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What’s a waiting period and why do we have them?

3 minute read

Whether it’s holding out for a text back or standing by a box of unripened mangoes, no one enjoys waiting around for the good stuff; so why are there waiting periods when it comes to health insurance?

Understanding your health cover should be simple, which is why we’ve explained what a waiting period is and why we have them.

What’s a waiting period?

Whenever you increase your level of health cover, or sign up for a new policy, you’ll be required to serve a ‘waiting period’. This is the time frame you’ll have to wait before you can start claiming benefits and it applies to both Hospital and Extras Cover at different levels.

The government is responsible for setting the maximum hospital waiting periods that health funds can have to make it as fair as possible for all Australians.

How long do I have to wait?

nib waiting periods for extras cover

Why do we have them?

Waiting periods protect the majority of our customers by ensuring that individuals don’t join a health fund, claim immediately and then cancel their private health insurance as soon as they’ve received their benefits. This would lead to premiums increasing - potentially making health insurance unaffordable for many Aussies.

What’s a pre-existing condition and how does that affect my waiting period?

If you have a ‘pre-existing condition’ – i.e. you show signs or symptoms of an ailment in the six months prior to joining or upgrading your private insurance cover – you’ll be required to serve a 12-month waiting period for hospital procedures1.

This is outlined as part of the government’s Private Health Insurance Act 2007, and aims to keep health cover fair and as affordable as possible. Check out our pre-existing conditions page for more information.

When do waiting periods not apply?

If you’re considering switching health insurers, don’t worry, if you’re transferring a policy that has an equivalent or lower level of benefits, you won’t have to re-serve any waiting periods. We’ll also recognise partially served waiting periods – so even if you’ve only served three months of a 12 month waiting period, the three months still counts when you transfer to us.

How can I check my waiting periods?

If you’re already an nib customer, you can check whether you have any waiting periods in Online Services.

1Psychiatric care, rehabilitation or palliative care services pre-existing conditions have a 2 month waiting period.

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