Waiting periods in Allianz Health Insurance refer to the timeframes set for each type of coverage, beginning either from the start of the policy or the insured person’s enrolment date (whichever is later). These periods determine when specific benefits become available under the policy.
In other words, during the waiting period, even though you have paid your insurance premium, you will not be able to claim reimbursements from Allianz for certain treatments. The healthcare expenses covered by your policy will only be reimbursed once the applicable waiting period—outlined in the policy’s Specific Conditions—has ended.
Waiting periods exist to prevent individuals from taking out a health insurance policy only when they anticipate needing an expensive or specific treatment, immediately claiming benefits without contributing to the insurance pool.
Key Waiting Periods and Practical Examples
Hospitalisation and Surgery (General) – 90 Days
Most hospitalisation and surgery cases have a 90-day waiting period.
- Example: If you subscribe to Allianz Health Insurance and require non-urgent surgery 60 days after joining, your hospitalisation and surgery costs will not be reimbursed due to the 90-day waiting period.
Childbirth, Caesarean Section, or Miscarriage (if the Childbirth Cover is included) – 365 Days
Events related to childbirth are subject to a 365-day waiting period.
- Example: If you purchase childbirth cover under Allianz Saúde Mais, you must wait 365 days from the start date for the costs of normal delivery or a caesarean section to be covered.
Specific Hospitalisation and Surgery Treatments – 365 Days
Certain specialised treatments under hospitalisation and surgery coverage have an extended waiting period of 365 days. These include:
-
Treatment of arterial or venous conditions in the lower limbs
-
Medical, surgical, or diagnostic procedures for herniated discs, abdominal wall conditions, or similar issues
-
Medical or surgical treatment, including lithotripsy, for kidney stones, urinary tract stones, gallstones, and bile duct stones
-
Surgical or other invasive treatment of benign prostate conditions
-
Cataract surgery
-
Example: If you require varicose vein surgery (a venous condition of the lower limbs) six months after subscribing to Allianz Health Insurance, the surgery will only be covered if the 365-day waiting period has elapsed.
Oncology (for Adults Over 18) – 180 Days
Cancer treatment coverage for policyholders over 18 has a 180-day waiting period.
- Example: If you are diagnosed with cancer 100 days after subscribing to Allianz Saúde Mais, the related treatment and diagnosis costs will only be covered once the 180-day waiting period has passed.
Prosthetics and Orthotics (Ocular and Non-Ocular) – 180 Days
Coverage for prosthetics and orthotics usually has a waiting period of 180 days.
- Example: If you need a hearing aid 150 days after subscribing to Allianz Saúde Mais, the reimbursement will only be available after the 180-day waiting period.
Outpatient Care, Medication, and Dentistry – 90 Days
These types of coverage typically have a 90-day waiting period.
- Example: If you require specialist consultations or physiotherapy 70 days after subscribing to Allianz Saúde Mais, these expenses will not be reimbursed until the 90-day waiting period has ended.
Exceptions in Case of Emergency
It is important to note that if you require urgent hospital care due to an accident, the waiting periods for affected coverage do not apply.
Additionally, during the waiting period, you can still access Allianz’s healthcare network at agreed rates for any contracted coverage, although without reimbursement from Allianz.
For precise details on the waiting periods applicable to your Allianz Saúde plan, refer to the “Coverage” section in the Specific Conditions of your policy.
Find the Best Health Insurance with a Specialist Broker
Waiting periods and coverage conditions may vary depending on the chosen insurance plan. Understanding these details is crucial to avoid unexpected costs and ensure that you have the necessary coverage when you need it most. However, health insurance policies can be complex, making it difficult to select the right plan for your lifestyle, needs, and budget.
For example, Allianz offers three different health insurance plans, each with distinct coverage levels:
- Mais – Includes hospitalisation and outpatient care with a set coverage limit.
- Extra – A more comprehensive plan covering childbirth and dental care.
- Total – The most extensive plan, including oncology treatment, medications, and extended coverage.
Additionally, Allianz offers the 55 Mais discount card for additional healthcare benefits.
This is where C1 Broker can assist you. As health insurance specialists in Portugal, we have in-depth knowledge of the available policies, including coverage details, waiting periods, reimbursement systems, and insurer-specific policies. Our team continuously monitors industry updates to provide you with the best solutions and expert guidance.
At C1 Broker, our mission is to help you find the ideal health insurance plan for you and your family, ensuring full transparency and dedicated support throughout the selection process.
Don’t make the decision alone! Contact us today and discover how we can help you secure the health insurance policy that best fits your needs.
