Waiting Periods

What is a Waiting Period?

A Waiting Period is a period of time a member must wait before their cover commences.

A 2 month waiting period applies to most services, however some services, such as Maternity and Pre Existing Conditions,  have longer waiting periods.

Do any waiting periods apply?

General Treatment 

Waiting periods for extras items are provided in this brochure and need to be read carefully in conjunction with the conditions of the selected cover.

Hospital

Hospital benefits are payable after two months of membership on the selected level of cover, excluding any waiting periods for pre-existing conditions.

Maternity (or admissions related to the management of) and IVF procedures, attract a 12 month waiting period at the selected level of cover.

Transferring Cover

If you transfer to a higher level of cover new waiting periods will be applied. However, benefits at the previous level will still be available whilst the new waiting periods are being served.

Transfers between or from products containing a lesser level or predetermined excess will result in additional waiting periods being applied. Any excess applicable to a higher excess product from which a member is transferring will continue to be applied for a period of up to 12 months after transfer.

Dependants are required to complete waiting periods of the same length as members.

Pre-Existing Conditions

For pre existing conditions, benefits will not be payable for the first 12months of membership for any illness, ailment or condition, the signs or symptoms of which were known, or which a medical or para-medical practitioner appointed by the company considers, after examining information furnished by the member’s practitioner, and other material relevant to a claim for benefits, were in existence in the member or his/her dependant at any time during the six months preceding the commencement or transfer date.

This is irrespective of whether the member or dependant was aware of the pre-existinf illness, ailment or condition, and includes all proposed elective or cosmetic procedures.