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About Private Health InsurancePage | 1 | 2 | 3 | 4 | 5 | 6 | 7 | Waiting periods applying to New-bornsIf you have a single membership and are expecting a child, you may need to transfer to a family membership or a single parent family membership. If you want your child to be insured from the time of birth, you may have to transfer to the new policy two months before your child is born. Ask your insurer to explain its policy on new-borns.
Transferring between insurersYou can transfer from one health insurer to another, for the same or a lower level of benefits, without serving additional waiting periods. The insurer to which you transfer may impose waiting periods before you are eligible for any new or higher benefits on your new policy. The insurer to which you transfer must give you credit for the waiting periods you have already served. Benefits paid by the previous insurer may be taken into account by your new insurer when it determines your annual benefit limits. Transferring between insurers will not affect your Lifetime Health Cover entitlements provided that you transfer from hospital cover with your existing health insurer to hospital cover with the new health insurer. The transfer rules also apply when transferring to a different product of the same insurer. No waiting period for DVA ex-Gold Card holdersIf you held a DVA Gold card, or were entitled to treatment under a Gold Card before applying for private health insurance, no waiting period will apply for any hospital or general treatment covered by the policy. You must apply for the insurance no longer than 2 months after you ceased to hold, or be entitled under the Gold Card. Suspending your membershipMost insurers will let you waive, defer or suspend your membership if you are away from Australia for a certain period of time specified by your insurer. Suspension may also be permitted under other conditions, such as periods of unemployment. Ask your insurer what conditions apply. You will not be paid benefits for services used or treatment provided while your membership is suspended. Similarly, the time for which your membership is suspended cannot count towards any waiting or qualifying periods. Suspending your membership with the agreement of your health insurer will not affect your Lifetime Health Cover entitlements. When you start paying contributions again, your benefit entitlements will continue on the same basis as before your membership was suspended. Standard information statementsWhen you first purchase a private health insurance policy, the insurer is required to give you an up-to-date copy of the standard information statement (SIS) which contains details of what the policy covers and how benefits provided under it are worked out. Your private health insurer must issue you with an up-to-date standard information statement for your policy at least once every 12 months. Notifying members of changes to insurer rulesHealth insurers change rules and premium prices from time to time. Where the proposed change is or might be detrimental to your interest, the insurer must inform you of the proposed change within a reasonable time before the change takes effect. In addition, the insurer must provide you with an updated standard information statement as soon as practicable after the statement is updated.
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Private Health Insurance Administration CouncilSuite 16, Level 1, 71 Leichhardt Street, KINGSTON ACT
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Last modified: 22 July, 2005 |
