When buying any insurance product, you might encounter terminology with which you're unfamiliar. One term you will find in almost all private health insurance plans is "waiting period." While this term can confuse some people, it's one of the more straightforward to understand.
So what exactly is a waiting period?
Some aspects of your plan may not become active for a specific period. This is what's known as the waiting period.
So, the waiting period is the time you must wait before those specific elements of your coverage become active and you can use them.
If you make a claim for something subject to a waiting period during it, your insurer is unlikely to approve it, although certain insurers may apply discretion in some cases.
Depending on your insurer, you may see a waiting period called an elimination or qualifying period.
How do waiting periods work?
Waiting periods can vary by insurer and the level of coverage you buy.
As such, if you want to ensure that you will have coverage for specific conditions from day one of your insurance plan, you’ll need to ask a sales representative or review each insurer’s available documentation.
Why do waiting periods exist?
Waiting periods often apply to conditions or circumstances that are expensive to treat or that may require long-term attention.
However, the primary reason insurers apply waiting periods is to safeguard against individuals who may take out insurance, not disclose any pre-existing conditions, and immediately seek treatment for the condition in question.
Are waiting periods fixed?
It depends on your insurer.
In addition to waiting periods sometimes changing depending on the level of cover you're buying, you may also have the option to alter a waiting period, similarly to how you can often choose your deductible.
The main thing to understand is that if you're able to change waiting periods, that will impact your premium.
For example, if you get a health insurance quote that you feel is unaffordable, an insurer might be able to extend your waiting period for certain conditions to reduce your premium. While this may seem positive, consider whether you would be happy with this. Remember, if you fall ill with the condition that is subject to a waiting period, you won't be covered and will have to pay for treatment yourself. So as well as thinking about the reduced premium, consider your ability to cover your medical expenses should you fall ill with a condition subject to a waiting period.
In contrast, if you're worried about developing a specific condition for whatever reason, some insurers may give you the option of paying a higher premium to reduce your waiting period for particular conditions.
Are there any typical waiting periods for certain conditions?
While they vary across insurers and plan types, there are some ballpark waiting periods for certain conditions that it’s worth knowing before you search for or buy health insurance.
- Cancer and cardiovascular conditions can sometimes have waiting periods of up to two years. As of 2023, there is no waiting period to claim for these conditions with a Now Health International plan, so long as they're not pre-existing.
- Maternity care often has a waiting period of 10 to 12 months. In such cases, for maternity cover to be valid, you'd need to not be pregnant when you took out a health plan. However, some insurers may provide full cover after as little as 90 days.
- Dental care typically has a waiting period of six to 12 months. Sometimes, insurers impose specific waiting periods for individual treatments or restrictions on how often you can receive a particular type of dental treatment.
In addition to these typical waiting periods, some insurers may offer specific benefits that only kick in after a certain period of cover. For example, as of 2023, Now Health International offers AIDS coverage as an additional benefit on WorldCare plans, but only after three years of continuous coverage.
What about pre-existing conditions?
In most cases, health insurers won’t cover pre-existing conditions as standard.
However, some may cover pre-existing conditions at an additional premium, although these will likely also be subject to a waiting period. Waiting periods attached to pre-existing conditions are likely to depend on several factors, including the condition itself, how often you require treatment, and the last time you exhibited symptoms.
If your pre-existing condition increases your risk factors for other, non-directly linked conditions, this may also impact your premium.
Ultimately, how any pre-existing conditions are treated will depend on your insurer and plan type, so ensure you do your research and ask plenty of questions if you feel you require coverage for pre-existing conditions.
Get a private health insurance quote from Now Health International
If you're looking for private health insurance, you can review all our brochures to learn more about our waiting periods and all the features and benefits you'll enjoy when you can become a Now Health International member.
Alternatively, you can view all our plans and get a quote here.