Extras waiting periods explained

Extras covers come with waiting periods which can vary depending on the type of service and whether you’re new to extras health insurance, switching or upgrading covers.

Find extras cover

Two people relaxing on the couch looking at phones

What is a waiting period?

A waiting period is the time you must wait after taking out or upgrading your cover before you can make a claim. These waiting periods help protect members by preventing people from signing up only when they need immediate treatment and then cancelling soon after. Without waiting periods, claim costs could rise, increasing premiums for all members.

Extras waiting periods

Extras services (when included on cover)	Waiting period
Ambulance subscriptions and transport	0 days
Any eligible extras services that are not specified below	2 months
Optical	6 months
Major dental services (including full and partial dentures, crown and bridgework, endodontic services such as root canal, gold fillings, indirect restorations, surgical extractions of a tooth/teeth including wisdom teeth) and orthodontics.	12 months
Medical devices and aids 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, orthotic appliances (foot), and podiatry surgical procedures.	12 months

When do waiting periods apply for extras cover?

Waiting periods typically apply to services under extras cover. You'll need to serve a waiting period if you:

Take out extras cover for the first time - waiting periods start from the day your cover begins.

Upgrade your cover - if you move to a higher level of cover or increase your benefit limits, waiting periods normally apply to any newly added services or upgraded benefits. Waiting periods for the services and limits included on both your new and previous level of cover will be recognised as served.

Rejoining after a break – if your policy lapses and you rejoin with a gap of more than 30 days, waiting periods may reapply.

Adding someone to your policy – new members or those transferring from another fund added to an extras policy generally need to serve their own waiting periods. When adding a newborn to your private health insurance, waiting periods will depend on a range of factors. Learn more

Does GMHBA have extras cover with no waiting periods?

Generally, the answer is no. Extras cover has waiting periods that you will need to serve before you can make a claim. This helps discourage people from joining GMHBA solely to use their benefits immediately then cancelling their cover.

Extras waiting periods FAQS

Extras cover typically includes waiting periods.

Ambulance subscriptions and transport have 0 days waiting periods on eligible extras covers.

When you transfer from another fund and have previously served waiting periods for an equivalent or higher level of cover, GMHBA will recognise served waits when you switch, so long as this takes place within 30 days of cancelling your cover.

Yes, you can take out standalone extras cover, hospital cover, or combined hospital and extras cover with GMHBA. The choice is yours.

Finding the best extras health insurance in Australia depends on what you value most, whether that’s services like dental or physio, the price, or flexibility in how you use your cover. It’s up to you.

SmartCare Extras when combined with eligible hospital cover lets you hold onto your unused benefits (excluding optical) with annual limit rollover.

That all depends on your lifestyle, health needs, and your budget. If you find yourself using common health services, like dental, physio and optical regularly, it might make sense to take out extras cover to help lower your out-of-pocket costs for these.

If you have already served your waiting periods on an equivalent or higher level of cover with another fund, and joined GMHBA within 30 days of leaving that fund, you won't have to re-serve your waiting periods.

Otherwise, waiting periods will apply from the date you take out your new cover with GMHBA. If you’ve upgraded your cover, your waiting periods for higher cover will start on the date you upgraded, but you can still claim the equivalent benefit to your previous level of cover during that period.

Yes, health funds can waive waiting periods, but only in specific situations. In general, waiting periods are set under Australian private health insurance rules, so funds don’t have complete discretion.

Situation	Can extras waiting periods be waived?
Switching funds	Yes, with conditions (same or lower level of cover within 30 days of cancelling previous cover)
Upgrading cover	No (for upgraded benefits)
Extras promotions	Sometimes during promotional periods – terms and conditions apply.
Student dependants taking out their own cover	Yes, with conditions (same or lower level of cover within 60 days of removal from family cover)