What´s not covered
As with all health insurance policies, there are certain things that are not covered. Flexible Health essentials, premier and elite specifically excludes the following list which is a summary only. For a full list please see ´What is not covered´ in ´A Guide to Your Policy´. A copy is also available on request.
- Pre-existing conditions - If you have chosen full medical underwriting: You will not be covered for pre-existing conditions that you had when you took out the policy unless declared to and accepted in writing by WPA. If you have chosen moratorium underwriting: You will not be covered for any pre-existing condition(s) and other directly related conditions which existed in the five years before cover starts, unless during two continuous years after the policy starts you don´t receive medication, advise or treatment or experience symptoms of that disease, illness or injury.
- Emergency surgery.
- Cancer surgery and non-surgical or diagnostic treatment (essentials only).
- Cancers diagnosed or for which symptoms or signs develop within the first 90 days of the policy commencing or the first 90 days of upgrading your cancer cover (by adding the advanced cancer drugs or cancer cover extras), unless we agree in writing. This is also referred to as ‘90 day deferment period’. You will be required to complete a medical declaration to upgrade cancer cover.
- Any long-term illnesses that lead to long-term monitoring or management (chronic conditions).
- Dental problems (unless dental cover is included in your level of cover or added as an extra).
- Fertility problems, pregnancy & childbirth.
- Neonatal treatment.
- Psychiatric conditions.
- HIV/AIDS.
- Cosmetic surgery.
- Care and/or treatment arising from or related to taking part in winter sports (e.g. skiing, snowboarding), scuba diving, motor sports or engaging in professional sport.
- Any claim that has not been pre-authorised.
- Note: If you first purchase essentials and at a future renewal decide to transfer to either premier or elite you must complete a medical declaration. Personal medical exclusions may then apply. (This is not required for transfers from premier to elite unless you are enhancing your cancer cover).
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