Your cover starts
Your OSHC policy has a commencement date. Waiting periods are measured from the OSHC start date under the current Deed.
A waiting period is the time you may need to hold your OSHC before benefits are payable for certain treatment. Not every service has the same waiting period, and emergency treatment is treated differently.
Waiting periods are subject to the OSHC Deed and the insurer's policy terms. Confirm your individual cover with your insurer before treatment.
It is a period after your OSHC starts during which you may not yet be entitled to benefits for specified services. Once the applicable waiting period has been served, eligible benefits can become payable subject to your policy.
Your OSHC policy has a commencement date. Waiting periods are measured from the OSHC start date under the current Deed.
For a service subject to a waiting period, benefits may not be payable until the required period has been completed.
After the waiting period, you can claim eligible benefits in accordance with the policy's terms, limits and exclusions.
The current OSHC Deed sets maximum waiting periods for specified services.
Waiting periods do not apply to treatment that meets the OSHC Deed definition of emergency treatment.
Seek urgent care immediately in an emergency.Hospital or hospital-substitute psychiatric care, other than emergency treatment, can have a waiting period of up to two months.
Hospital or hospital-substitute treatment for a pre-existing condition can have a waiting period of up to 12 months.
For current OSHC products, policies of less than two years can have a waiting period of up to 12 months. For policies of two years or more, the current Deed provides for no pregnancy-related waiting period once the insurer's relevant premium change has been implemented.
The OSHC Deed commencing 1 July 2025 introduced a significant change. For OSHC products with a duration of 2 years or more, the pregnancy-related waiting period becomes nil from the implementation date of the insurer's premium change occurring after 1 July 2025.
For OSHC products of less than 2 years, insurers may still apply a pregnancy-related waiting period of up to 12 months.
A pre-existing condition can affect when benefits become payable for hospital or hospital-substitute treatment. Under the OSHC Deed, an insurer can apply a waiting period of up to 12 months for this treatment, except where the treatment qualifies as emergency treatment.
Do not assume a previous diagnosis is required.
Ask your insurer how its policy and the applicable rules assess a pre-existing condition.
Emergency treatment is different.
The OSHC Deed specifies no waiting period for emergency treatment.
Keep your cover continuous.
Waiting periods already served can be credited when moving between OSHC products where there is continuous cover.
You do not necessarily start every waiting period again.
The current OSHC Deed states that a waiting period already served under a previous OSHC product is offset against, or credited towards, the waiting period under the new OSHC product when cover is continuous.
If your cover is not continuous, waiting-period treatment can differ. Confirm the consequences with the new insurer before switching.
Give the insurer enough information about the treatment you are planning.
Check your policy start date and any continuous previous OSHC cover.
Finishing a waiting period does not necessarily mean every cost is paid in full.
Ask about likely out-of-pocket costs before non-emergency treatment.
It is a period before benefits are payable for certain services under your OSHC. Different services can have different maximum waiting periods.
No waiting period applies to treatment that meets the OSHC Deed definition of emergency treatment.
Hospital or hospital-substitute treatment for a pre-existing condition can have a waiting period of up to 12 months, other than emergency treatment.
The current OSHC Deed permits a waiting period of up to two months for psychiatric hospital or hospital-substitute treatment, except emergency treatment.
No. Under the current Deed, pregnancy-related waiting periods differ according to policy duration and the insurer's implementation date. Policies of less than two years can have up to 12 months; qualifying policies of two years or more have nil waiting period after the relevant implementation date.
The current Deed provides for nil pregnancy-related waiting period for OSHC products of two years or more after the insurer implements its premium change occurring after 1 July 2025. Confirm the implementation date with your insurer.
Where OSHC cover is continuous, a waiting period already served under the previous OSHC product is credited towards the new product's waiting period.
The Australian Government's OSHC fact sheet says an insurer may agree to reduce a waiting period in some cases. Ask your insurer whether this is available in your circumstances.
No. Policy benefits, limits, exclusions and provider charges can still leave you with out-of-pocket costs.
Contact your OSHC insurer before non-emergency treatment to confirm whether you have served any applicable waiting period and what benefits may be payable.
Waiting periods are measured from the commencement date of your OSHC under the current Deed. Check your policy start date and insurer records if you are unsure.
Yes. Where cover is continuous, waiting periods already served under a previous OSHC product can be offset against or credited towards the waiting period under the new OSHC product.
Completing a waiting period only addresses when an eligible benefit may become payable. Policy limits, exclusions and provider charges can still affect what the insurer pays and what you pay.
No. The guide identifies emergency treatment as having no waiting period under the OSHC Deed. Seek urgent medical care when it is needed.
Confirm that your cover will remain continuous and ask the new insurer how previously served waiting periods will be recognised before making the change.
Compare OSHC options and check the current policy terms before choosing your cover.
General information only: Waiting-period rules and product terms can change and individual circumstances differ. This guide is based on the current Australian Government OSHC Deed and fact sheet. Always check the insurer's current policy documents and confirm your cover directly with the insurer before treatment.