What waiting periods are included in the extras policies?

Why do health funds have waiting periods?

No matter which health fund you belong to, there will always be waiting periods included in your extras policy. This is for the benefit of all members. If waiting periods didn’t exist, then new members could sign up knowing they need a treatment, have the treatment, claim for it, then cancel their membership straight away. That would mean the current members would have to foot the bill for that cover, and it would make extras cover almost unaffordable for most people. That would likely result in increased pressure on the public health system, which would be bad for everyone. So, while the idea of having waiting periods included in your extras policy can seem a little annoying, it really can be to everyone’s benefit. And if you plan well enough ahead, you can still take advantage of the benefits of extras cover and use it when you need it.

Waiting periods are the time you have to wait between when you sign up as a member to health insurance, and when you can claim. If you are a new member who has never had cover before, then all the waiting periods included in your extras policy will apply. If you are an existing member and you upgrade your cover, the new waiting periods on will apply for the new, or upgraded, treatments. Your old waiting periods will stay as they are. If you are making the switch to GMHBA from another fund then the waiting periods included in your extras policy will also apply. However, if you are signing up to the same level of cover, then the waiting periods you have served at the previous fund will count with us.

Newborns and adopted or permanent foster children who are added to a family cover that has been with us for at least two months won’t usually have to serve the waiting periods included in your extras policy. Any other new additions to the policy will have to serve the waiting periods from the time they sign up, unless they have been signed up to GMHBA or another fund, and served the relevant waiting periods already.

How does extra cover work?

Extras cover provides benefits for the treatments you usually don’t have to go to hospital for, such as dental, optical, physiotherapy, chiropractic, orthodontic, alternative therapies and much more.

The other kind of health insurance is hospital cover, which covers you for when you are admitted to hospital, either for an emergency or for elective treatment or surgery.

Bronze Hospital & Bronze Extras Set Benefits

Entry level hospital cover. Includes preventative dental and optical.
$ 20.35
per week
Select

Bronze Hospital & Silver Extras Set Benefits

Entry level cover. Cover for a range of popular services that suit your lifestyle.
$ 24.35
per week
Select

Silver Hospital Plus & Bronze Extras Set Benefits

Moderate cover. Includes private hospital with some exclusions. Includes cover for preventative dental.
$ 29.90
per week
Select

Bronze Hospital & Bronze Extras Set Benefits

Entry level hospital cover. Includes preventative dental and optical.
$ 20.35
per week
Select

Bronze Hospital & Silver Extras Set Benefits

Entry level cover. Cover for a range of popular services that suit your lifestyle.
$ 24.35
per week
Select

Silver Hospital Plus & Bronze Extras Set Benefits

Moderate cover. Includes private hospital with some exclusions. Includes cover for preventative dental.
$ 29.90
per week
Select

* The price shown is per week and applies to a Single living in VIC with a $500 excess. It excludes LHC loading and includes a Base Tier Government Rebate

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* For new health insurance members on direct debit. Must pay first month to be eligible. Prize does not include flights or transfers. Promotional period 4 August 2017 - 24 September 2017. Valued at $1000. View Full Terms and Conditions

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Apart from accidents or injury, there are also waiting periods in hospital cover, and there are waiting periods included in your extras policy for all treatments and services, but the time periods can vary. At GMHBA, there is a 6 month waiting period for optical treatment, home and domestic aids and medical aids. There is a 12 month waiting period for major dental treatments and health appliances, which can include things like pressure garments, hearing aids, approved orthopaedic appliances and prostheses, and nebuliser pumps.

There is only a 2 month waiting periods included in your extras policy for all other treatments. At GMHBA we have three main extras policies – Gold, Silver and Bronze. We believe in choice, and our extras policies certainly give you that. Our extras come with either set benefits or a percentage benefit. This can mean a slight difference in your premium and the knowledge of knowing exactly what you can claim for each treatment before you walk in. With Bronze, our claim percentage is 55%, with Silver it’s 65% and with Gold it’s 75%. Bronze can be an ideal option if you want a cheap extras cover but still claim benefits for popular services like dental and optical.

Silver is our medium policy that has cover for common treatments and a medium level of benefits and annual limits. Our Gold cover is a comprehensive extras cover that offers general benefits on a wide range of treatments and services. Annual limits are a cap on how much you can claim on an individual treatment for a calendar year. However, despite the difference in levels of cover and benefits, waiting periods included in your extras policy will be the same, no matter which one you choose. To find out which one is best for you, view our covers, answer a few simple questions and we’ll filter your answers to provide you with the best options.

How do I know which policy is best for me?

It is important to take the time to match the best policy for you when choosing extras cover and discussing the waiting periods included in your extras policy. There are a lot of policies out there and every one can be slightly different. While we will ask you a few questions to give you a few options, picking the final one really comes down to you. The first thing to consider is can you afford to put it off? Because of the waiting periods included in your extras policy, the longer the wait the even longer it will be until you can claim a benefit. Treatments like major dental can cost upwards of $1000, and the waiting period is 12 months. So, getting in early and having the peace of mind to know that you can claim benefits when you need them can be an important consideration. And if you have children, multiple dental treatments in a relatively short period can put a lot of pressure on the family budget. And things like the Australian Government Private Health Insurance Rebate can also make things a little easier financially, if you are eligible.