Pre-existing conditions explained

pre-existing condition is an ailment, illness or condition, the signs or symptoms of which, in the opinion of our appointed Medical Practitioner, existed in the 6 months prior to you arriving in Australia or your visa being grated, whichever date is later.

This includes any undiagnosed ailment, illness or condition.

Waiting Periods

The OSHC and OVHC policies include waiting periods for the treatment of pre-existing conditions. This means if you receive treatment for a pre-existing condition during the relevant waiting period, you cannot claim for the costs and you will need to pay the entire amount. A waiting period is calculated from either the date you arrived in Australia or the date your visa was granted, whichever date is later. Please refer to the policy wording for further details.

  • For international student with OSHC policy you can see your waiting periods here.
  • For international visitors and worker with an OVHC policy you can see your waiting periods here.

For example, if you have been diagnosed with asthma within 6 months before arriving in Australia, this will be considered a pre-existing condition. You will need to wait the applicable waiting period before cover will be provided and you can claim for treatment received after the end of the waiting period.

Who decides if your condition is pre-existing?

When you make a claim, we will appoint or approve a medical practitioner to assess whether there were signs or symptoms of the condition prior to purchasing your cover.

The medical practitioner will take into account any information relating to your ailment, illness or condition. The information will usually come from the medical practitioner who treated you. The condition may not have been given a diagnosis, but if the symptoms or signs were there, then it can be considered a pre-existing condition.

A health condition can still be considered pre-existing even if an illness had not been diagnosed prior to when you first got health cover from us.

A pre-existing condition includes a secondary related condition or disability directly arising from a pre-existing condition.

Carefully review your policy to ensure you are aware of the different waiting periods.

Still need help?

Our team is here to answer your questions