Extras Cover FAQs
What is a waiting period?
A waiting period is a period of time a member must wait before they are able to claim benefits under their cover. Waiting periods apply where a person:
- is insured for the first time
- has had a break in cover of two or more months immediately prior to joining
- upgrades to a higher level of cover
- transfers from another fund and has not completed an applicable waiting period at that fund for equivalent benefits or chooses to upgrade their cover when they transfer.
What is a pre-existing condition?
A pre-existing condition is an ailment or illness, where signs or symptoms existed at any time in the six months prior to you joining or upgrading to a higher level of cover.
A pre-existing condition is determined by a medical or other health practitioner appointed by Defence Health. The practitioner will consider the opinion and evidence presented by your treating practitioners before making an informed judgement.
If you have had your cover for less than 12 months and need treatment, you should confirm with Defence Health whether the pre-existing condition waiting period will apply.
Defence Health may require you and your treating practitioners to complete a Pre-existing Condition form in order to obtain facts about your illness. The practitioner appointed by Defence Health to review your case will need a number of business days to investigate and make an assessment.
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Do excesses apply to extras such as optical or physiotherapy?
No, an excess is not applied to extras claims. However, out-of-pocket expenses may apply.
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