Waiting Periods

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A waiting period is the time between when you join GMHBA and when you can start claiming. Waiting periods exist to protect members’ funds from those who wait until they are sick and then join a health fund just to claim large sums immediately.

Waiting periods apply to:

  • New members to health insurance (members who have never held hospital or extras cover with a health fund).
  • Existing GMHBA members who upgrade to a higher level of cover or reduce their excess payable.
  • Members who transfer from another health fund who have not fully served the required waiting period for equivalent benefits.
  • Treatment for a pre-existing condition.

Dental benefit limitation

For new memberships (no previous extras cover) or where 12 months continuous dental cover has not been in existence, all dental benefits will be limited to $200 per person/single membership and $400 per family membership during the first 12 months of membership with GMHBA.

Hospital services (when included on cover) Waiting period
Accidents - Bodily injuries resulting from accidents which occur after the date of joining GMHBA or upgrading to a higher cover No waiting period
Obstetrics and maternity 12 months
Pre-existing ailment, illness or condition (other than psychiatric, rehabilitation and palliative care) 12 months
Other hospital services 2 months
Extras services (when included on cover) Waiting period
All extras benefits except as specified below 2 months
Optical, home and domestic aids and medical aids 6 months
Major dental services (including full & partial dentures, orthodontics, crown & bridgework, gold fillings, indirect restorations, surgical extractions of a tooth/teeth including wisdom teeth) 12 months
Health appliances including nebuliser pump, blood glucose monitor, pressure garments, sleep apnoea monitor, extremity pump, hearing aids, orthopaedic appliances (GMHBA approved), prostheses (GMHBA approved non-surgical), tens monitor, podiatry surgical procedures and orthotic appliances (foot) 12 months

Further information about waiting periods can be found in the Important Information section of the GMHBA Member Guide.