Private Health Insurance Waiting Periods

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  avoidfullprice on 09/09/2021 - 10:28

  +1

  the shortest waiting period for pre-exisiting injuiry/conditions please?

  Yeah I hear your frustrations. The law allows insurer to impose 12 months of waiting period, and they would reduce cost (even for not for profit) where they can.

  Also of importance is the various different type of services required under your surgery, and have different waiting period. E.g. some might need 2 months, some might need 6 months and some full 12 months.

  Have you got a quote from the surgeon the cost breakdown, and ask a few fund what's the waiting period for each of the service is?

  Partial service coverage is probably more achievable then wait for full service coverage. Besides they won't cover 100% of the cost so you will have to factor that in too.

  • 

    Jbrennan on 09/09/2021 - 10:37

    +1

    Cheers mate, currently awaiting offical quote was just given a ball park figure at this stage.

    appreciate your response and have been looking at different providers / sussing it all out :)

    • 

      avoidfullprice on 09/09/2021 - 11:05

      Correction to my comment, I meant insurers unlikely to waive. Sorry for typos

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  The Value on 09/09/2021 - 10:35

  Some policies allow children to remain on parents policies until 26.

  • 

    Jbrennan on 09/09/2021 - 10:38

    Thanks but parents policy ran out when I was 23 :)

  • 

    Drakesy on 09/09/2021 - 11:19

    +1

    This was recently increased to 31 :)
    https://www.9news.com.au/national/private-health-insurance-c…

• 

  dtc on 09/09/2021 - 10:39

  Under the relevant legislation, PH insurers can impose a 12 month waiting period for pre existing conditions. And they all do, even if they waive 'waiting periods' they dont waive them for pre existing conditions - you will see they waive them for 2 and 6 month waiting periods (eg palliative care, optometry, lots of the extras cover), but pre existing is 12 months and is hardly ever waived (I've never seen it).

  So unfortunately you are looking at 12 months

  Some funds offer cover for children up to 25 years but you are now 25 so…again unfortunately. The 25 year age limit is about to increase to 31 although I dont think its in force yet; plus you need to be 'dependent' which usually involves not earning much money (under ~$25k per year). Probably not an option

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  resubaehtgnolhcs on 09/09/2021 - 10:40

  +1

  All private health funds that I know of, impose a 12 month waiting period for pre-existing conditions (for their hospital cover).

• 

  mskeggs on 09/09/2021 - 10:49

  +6

  If you do decide to wait, make doubly certain you know what the fund will pay.
  Some cover has ceilings, or annual limits or just flat out only partially covers services.
  I would be quoting item numbers and asking them to confirm that full reimbursement will happen, not leaving you with substantial gaps to pay.

  • 

    jjjaar on 09/09/2021 - 10:54

    +1

    Exactly this.

    You need to check with the potential insurer exactly how much out of pocket you would be, including any excess, and factor that cost +12 months of insurance when comparing.

    • 

      Jbrennan on 09/09/2021 - 11:01

      Yep kinda of sounds like by the time I paid 12months cover that potetially I wouldn't save much money and have had to wait longer to get the issue fixed… Its a diverted septum in my nose stopping me from breathing fully causing mild sleep apena and a very upset partner from snoring….

      • 

        jjjaar on 09/09/2021 - 11:09

        It’s worth doing the exercise to see how much would be covered, but if you’d rather get it done ASAP and money isn’t an issue, then I think you’ve resolved your own predicament.

  • 

    sam-1966 on 09/09/2021 - 10:59

    +1

    Well put - our PH covered our daughter's spinal fusion for scoliosis in full, but another person I know found out too late that their top hospital plan didn't cover their daughter for it.

    With all of the changes to cover it is very important to ensure the exact surgery will be covered, so getting item numbers is your best bet to be sure. And make sure you have it in writing.

• 

  JimB on 09/09/2021 - 11:18

  +1

  'I recently found out I need surgery that will drastically incrase my quality of life…
  I am looking for a private health cover that has the shortest waiting period for pre-exisiting injuiry/conditions please? (Otherwise I can fork out $6000-$10,000 cash to get it done)'

  It may seem like a lot of money, but $6-10k is cheap if it can drastically increase your quality of life. 12 months is a long time to wait.

  I'd speak to the specialist and tell him/her that you are paying out of your own pocket and find out if there are any ways to reduce the costs, i.e. have the surgery done in a public hospital the specialist consults at or perhaps the specialist may discount their rates.

  Also shop around for specialist as their fees vary dramatically… they are all very good and experienced (except if you ask Dr Charlie Teo, he'll tell you how much better he is than his peers).

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  Drakesy on 09/09/2021 - 11:20

  I believe you can go back onto your parents policy as it's now a max age of 31
  https://www.9news.com.au/national/private-health-insurance-c…

  What's the surgery out of interest?

• 

  loulou1 on 09/09/2021 - 11:45

  Given the procedure you are needing, I can say that I have had similar but went with private doctor in public hospital or something like that, made it substantially cheaper. I was out under $4,000 all up. I can’t remember what they called it but it is a cheaper option than 100% private.
  I waited three months I think.
  Edited to add, I didn’t have any private health insurance