How waiting periods affect your cover
All health funds, including HBF, have waiting periods to stop people from signing up, claiming and leaving without contributing
money (premiums) to the fund - which wouldn’t be fair to our other members.
A waiting period is a set amount of time from the day your policy starts during which you can’t make a claim from HBF. Waiting
periods apply when you have:
-
Never had health insurance
-
Upgraded your level of cover
-
Rejoined after a break from cover
Waiting periods when you’ve switched health funds
You won’t have to re-serve waiting periods if you’ve switched from a different health fund, as long as your HBF cover includes
the same services as your previous cover. If you’re part way through serving your waiting periods, you will just have to serve the remainder before
you can claim.
It’s important to note that all health funds have different types of products so though we honour waiting periods you’ve
already served on similar services included in your new HBF product, variances might still exist. This means you may
have to serve additional waiting periods for:
- Any new services
- Services with increased benefits and annual limits
- Services where only part of the waiting period has been served
Refer to your product sheet in myHBF or contact us before beginning treatment so we can provide
a quote on what benefits you will receive.
Government maximums for waiting periods
The Government sets the maximum waiting period health funds can impose before you can make a claim. The maximum amount of
time you’ll have to wait before making a claim is:
-
Pre-existing conditions
- 12 months
-
Pregnancy and Birth
- 12 months
-
Psychiatric, rehabilitation or palliative care
- 2 months
-
Other Hospital Services
- 2 months
Contact us for details of your personal waiting periods and the time you have left to serve. We
can also provide a benefit quote, which tells you what you’re covered for and how much you will get back when you make
a claim.
Pre-existing conditions
A pre-existing condition is an illness or condition which, in the opinion of an independent medical practitioner (appointed by HBF), was known to exist, or where signs or symptoms were evident during the six-month period before you became an HBF member, including on the day you joined. This also applies if you transfer to a level of cover with higher benefits or reduce your excess level.
HBF will appoint an independent medical practitioner to examine information provided by your doctor, together with other
relevant claim details, to assess whether a condition is pre-existing. If it is confirmed that you have a pre-existing
condition, you’ll need to wait 12 months from when you joined HBF or transferred to a higher level of cover before you’re
able to make a claim relating to that condition. Be aware that if you choose to go ahead with the treatment and it is
found to be a pre-existing condition, you will be liable for all costs not covered by Medicare.