Waiting Periods & Pre-Existing Conditions

 

Pre-Existing Conditions

A pre-existing condition is any ailment, illness or condition that you had signs or symptoms of (in the opinion of a medical practitioner appointed by the health insurer) that existed during the 6 months before you joined a hospital cover or upgraded to a higher hospital cover. It's not necessary that you or your doctor knew what your condition was or that the condition had been diagnosed. A condition can still be classed as pre-existing even if you hadn't seen your doctor about it before joining hospital cover or upgrading to a higher hospital cover.

If you are new to health insurance and have a pre-existing condition, you will need to serve a 12 month waiting period (under Hospital cover, not Extras) before the RBHS is able to cover the condition. If you have health insurance with another fund and have served all of your waiting periods with them, you will be covered straight away and won’t have to re-serve your waits if you move to a similar or lower level of cover with the RBHS.

 


Waiting Periods

All health funds have waiting periods to protect all members by encouraging people to maintain their health cover. A waiting period is a length of time applied to each new health cover and also applies when cover is upgraded. During this period, benefits are generally not payable.

The RBHS will provide continuity of cover for anyone transferring from another registered Australian health fund or changing from another RBHS product, provided that equivalent or a higher level of cover was held. To be eligible for continuity of cover the transferring health cover must be financial and a Clearance Certificate provided by the previous health fund. If you have served part of your waiting periods with your previous health fund, you will receive waiting period credits when you transfer to RBHS for the portion you have already served.

The following table outlines waiting periods for Hospital and Extras. For more information on waiting periods, Clearance Certificates or continuity of cover please give us a call on 1800 027 299 or email info@myrbhs.com.au.

GOLD HOSPITAL COVER
Months Type of Waiting Period
0 Accidents requiring hospitalisation
2 Most other hospital treatment (excluding pre-existing ailments)
Palliative care, rehabilitation and psychiatric treatment
12 Pre-existing ailments and conditions*
Obstetrics & IVF (including midwifery)

Please note that not all items are listed and other waiting periods may apply. Please contact the fund for more information. 

*Pre-existing conditions: any ailment, illness or condition that you had signs or symptoms of (in the opinion of a medical practitioner appointed by the health insurer) that existed during the 6 months before you joined a hospital cover. It is not necessary that you or your doctor knew what your condition was or that the condition had been diagnosed. A condition can still be classed as pre-existing even if you hadn't seen your doctor about it before joining hospital cover. This waiting period applies to Hospital cover, not Extras cover.

EXTRAS COVER
Months Type of Waiting Period
2 Ambulance
Physiotherapy
Chiropractic & osteopath
General dental
Approved health management programs
Other general treatment
12 Optical & laser eye
Major dental
Health aids & screening

 

Please note that not all items are listed and other waiting periods may apply. Please contact the fund for more information, or click here.