What are the waiting periods in private health insurance?

How long are the waiting periods?

I thought there would be no waiting period. Can I still get coverage right away?

1. What are waiting periods?

Waiting periods are the time between the start date of your health insurance and the moment you can benefit from your coverage.

Waiting periods exist to ensure that the health cover is not abused. Let’s have a look at an example: someone wants to do some dental treatment and signs up for health insurance to go to the dentist on the same day. The insurance provider would have to carry a high amount of costs right away. Had they known that the person had dental issues, they might have adapted the coverage (as private insurances adapt the cover based on the medical history).

If a couple of people like that join the insurance, the monthly payments of the community would skyrocket. By having waiting periods, insurers make sure that the coverage is adapted to the actual needs of each person, and this means everyone can make a fair contribution.

2. How long are the waiting periods?

There are different types of waiting periods for every health insurance policy. Here, we will focus on the waiting periods on our Standard and Premium plans under private health insurance. There are two types of waiting periods:

  • 3 months: General waiting period for all types of claims

  • 8 months: Special waiting period for claims involving childbirth, psychotherapy, dental treatment, dentures and orthodontics.

3. I thought there would be no waiting period. Can I still get coverage right away?

Typically, all health insurance plans have waiting periods. But luckily, they can be waived most of the time. If you submit a claim within the first 3 or 8 months of signing up, it might happen that we ask for more information before paying out the claim. There are no waiting periods, if:

  1. You had comprehensive public or private health insurance* anywhere in the world for 12 months before your private health insurance started.

    To prove that, you can send us a certificate that states the start and end date of your previous comprehensive health insurance.

    If your previous insurance was provided as part of a residence based statutory healthcare (e.g. NHS,Medicare) and no document can be used as proof of your previous insurance, you can ask your previous GP for this certificate/signed letter. Again, the letter needs to state the start date and the end date of your previous coverage.

  2. You have done a medical and a dental examination to join private insurance

  3. You had and accident and need medical treatment or hospital care or

  4. You signed up more than 2 months before your delivery and you insure your newborn baby within 2 months after they are born

  5. Your spouse had private insurance for more than 3 months and you got private health cover as their dependent within 2 months of your marriage (or entry into life partnership)

If none of this evidence is available, a medical and/or dental check-up are required before your claim can be processed.

You have some questions about waiting periods or you are not sure how to waive them, our support team will be happy to help!

*Examples of comprehensive health insurance are private health insurance, public/statutory healthcare (e.g the NHS in the UK) and some Expat health insurances. Travel health insurance is not comprehensive health insurance!

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