What is a waiting period in health insurance?

A waiting period is the time you must wait after taking out health insurance before you can claim for certain treatments or conditions. During this period, you're paying premiums but can't claim benefits for specified services. Waiting periods range from 0 days for accidents to 6-12 months for pre-existing conditions and specific treatments like joint replacements. They exist to prevent people from taking out insurance only when they know they need treatment.

How long are typical waiting periods for health insurance in NZ?

Standard waiting periods in New Zealand health insurance are: Accidents - 0 days (immediate coverage), General medical treatment - 2-6 months, Pre-existing conditions - 12-36 months, Cancer coverage - 3-6 months, Mental health services - 2-6 months, Pregnancy and maternity - 12 months, and Joint replacements - 12-24 months. These periods vary by insurer and policy level.

Can waiting periods be waived or reduced?

Yes, waiting periods can sometimes be waived or reduced in these situations: Transferring from another health insurance policy without a break in coverage (continuity credit), Upgrading your plan with the same insurer may credit your existing waiting periods, Group health insurance through employers often has reduced or no waiting periods, and Emergency treatments may bypass normal waiting periods depending on the policy.

Do I still pay premiums during waiting periods?

Yes, you must pay your full premium from day one, even during waiting periods. While you can't claim for treatments subject to waiting periods, you are still covered for accidents immediately and for other treatments once their specific waiting period ends. Think of waiting periods as a time when your coverage is building up to full protection.

Waiting Periods Explained

Understanding health insurance waiting periods in New Zealand. When your coverage starts, what's covered immediately, and how to plan ahead.

What Are Waiting Periods?

Waiting periods are specific timeframes after your health insurance policy starts during which certain conditions or treatments are not covered. These periods protect insurers from people who only buy insurance when they need immediate medical care.

During a waiting period, you still have an active policy and may be covered for other conditions, but specific treatments or condition categories are excluded until the waiting period expires.

Common Waiting Periods by Category

General Medical

Accidents:24-48 hours

General illness:30-90 days

Specialist care:30-90 days

Surgical Procedures

General surgery:6 months

Joint replacement:6-12 months

Cardiac surgery:6-12 months

Specific Conditions

Pregnancy:12 months

Mental health:2-6 months

Pre-existing:12 months+

Coverage Timeline Example

Policy Start

Day 1

Accidents Covered

24-48 hours

General Illness

30-90 days

Surgery

6 months

Pregnancy

12 months

What's Usually Covered Immediately

No Waiting Period

• Emergency accident treatment
• Life-threatening emergencies
• Ambulance services
• Emergency room visits
• Urgent medical conditions

Short Waiting (24-48 hours)

• Accidental injuries
• Sports injuries
• Home accidents
• Workplace injuries (if not ACC covered)
• Sudden onset medical conditions

Strategies to Minimize Waiting Periods

Apply Early

The best time to get health insurance is when you're healthy and don't need it immediately.

• Get coverage before you need it
• Don't wait for health issues to arise
• Consider coverage in your 20s-30s

Continuous Coverage

Switching between similar policies may reduce or eliminate waiting periods.

• Avoid gaps in coverage
• Transfer between similar plans
• Check insurer transfer policies

Employer Plans

Group insurance through employers often has reduced waiting periods.

• Group plans have shorter waits
• Some offer immediate coverage
• Check employer benefits

Waiting Periods by Provider

Provider	General Illness	Surgery	Pregnancy	Mental Health
Southern Cross	30 days	6 months	12 months	6 months
nib	30 days	6 months	12 months	2 months
AIA	90 days	12 months	12 months	6 months
Partners Life	30 days	6 months	12 months	6 months

Frequently Asked Questions

Can waiting periods be waived?

In some cases, yes. If you're switching from comparable coverage without a gap, some insurers may waive or reduce waiting periods. Group insurance plans may also have shorter or no waiting periods.

What happens if I need treatment during a waiting period?

You would need to pay for the treatment yourself or rely on the public health system. The condition would likely then become a pre-existing condition for insurance purposes.

Do waiting periods reset if I change plans?

Not always. If you move to a plan with similar or less coverage with the same insurer, waiting periods may be credited. However, upgrading to better coverage or changing insurers may restart some waiting periods.

Don't Wait - Get Protected Today

The best time to get health insurance is before you need it. Compare plans and start your coverage to begin your waiting periods now.

Get Quotes Today Compare Waiting Periods

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