When you join a health fund or upgrade your existing cover, you may have to wait some time before you can claim benefits.
No-one plans to become unwell. However, the need for some treatments and services can be anticipated. To ensure private health insurance is fair for all, some waiting periods apply.
Waiting periods apply where a person:
Waiting periods that apply to Defence Health cover are:
Cover for an accident is immediate provided it is not claimable from another source such as Workers Compensation, third party or other liability provision.
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 Ailment 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.
Make sure you tell us the good news and your newborn will be covered from birth with no waiting period.
After your baby is born, you have up to two months to upgrade your singles or couples policy to a family policy. The new premium will be payable from the date of your baby’s birth.
If you already have a family policy, you can add your newborn child by advising us of the baby’s name and date of birth (by phone, email, fax or post) within two months of their birth. It’s that easy - immediate cover with no waiting periods.
If you join within 2 months of discharge from the ADF your new cover takes effect from the day following your discharge. That means continuity of cover and absolutely no waiting periods on your own cover.
You may also be eligible for the 10% transition discount for your first year on civilian premiums.
Waiting periods may apply to dependants not previously covered by private health insurance or those upgrading their cover.
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