Before You Switch: A Simple Guide to Health Insurance Waiting Periods
Published November 28, 2025
Changing health funds can be an utterly daunting task, especially for people who are worried about waiting periods and whether their cover will lapse in the transition period. But getting to grips with the rules around portability and waiting periods can make it much more straightforward and therefore less stressful.
Health insurance waiting periods and portability Australia rules are designed to protect you when switching funds, ensuring you don’t lose cover or have to re-serve waiting periods you’ve already completed.
What are waiting periods in private health insurance?
The waiting periods refer to the periods of time when you can’t claim certain benefits once you subscribed to a new policy. It is one way of discouraging people from taking out insurance only when it is needed and going to cancel immediately after treatment. Commonly, waiting periods include the following:
- 1 year for pre-existing conditions and major dental treatments.
- 2 months for general hospital cover and some extras.
- 6 months for optical and other specific extras.
Remember, when changing health funds, these waiting periods are subject to the rules of portability, meaning your cover can be continuous.
What is portability, and how does it protect you?
Portability is a Private Health Insurance Act 2007 provision that guarantees you in no way losing current level of cover when it comes to switching health funds. This rule, policed by the Office of the Commonwealth Ombudsman – aka the Private Health Insurance Ombudsman – ensures three things:
- Cover Transfer: The new health fund is required to honor the waiting periods served with your previous fund.
- Guard against pre-existing conditions: Your new fund is unable to impose new waiting periods for equivalent cover, eve4n if you come up with pre-existing conditions.
- Lapsed policy grace period: Most funds come up with a grace period of 1 -2 months for lapsed policies, during which you gain the freedom of switching.
How does the transfer process work?
- Step 1: Obtaining the Transfer Certificate
- Step 2: Matching your current coverage
- Step 3: Serving waiting periods for upgrades
What to watch out for when switching health funds
Grace periods for lapsed cover
While most funds will allow a 30–60-day grace period for lapsed policies, some may require you to be up to date with payments to retain the portability benefits. Always check this with your new insurer before switching.
Restrictions on upgrading extras
If you switch to a higher level of extras cover, the higher benefits may not apply immediately. For example, if your old policy paid $800 for major dental and your new policy pays $1,100, you’ll still only be covered for $800 in the first year.
Combined limits
Some funds may also impose combined limits on extras, meaning that some services share the same annual cap.
To Summarise,
Switching health funds doesn’t need to be daunting. With portability rules in place, you can seamlessly move onto a new provider and won’t lose cover or have to re-serve waiting periods for those same benefits. Well, what needs to be taken into consideration is don’t let waiting period concerns stand between you and checking your options. When you are ready to compare health insurance and start switching private health insurance, Utility Market can streamline the whole process for you.
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