Like all private health funds, Emergency Services Health has waiting periods for new members, including people transferring from another insurer when taking out a higher level of cover. Waiting periods also apply to current members upgrading their cover.

Waiting periods are designed to protect the interest of our members. Without them it would be easy for people to join only at the times when they need cover and to receive benefits. This would lead to higher premiums for all fund members.

At Emergency Services Health the waiting periods are:

Hospital benefits of Lifelong Hospital and Lifelong Combined:

  • 2 months membership for all benefits, excluding accidents
  • 12 months membership for obstetric treatment
  • 12 months membership for pre- existing conditions, excluding psychiatric care, rehabilitation or palliative care.
  • 12 months membership for aids & appliances.

Extras benefits for Lifelong Extras and Lifelong Combined:

  • 2 months membership for all benefits, excluding accidents
  • 12 months membership for major dental (like crowns and dentures) and orthodontics, hearing aids, nebulisers, blood glucose & blood pressure monitors, blood coagulation monitor and for pre-existing conditions
  • 12 month membership for Rollover Benefit (2 years Major Dental).

Platinum Health and Platinum Plus:

  • 3 years membership for corrective laser eye surgery.

It is important to note that if you are transferring from another insurer, waiting periods only apply to the level of cover that is greater the previously held.

For instance if you previously had a top hospital cover with the previous insurer but with an excess, the waiting period only applies to the excess when joining Emergency Services Health.

A government leaflet containing further information is available by clicking here.

Pre-existing conditions

If a new member has a pre-existing condition before joining Emergency Services Health, they may need to serve a 12-month waiting period under the terms of our policy before benefits are payable for the particular condition. This does not apply for psychiatric care, rehabilitation or palliative care.

A pre-existing condition is one where signs or symptoms of your ailment, illness or condition existed at any time during the six months preceding the day on which you purchased your insurance or upgraded to a higher level of cover.

A medical practitioner appointed by Emergency Services Health (not your own doctor) is the only person authorised to decide that a condition is pre-existing. The practitioner must, however, consider any information regarding signs and symptoms provided by your own treating doctor or specialist.

A government leaflet containing further information is available by clicking here

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