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Can I get Hospital Cover without a waiting period?

Reviewed and updated 20 April 2023

Generally, private health insurers impose waiting periods before you can make a claim, when you take out Hospital Cover or upgrade your policy.

Occasionally, insurers may waive waiting periods.

Waiting periods are designed to ensure that individuals cannot make a large claim and then cancel their policy shortly after becoming members.

Waiting periods vary depending on the clinical category and your insurer. 

The Private Health Insurance Ombudsman sets maximum waiting periods for hospital services:

  • 12 months for pre-existing conditions
  • 12 months for pregnancy and birth-related services
  • 2 months for Psychiatric Care, Rehabilitation or Palliative care (even for a pre-existing condition
  • 2 months in all other circumstances.

In some cases, you can upgrade to receive mental health treatment in hospital without a waiting period. This exemption applies only once in a lifetime. You can receive this only if you have already completed an initial 2 months of membership on any level of Hospital Cover.

If you want to swap to a new policy that offers the same level of cover as your existing policy, your insurer is not allowed to impose extra waiting periods.

This is also the case if you change insurers.

You should check your insurance policy to find out the waiting periods for specific clinical categories.

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