Q: What does it mean by waiting period?
On joining health insurance for the first time, waiting periods must be served before benefits will be paid on all hospital and general treatment covers with ACA Health. The exception to this is where you have an accident, not related to pre-existing condition, and you require hospital and/or ambulance treatment.
If you transfer from another fund within 60 days of terminating your old cover, then normal waiting periods are waived and our benefits up to the level of your previous cover may be paid immediately, subject to financial continuity.
If changing to a higher level of cover, normal waiting periods will apply before the higher benefits will be paid.
If adding a spouse to a membership (changing from single to family membership), normal waiting periods will apply for the spouse, unless they are transferring from another fund in which the rule above will apply.
If adding a child dependent to a membership, the child would be subject to the normal waiting periods, unless they are transferring from another fund in which the rule as above will apply.
If adding a newborn to a family membership, the baby will be covered immediately.
Please note: – If you are planning to have a baby and are currently on a singles cover, you will need to upgrade your cover to a family membership at least 2 months prior to the actual birth of the baby to ensure that your newborn will have immediate cover as part of your membership.
|Accident requiring hospitalisation||No waiting|
|Hearing aids and health appliances||12 months|
|Treatment relating to pre-existing condition||12 months|
|All other services (inc psych, palliative and rehab)||2 months|
The Mental Health waiting period exemption for higher benefit is available to each insured person on a hospital policy one in their lifetime and will apply from the beginning of a current admission if the election (fund was notified) was made within 5 days of admission, if not from the date of the election (fund notification received) where;
- The 2 month psychiatric/rehabilitation period has been served
- It is for psychiatric or drug and alcohol related treatment