At AIA Australia, we understand that waiting periods are often one of the more confusing aspects of private health insurance. Yet, they’re essential for clients to understand so they can make informed decisions and maximise the value of their cover.

 

To help you guide your clients through waiting periods, we’ve outlined the key details they need to know, including what waiting periods are, how they apply, and how they can affect access to cover. So, let’s dive in.

Waiting periods are specific timeframes that members must serve after joining or upgrading their private health insurance before they can claim on certain benefits. They exist to promote fairness across the system by preventing immediate high-cost claims and helping maintain sustainable premiums for all members.

Waiting periods apply differently depending on the type of cover and the insurer. For hospital cover, the maximum waiting periods for different hospital treatments are set by the Federal Government. For extras cover, waiting periods are set by individual insurers.

Whether waiting periods apply when clients switch policies will depend on the nature of the switch. If your client switches to a new insurer, but maintains the equivalent level of cover, waiting periods already served on their existing cover will be recognised. However, if your client upgrades their cover – whether with a new insurer or the same one – waiting periods will typically apply to the new or upgraded benefits.

Here are a few ways you can help clients navigate waiting periods with confidence: