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Last Updated on 15 October 2019

What Happens to My Private Health Insurance if I Lose My Job?

Private health insurance is recommended for a number of reasons, but it can become an expensive luxury if you suddenly lose your job and have much less disposable cash to play with. There is some good news though – rather than automatically having to dispense with private health cover because you’re not sure how long your unemployment will continue, there may be ways to get around this until your luck changes.

Image by Eric Beasley

Can I Get Help?

If you lose your job or become seriously ill and can’t afford to keep up with your private health insurance premiums, you may be able to get help from your health fund if you inform them of your new circumstances.

Suspending Your Cover

Your health fund may allow you to temporarily suspend your private health insurance, although some may have rules on the type of situation in which this is accepted. If your health fund agrees to suspend your private hospital cover, you’ll usually be classed as still continuing your cover despite not paying the premiums while it’s dropped, but you won’t be able to claim any benefits until your suspension is over.

Once you resume your private health cover and start paying your premiums again, there shouldn’t be any waiting periods to serve before you can claim benefits, unless you didn’t finish serving them before your suspension began.

If you’re looking for a new policy at the moment, compare private health insurance plans that permit temporary suspension – you never know when this facility might prove useful!

What If Your Health Fund Won’t Suspend Your Cover?

If you don’t envisage being out of work for too long, you can drop your private hospital cover temporarily for up to 1,094 days through the Lifetime Health Cover period of absence provision without it affecting your Lifetime Health Cover (LHC) loading fees.

Bear in mind that the permitted 1,094 days that you can be without private hospital cover extend across your lifetime and once you’ve used them up, any further gaps without private hospital cover will mean that you incur LHC loading fees in the future. LHC loading stays in place for ten consecutive years, and if you drop your private hospital after this point, you may have to pay loading again.

If your health fund rejects your request to suspend your private health cover and you’re not in a position to drop your private hospital cover for a short period of time via the LHC period of absence provision, it can be worth your while to compare private health insurance from other providers to see whether they would be willing to grant you a period of suspension if you switched to them.

This won’t always be possible, as health funds may prefer not to grant this to new clients straight away, but it’s worth trying to see if they will agree. As long as you’d be transferring to a policy that is equivalent to your current one, you shouldn’t have to serve a waiting period unless you haven’t seen out the full waiting period on your current policy.

If You’ve Got Unemployment Cover

If you’ve got unemployment cover and are retrenched or made redundant from your job on an involuntary basis, your private health insurance premiums may be paid for you for up to a year, depending on the length of time that you remain unemployed.

If you’re part of a couple or family, this only applies to the main income earner, who must meet certain eligibility requirements. For one prominent health fund, this involves having held health cover for at least a year before losing your job; having been employed on a full-time basis in the same job for at least 6 months prior to losing your job; being an employee rather than a contractor or self-employed individual, and providing proof of your unemployment on a regular basis.

Falling Behind on Your Premiums

If you’re less than two months behind in paying your premiums, your health fund is obliged to cover them to make sure that your cover is continued and you’re not deemed to have let your membership lapse. If you’re further behind on premiums than this, contact your health fund to check that you’re still a member.

What If I Lose My Private Health Insurance?

If you find that you need to drop your private health insurance altogether, public health provision from Medicare is a quality fall-back until you’re in a position to arrange private cover again.

Disclaimer: The above information is correct and current at the time of publication

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