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Waiting periods

A waiting period starts from the date you join. 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 this time, 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.

Emergency Treatment is any treatment required where a person:

  • is in a life threatening situation and requires urgent assessment and resuscitation
  • has suspected acute organ or system failure
  • has an illness or injury where the function of a body part or organ is acutely threatened
  • has a drug overdose, toxic substance or toxin effect
  • has psychiatric disturbance whereby the health of the person or other people are at immediate risk
  • has severe pain and the function of a body part or organ is suspected to be acutely threatened
  • has acute haemorrhaging and requires urgent assessment and treatment
  • has a condition that requires immediate admission to avoid imminent threat to their life and where a transfer to another facility is impractical.

If you’re changing from another OSHC provider to Bupa, you’ll continue to be covered for all benefit entitlements that you had on your old cover. We will honour all waiting periods you have already served when we receive confirmation of your previous membership.

Waiting periods

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.

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Need assistance?

If you have any questions or need assistance:

  •   Call us on 1800 888 942