrading to a higher tier, there will be waiting periods for those additional services. Ask your insurer what waiting periods will apply.   

And if you’re changing to a new insurer at the same level of cover, and have not completed your waiting period yet, you will need to serve the remainder of that waiting period with the new insurer. 

Wondering about whether you can get health insurance waiting periods waived? The Private Health Insurance Ombudsman says it’s rare for insurers to waive waiting periods for pre-existing conditions, obstetrics or major dental treatments. 

Is there a waiting period for mental health treatment?  

To help people access hospital care more quickly, the government introduced an exemption to waiting periods for some psychiatric treatments. This means that if your existing policy doesn’t cover you for psychiatric care – including mental health services and drug and alcohol rehabilitation treatment – you can upgrade your policy and be eligible to claim right away. This exemption can only be used once in your lifetime and you must have already served a 2-month waiting period when you took out the original policy.  

Under this exemption, you can also upgrade your policy and claim on hospital treatment you’ve had within the last 5 days of going into hospital.  

Your excess, co-payments and any other conditions of your policy will still apply. Talk to your insurer to find out more about the mental health waiting period exemption.  

How to find a new health insurance policy 

Thinking of changing to a new insurer? Find the best policy and premium with the healthslips.com.au Calculator, which is the only comparison calculator that compares every policy on the market. It’s free to use and you don’t have to enter your contact details. We don’t sell insurance so we list every policy that suits your search criteria, without any bias. 

Look for a new policy, or compare your existing policy. 

Trudie McConnochie

Writer and Researcher

Knowledge is power – that’s the guiding principle behind everything Trudie writes, and it’s a philosophy she brings to her work at healthslips.com.au. By breaking down complex information into easy-to-understand blogs and stories, she aims to empower Australians to make the best choices and an informed decision around private health insurance.

Trudie understands firsthand some of the complexity of private health insurance having moved to Australia from New Zealand and having to navigate a vastly different public healthcare system and health insurance structure.

Trudie holds a Bachelor of Communication Studies (journalism major) from the Auckland University of Technology.

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