Questions about 12 Months Waiting Period for Private Health Insurance

duluxe2000 on 28/02/2024 - 22:07
Last edited 29/02/2024 - 09:42 by 1 other user

Hello, asking for a family member. They plan their 1st pregnancy and want to go private.

They are looking at several health funds. So this is about the 12 months waiting period for pregnancy. I told them that they can buy it now (say Feb) and start trying in June (4 months later) so if they are lucky, they will conceive in June and will deliver in Feb/March which is exactly 12 months waiting period.

Is my understanding/calculation correct ? Do they need PHI before delivery date as well (it means that they will have to wait until Feb next year to start trying).

Thank you.

Health & Beauty Health Insurance Insurance

Comments

  • jv on 28/02/2024 - 22:11
    +3

    they will conceive in June and will deliver in Feb/March which is exactly 12 months waiting period.

    What if they deliver early as often happens???

    • duluxe2000 on 28/02/2024 - 22:17

      Excellent question, a quick search shows that some PHI do not cover early births, some do (just need estimated deliver date). I will tell them to keep it in mind while choosing funds

      • deme on 28/02/2024 - 22:26

        This seems like you were trying to save a few bucks while risking thousands.

        • duluxe2000 on 28/02/2024 - 23:02

          Not really they r so eager to start their family so not sure when the best/safest time is to start trying …

          • brendanm on 29/02/2024 - 08:30

            @duluxe2000: The best way would be to not worry about private health.

  • JimmyF on 28/02/2024 - 22:27
    +4

    So this is about the 12 months waiting period for pregnancy.

    It is as simple as this. They need to have a PHI policy for 12 months before they can claim anything related to the 'pregnancy'. So if the kid arrives early and under 12 months, not covered.

    So don't go putting a bun in the oven too early ;)

  • Mechz on 28/02/2024 - 22:58

    There's probably a bunch of scans and checkups they'll want to claim before the birth.

    Maybe consider telling them to speak to a GP before they start doing anything.

    • duluxe2000 on 28/02/2024 - 23:12
      +4

      Pls correct me if I'm wrong but PHI only covers inpatient's services. It means that all checkup or scans as outpatient won't be covered by PHI (either through Medicare or out of pocket)

  • sumyungguy on 29/02/2024 - 00:00

    Have you checked out any online resources? Likely to be a better starting point than OzB forums. The government advises to take out private health insurance with relevant cover, 12 months before you are pregnant.

  • Dollar General on 29/02/2024 - 07:57
    -1

    If they plan everything to that level, god help the child

  • impoze on 29/02/2024 - 08:01

    Your calculations are correct, can technically start at 3 months but best to add a buffer in case of an early delivery. Baby just needs to be born after 12 months.

  • knobbs on 01/03/2024 - 10:25
    +2

    Despite what others are saying in here for us it was based on due date. If the 12m is up before the Dr approved due date then you are covered, even for early birth. We did 3 months on phi then into it

    • duluxe2000 on 01/03/2024 - 14:18

      Thanks, good to know someone actually did it. That's an excellent news. I will let them know.

      • knobbs on 01/03/2024 - 14:42

        Probably a good idea to check with your PHI or the practice that you will be using for the birth as well.

  • hit23head on 16/03/2024 - 18:09

    any idea if Corporate quotes which Bupa , medibank gives is better than retail ones ?

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