Beware of Health Insurance Waiting Periods | Compare The Market

Aussies who are thinking of starting or growing their family are being urged to check their private health insurance cover at least a year ahead to avoid being caught short with potential waiting period traps. reveals a number of ways that parents could be caught out, given that there is a 12 month waiting period on pregnancy cover for hospital insurance. A mother could miss out on cover if she has an earlier-than-expected birth within the 12-month waiting period, or hasn’t upgraded her health insurance policy to cover the delivery of her baby 12 or more months before the birth.

Abigail Koch, spokesperson at, says, “Often, parents make the mistake of thinking they can take out pregnancy cover any time before the baby is due. The fact is, they need to get covered at least 12 months ahead of the birth.  When the baby is born, the mother is the patient, so there is no need for the baby to be covered, unless there is additional treatment that the baby requires.  This can include the baby being premature and needing a humidicrib.” 

For the baby’s health needs to be covered (and not have to serve out any waiting periods), some insurers require the mother to upgrade the policy to family cover a couple of months prior to the birth.  Other insurers may require the upgrade to take place 12 months prior to the birth.

“We encourage parents to call their insurance provider to ensure they are aware and are covered by the date of the delivery,” Abigail says. points out the pregnancy waiting period traps all parents should be aware of:

  • There is a minimum 12-month waiting period for pregnancy and birth related coverage in private hospitals.[1] Therefore, you’ll need to be on a health cover that includes pregnancy at least three months before you start trying to fall pregnant.
  • The completion of the waiting period – or the cover start date – must fall before, or on, the hospital admission date for delivery.
  • You are not covered if you have a premature birth within the waiting period.
  • You may not be covered if you give birth even a day before the end of the waiting period, depending on your policy.
  • Some funds require you to switch from couples to family cover anywhere from 1-12 months before the birth.
  • Insurance policies that cover assisted reproductive services require 12-month waiting periods, such as IVF.

Abigail adds: “A common misconception is that family policies are more expensive than couple policies, but this simply isn’t true.  Often, dependents are covered for free, and sometimes up until the age of 25 if they are studying full-time and are not married. Depending on what policy you have, your child usually needs to be added to the policy to ensure their health costs are covered.”

“However, if you’re a single parent, you may pay more for a single policy than a family policy, so it’s important to shop around and find the best deal for you. The best way is to compare policies online against your health requirements through comparison services such as”


For interviews and more information, please contact: Phemmie Wilkinson | 02 9279 3330 | e: 

About is an online comparison service that takes the hard work out of shopping around. We help Australians to quickly and easily compare and buy products from a wide range of providers. Our easy-to-use comparison tool enables consumers to find a product that best suits their needs and their back pocket. We’re also in the business of comparing personal finance products, utilities and can help find the lowest fuel prices in your area. Whether it’s car, health or home & contents insurance, we provide a completely free service, that empowers Australians to make buying decisions with greater trust, knowledge and savings. We’ve got your back, simples.


[1] The 12-month waiting period will apply for both private patients in a private hospital and private patients in a public hospital.


Launched in September of 2012, – operated by Compare the Market Pty Ltd (CTM) – has teamed up with a range of Australia’s insurance providers so you can compare some of the latest deals, in one place, side-by-side. The team behind have experience in insurance, comparison, customer service and digital. If this was a stuffy corporate monologue, we’d tell you that we’re a bunch of subject matter experts specialising in User Experience, Customer Insights & Online Strategies. But to be honest, it’s just as accurate (and a whole lot easier) to say that we’re a bunch of people who want to make your experience with online comparison better. We pride ourselves on the fact that we’re forward-thinking, that we share an entrepreneurial spirit, and the fact that we like to have a bit of a laugh too. We’re all a bit too addicted to chocolate, but no one’s perfect, really.

More posts by

On this website you can compare quotes and purchase products from participating brands for health insurance, car insurance, travel insurance, life and income protection insurance, home and contents insurance, energy plans, roadside assistance products, home loans and credit cards.

We do not compare all products in the market and at times not all brands may be available. Visit each product page, as well as our Website Terms of Use, Financial Services Guide (Car, Home and Travel Insurance Products), Financial Services Guide (Life Insurance Products) and Credit Guide for detail about who we compare, how we make money and how our comparison service works for each product.

The Compare The Market website and trading name are owned by Compare The Market Pty Ltd ACN 117 323 378.