Waiting Periods

When you take out private health insurance in the form of hospital cover or extras cover, or upgrade your existing cover you may have to wait a period of time before you can claim for some services.  Benefits may vary according to your level of cover. To determine which waiting periods apply for your level of cover, please refer to your policy document which you can download and save for future reference.

If you switch from another private health insurer

If you’re switching from another private health insurer we’ll recognise waiting periods already served for comparable benefits.

If you are joining ahm and haven't had continuous hospital or extras cover

You have to serve the following health insurance waiting periods:

Waiting Periods
1 day
  • Ambulance services
  • Hospital treatment required as a result of an accident
  • Travel and accommodation relating to a hospitalisation
  • Disease prevention and chronic disease management programs
2 months
  • Hospital treatment (where there's no pre-existing conditions)
  • Rehabilitation, psychiatric and palliative care (regardless of whether pre-existing)
  • All extras and routine dental services except as specified below
  • Travel and accommodation relating to specialist medical services
  • Hospital substitute services (except pre-existing conditions or pregnancy related)
6 months
  • Optical except for laser eye surgery (3 yrs)
  • Outpatient procedure room fees, post operative and medical aids
12 months
  • Pre-existing conditions
  • Obstetrics, pregnancy, IVF and birth related conditions in a public or private hospital (including hospital substitute services)
  • Pre- and post natal services
  • Disease management appliances
  • Complex  and major dental services including orthodontics
  • Podiatric surgery, orthotics and orthopaedic shoes, hearing aids, medical gases and joint fluid replacement injections
3 years
  • Refractive sight correcting laser eye surgery (you need to have held either Super or Lifestyle Extras for 3 years before you are entitled to this benefit)

 

If you upgrade your ahm health insurance cover

You will need to serve the waiting periods outlined above. Your existing health insurance cover applies until waiting periods are completed.

If you have a health insurance query, please contact us.