Having cover that suits your health needs

Our health needs change over time, whether we are going through a milestone event or are simply entering a new stage of life. With this change comes different requirements for our health cover.

We address some common occasions below where you may need to change or add to your cover to plan for future health events. Especially for services that attract longer waiting periods.

Please note this is general information and may not apply to your specific situation. Our Member Services team will happily answer any questions you may have about your cover and guide you through the different cover options that are available.

Planning for a baby?

Having a baby is an exciting but busy milestone for all new and soon-to-be parents.

There are two important occasions where you will need to review your health cover to ensure you will be covered for all necessary services before and after birth. These are before falling pregnant and once your baby is born.

A 12-month waiting period applies to all pregnancy and birth services. If you are on Smart Starter Bronze Plus where pregnancy and birth is an exclusion, you will need to upgrade at least three months before falling pregnant. This is to ensure your 12-month waiting period will be served by the time your baby is born. Unfortunately, we will be unable to cover you if you upgrade just before your baby is born.

It’s also important that you notify us of your baby’s arrival within 60 days of their birth date, to ensure your baby can be insured straight away under your level of cover with no waiting periods. If you are on a Single or Couples policy, you will also need to upgrade to a Family or Single Parent policy. Waiting periods will apply for any services required by your baby if we are notified of their birth after this 60-day period.

Orthodontics

Do you have children who will need orthodontics in their teenage years? Or are you planning to undergo orthodontic treatment in the future? Orthodontics are a service that requires some planning ahead.

The benefits and annual limits for orthodontics work a little differently to other Extras services. Instead of receiving a refreshed annual limit, you accrue benefits over consecutive years until you reach what is called a ‘lifetime limit’. A 12-month waiting period also applies if you are taking out cover for orthodontics for the first time.

To understand more about orthodontics and how it works at Doctors’ Health Fund, visit our Frequently Asked Questions page.

As we mature

Our health needs become more complex as we age. We become more susceptible to common and chronic health conditions, and our frequency in needing health services can increase.

Some health concerns can creep up on us quite unexpectedly, and you want to ensure that you are covered for any treatment or care that you may need.

Because of this, our Gold hospital policies - Top Cover Gold and Prime Choice Gold - have been designed to be comprehensive cover, well suited to meet these increasing needs. They remove any uncertainty by covering you for all inpatient services eligible for Medicare.

Our Smart Starter Bronze Plus on the other hand, has been designed as entry-level hospital cover, recommended for younger members taking out cover for the first time. While it includes cover for a wide range of services, it does exclude services that are more commonly accessed as we get older; such as heart surgery, joint replacements or cataracts.

Preventative screening such as colonoscopies can also become more common as we age, so you may be required to visit hospital more regularly. In this case, you may consider a lower or nil excess option for your policy.

Will you need major dental work?

Major dental (such as crowns, bridges and implants) is another service where planning ahead can have its benefits. Unlike other extras services, major dental has a 12-month waiting period if you are taking out cover for the first time or to access higher benefits if you are upgrading.

If you are due for significant major dental work, it may be worth reviewing what kind of benefits you have available and how soon you can access these benefits. Both Essential Extras and Total Extras include benefits for major dental, with Total Extras offering the greatest benefits and separate annual limits for general and major dental.

Aids to assist you day-to-day

Hearing aids and other aids and appliances can become permanent solutions in managing our health needs, especially those that are chronic. Like major dental, hearing aids and aids and appliances have longer waiting periods, so its useful to check whether you have enough benefits to suit your needs or whether you need to plan ahead and consider another cover option.

Hearing aids have a 24-month waiting period if you are taking out cover for the first time or to access higher benefits if you are upgrading. For aids and appliances, it is 12 months. All our Extras covers provide benefits for aids and appliances, with hearing aids only covered on Essential Extras and Total Extras.

Maximising your cover with Doctors’ Health Fund throughout different life stages can have a positive impact on your overall health. Ultimately, your health cover is here to give you access to quality and timely care when you need.

Use our simple Hospital cover or Extras cover comparison tools at any time to see how your current policy compares to other Doctors’ Health Fund policies that are available. This is also a useful way to navigate through the different benefits and limits available with each level of cover.

Our Member Services Team is always readily available to service and support you in understanding your cover and the health events themselves.