Before you can start claiming on your health cover, you must have held your cover for a certain amount of time, known as a waiting period. This is necessary to keep health cover fair.
Waiting periods in health insurance protect members who make payments to a fund over time, for when they might need to use their health cover. If health insurance had no waiting periods, people could join a fund to claim for a planned item and then leave.
Pre-existing conditions will also affect your waiting periods so it's important to understand how these may impact you. Waiting periods may also apply to any additional benefits gained when you change your level of cover.
To find out what waiting periods apply on your policy log in to view your cover details, or refer to your Policy Booklet or Fund Rules for more information. You can also contact us if you have any questions.
Waiting periods for Hospital services
| Hospital service | Waiting period |
|---|---|
| Accidental injury benefit | 1 day |
| Emergency Ambulance Cover | 1 day |
| Other conditions requiring hospitalisation (except those listed) that aren't pre-existing conditions | 2 months |
| Hospital psychiatric services | 2 months* |
| Rehabilitation or palliative care (whether or not a pre-existing condition) | 2 months |
| Other pre-existing ailments/conditions (an illness or condition where evident at any time during the 6 months immediately prior to joining nib) | 12 months |
| Pregnancy and birth | 12 months |
Note: your cover may exclude some of these procedures. You should also check if a Restriction applies to your cover.
*A two month waiting period applies to members who take out a product that includes Hospital Psychiatric Services. Members upgrading to a product with full benefits for Hospital Psychiatric Services may be able to waive the 2 month waiting period. This Mental Health Waiver is only available to members who have held hospital cover for at least the previous 2 months, have not previously used their waiver with nib or any other fund, have been admitted to hospital and is under the care of an addiction medicine specialist or consultant psychiatrist.
Waiting periods for Extras services
| Extras service | Waiting period |
|---|---|
| Ambulance services | 1 day |
| All other services, except those listed below | 2 months |
| Optical appliances and repairs | 6 months |
| Healthier lifestyle | 6 months |
| Specialty dental (e.g. endodontia, periodontia) | 12 months |
| Removal of wisdom teeth and oral surgery | 12 months |
| Periodontic surgical, root therapy and endodontic services by a dentist not registered as a specialist | 12 months |
| Dentures, denture maintenance/repairs, other prosthodontic services | 12 months |
| Orthodontia | 12 months |
| Artificial aids (except orthotics and orthopaedic shoes) | 12 months |
| Hearing aids | 36 months |
Note: your cover may not include some of these Extras services.
