Taking out health insurance and assuming you can be admitted to a private hospital tomorrow is the most costly misunderstanding of the first year. The reality is more nuanced: some types of cover are available from day one, while others have a waiting period. I explain exactly which is which, so you know what to expect before you sign.
What is a waiting period and what is it for?
A waiting period is the time that has to pass from when your policy takes effect until you can use certain types of cover. It isn't a penalty aimed at you personally: it's a general measure insurers apply so that nobody takes out health insurance the day before a procedure they've already decided on, then cancels it as soon as they're discharged.
Put another way: the waiting period protects the balance of the whole pool of policyholders, not just yours. That's why not every type of cover has the same waiting period: emergencies and the most basic care are designed to be available to you right away, while planned procedures and higher-cost treatments wait a few months.
What you can use from day one
This is the first thing I clarify for anyone who asks me about waiting periods, because it tends to be a pleasant surprise: emergency care, primary care (general medicine, family medicine, paediatrics and nursing) and specialist medicine are available from the very day your policy takes effect. You don't have to wait months to see a specialist or to be treated if you hurt yourself on a weekend.
The idea, in one line: the things you'd use most in everyday life — a consultation, a specialist, an emergency — have no waiting period. The waits are concentrated in planned procedures and more complex tests.
The exact waiting periods: 6 and 8 months depending on the benefit
From there, the waiting periods fall into two groups. Hospitalisation has an 8-month waiting period, the longest in the policy. With a 6-month waiting period are outpatient surgery, special treatment techniques, family planning, psychotherapy and certain diagnostic tests.
- ✓8 months: hospitalisation.
- ✓6 months: outpatient surgery, special treatment techniques, family planning, psychotherapy and certain diagnostic tests.
- ✓6 months (indicative): high-tech tests such as MRI, CT or PET scans.
- ✓From day one: emergency care, primary care and specialist medicine.
These waiting periods are always counted from your policy's effective date, not from when you sign the paperwork or pay your first instalment. If you already have a date on the calendar for a test or a procedure, that detail is what decides whether you make it in time. I'll explain the three copay levels and confirm your specific case on the health insurance page .
Pregnancy, a case of its own
Pregnancy is by far the question I get asked most by couples looking at health insurance in the medium term. Obstetric cover has its own waiting period, so a pregnancy that's already under way when you take out the policy may be excluded or subject to special conditions.
That doesn't mean you can't take out a policy while pregnant: you can, to cover the rest of your medical care, for instance — but it's worth knowing in advance which part of maternity care is included and which isn't in your specific case, before assuming anything.
What to do if you already know you'll need a test or a procedure
If you already suspect you'll need a high-tech test, a planned operation, or any benefit with a waiting period, the sensible thing is to start the process with margin, not the week before you need it. Counting the months back from the date you have in mind is the first thing I do when someone calls me with this question.
It's also worth declaring any condition or history honestly on the health questionnaire: it's a legal requirement, and getting it right from the start avoids surprises when you actually need to use the policy. My job is to explain, before you sign anything, what each copay level covers and when it starts covering it.