The Government recognises that people may need to cease their hospital cover from time to time for various reasons such as during times of financial difficulty. Therefore people can cease their hospital cover for a cumulative period of up to 2 years and 364 days over their lifetime, for whatever reason, without incurring any premium loadings when they rejoin. The normal rules regarding waiting periods will still apply. This period without hospital cover is called a period of absence.
If a member ceases their membership for 3 years or more, calculated over their lifetime, they will have to pay an additional 2% loading for each full year of absence over and above the first 2 years when they return to private hospital cover. They will still pay a lower premium than someone of the same age who joins for the first time as they will receive recognition for the period during which they held hospital cover.
A period of absence applies to every adult covered on a policy and accrues over their lifetime. For example, if a person ceases their hospital cover for 1 year and 6 months, rejoins and ceases again for a further 1 year and 6 months, their total period of absence will be 3 years and they will have to pay a 2% loading when they rejoin.
If a person transfers from one fund to another, the clearance certificate will have to show a total of any days each adult beneficiary has been without hospital cover so as the accepting fund can record these days on the new policy.
Note:Any period of suspension, which has been authorised by the health fund, will not count towards a period of absence. In addition if a member is overseas for more than one year, the period overseas will not count towards a period of absence.