A waiting period is the time when you are not covered for a particular service. It starts on the date that you enter Australia or the date that you start your membership, whichever is the later date. During a waiting period you are not covered and will not receive any benefits for the types of treatment affected by the waiting period. Once the waiting period is over, you will receive the full benefits listed under your cover for that treatment type.
If you receive a service or treatment during a waiting period, you are not eligible to receive a benefit payment from us regardless of when you submit the claim. We will only pay a benefit for treatment received during a waiting period if the treatment is classified as Emergency Treatment (see below for more information on Emergency Treatment).
If you transfer to us from another OSHC provider you’ll continue to be covered for all benefit entitlements that you had with your previous provider. We will honour all the waiting periods you have already served when we receive confirmation of your previous membership.
When you upgrade to a higher level of cover, the benefits from your previous level of cover apply during waiting periods.
Emergency Treatment is any treatment required where a person:
|Pre-existing conditions or illnesses of a psychiatric nature||2 months|
|Pregnancy related services (including childbirth)||12 months*|
|All other pre-existing conditions or illnesses||12 months|
*Not applicable to OSHC members who joined before 1 July 2011.
If you have any questions or need assistance: