Waiting Periods

When taking out health insurance for the first time, the following waiting periods must be served:

New Customer Maximum Waiting Periods
Accident and Injuries Illnesses that commence after you join Illnesses that commence before you join Maternity related claims
None 26 weeks 5 years 52 weeks

If you switch to a different insurer, you will not have to reserve these waiting periods as long as you haven't had a break in cover of more than 13 weeks. If you switch provider while you are serving these waiting periods, the amount of time served with the first insurer will be carried over and you will finish the waiting periods with the new insurer. You will only have to serve additional waiting periods if you switch to a plan with higher benefits. This is known as the 'upgrade rule' and it there is a 2 year waiting period for any additional cover that is related to a pre-existing condition. VHI are the only provider that apply a one year waiting period for additional benefits that are not related to a pre-existing condition. 

Vhi Healthcare

Upgrade waiting periods


Outpatient Medical Expenses

Day to day Medical Expenses Inpatient New Conditions Inpatient Pre-existing conditions
Under 50 None None 26 weeks 2 years
50-54 None 52 weeks 26 weeks 2 years
55-64 None 52 weeks 52 weeks 2 years
65+ None 2 years 2 years 2 years

The four providers also apply a 52 week waiting period for any increase in maternity benefits. 

Newborns must be added  to their parents policy within 13 weeks of their date of birth to avoid waiting periods. If they are not added on within 13 weeks of birth, they will be subject to the 'New Customer Maximum Waiting Periods' as outlined above.