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Health Insurance for every life stage
Our health needs evolve over time. Happily, your Health Insurance can evolve right along with your lifestyle and budget.
Whether you’re moving out of home, starting a family, or enjoying the fruits of retirement, there’s a policy for you.
Health Insurance by cover type
When choosing Private Health Insurance, there’s a number of options to consider. To help your decision, here’s a breakdown of each of them.
Hospital and Extras
The best of both worlds, this type of cover brings your Hospital and Extras Policies together in one convenient package. You might also hear it referred to as Combined Cover.
Hospital Cover
Hospital Cover helps with the costs of hospital treatment as a private patient. With this type of cover, you can choose your own doctor and you might have a shorter wait for elective surgery.
Extras Cover
This type of cover helps with the cost of treatments that aren’t covered by Medicare. Think healthcare services that usually take place outside a hospital, like dental, optical, and physio.
Ambulance Cover
While some states offer free emergency Ambulance Cover, unfortunately it’s not the case everywhere. If your state doesn’t, Ambulance Cover can help cover transport costs in an emergency.
Found the same policy cheaper?
We’ll give you a $500 Gift Card
When it comes to Health Insurance, we make a Price Promise to you: if, within 30 days after buying with us, you find the same policy with a lower standard annual premium from the same insurer, we’ll give you a $500 eGift card.
Why buy with iSelect?
Our people are experts in comparison. They draw from our more than 20 years of experience to help you find
a better deal on your Health Insurance, Energy, Car Insurance, Internet, Home and Contents Insurance, and more.
Our service costs you nothing and comes with no obligation to purchase. Instead of charging you a fee, our partner funds pay us a commission. Learn more about how we make money
We don’t mark up the price of our policies, so you’ll pay the same as buying direct from the Health Fund.*
*Excluding corporate discounts and exclusive retail offers
If we can’t find you a better deal, we’ll be honest about it and tell you to stay exactly where you are
Our comparison experts are based in Australia, like you. When it comes to navigating the complexities of the Aussie health system, they know what’s what
While our service is provided to you completely free of charge, we know there is no such thing as a free lunch.
Great Health Insurance offers from our partners
How to buy with iSelect
Get acquainted
Share some basic details about yourself or your household and the type of policy you’re looking for
Learn your options
Compare our range of funds and policies, and filter your options based on what’s important to you
Get sorted
Once you’re happy with your choice, we’ll help you finalise and buy, either online or over the phone
Done!
We’ll even break up with your existing Health Fund for you, saving you the extra time and hassle
Need help understanding Health Insurance?
Do I need Health Insurance?
Private Health Insurance works alongside Medicare, Australia’s public healthcare system. Hospital Cover lets you get treated in hospital as a private patient. That can mean more choice of doctors and shorter wait times for elective surgery. There could be tax benefits, too.
Extras Cover can be helpful if you regularly get treatments not covered by Medicare, like dental, physio or optical.
The Medicare Levy Surcharge
Most taxpayers pay the Medicare Levy. The Medicare Levy Surcharge, on the other hand, is an additional tax for high-income earners – specifically singles earning over $97,000 or couples earning over $194,000. It’s designed to encourage people to take out Hospital Cover.
If you earn more than these amounts and don’t have Hospital Cover, you’ll have to pay an additional 1–1.5% in tax. Take out Hospital Cover to avoid paying more on your taxes.
Government rebate for Health Insurance
Depending on your income, you could be eligible for the Private Health Insurance Rebate. The lower your income, the higher the rebate. You can claim it when you file your taxes or as a reduction in your premiums.
Avoid paying extra down the track
Lifetime Health Cover Loading is a government penalty to encourage people to get Health Insurance earlier. If you wait until you’re over 31 to get Hospital Cover, you’ll likely have to pay more for several years.
Waiting periods for treatment
You might think you’d have to re-serve waiting periods if you switched policies. Not true! Hospital waiting periods you’ve served are protected by law if you switch to an equal or lower level of cover.
‘I love finding policies that match my customers’ priorities, their health needs, and their budget. It’s really rewarding getting to know people and figuring out how I can help.’
Nicole, Comparison Expert – Health
318 customers helped since October 2023
Health Insurance explained, with Canna Campbell.
Canna Campbell from SugarMamma TV breaks down the essentials of health insurance.
Canna Campbell
SUGARMAMMA TV
Which policies do iSelect customers choose?
You can buy Hospital Cover and Extras Cover separately, or together as a Combined Policy.
iSelect customers have shown they enjoy the convenience and peace of mind of having the additional coverage of combined Hospital and Extras Cover.
In fact, between 2019 and 2023, the number of our customers buying Combined Policies increased from 66% to 73%.
Compare Health Insurance
Health Insurance in Australia can be pretty complicated. Let our comparison experts
simplify the process and help you find a policy that suits you.
Your Health Insurance questions answered
What is Private Health Insurance?
Private Health Insurance provides financial cover for all or part of the costs of various health-related treatments and services. Depending on the policy, it can provide cover for treatment as a private patient in a public or private hospital, often allowing you to choose both your doctor and hospital, at a time that suits you. It can also provide cover for health services not covered by Medicare (such as physiotherapy, optical, and dental).
It functions like other types of insurance, such as Home and Contents or Car Insurance, although rather than being risk based, it’s community based. Community based means that everyone is eligible to receive the same base price for the same policy from any single provider, rather than being rated on their individual health circumstances.
There are two main types of policies you can take out: Hospital Cover and Extras Cover. These can be purchased separately or combined into a single policy with your health provider. One of the biggest benefits of Private Health Insurance is choice and flexibility.
For example, as a private patient you’re generally given choice of doctor and choice of agreement hospital (hospitals that have agreements with your insurer to either charge you no out-of-pocket expenses or to specify what they’ll be). You also have flexibility over the time of your appointments. In comparison, when you’re treated as a patient in the public system, the appointment times, doctors, and hospitals are typically inflexible, determined by your location and your health concern. Private Health Insurance can also help you avoid the long waiting lists for treatments (provided you’ve served the necessary waiting periods) that can exist in the public system.
How does Health Insurance work?
Private Health Insurance is divided into two categories: Hospital Cover and General Treatment cover, usually known as Extras Cover. These covers can be purchased separately or as combined policies by most Health Funds, depending on your individual requirements. In some states, a third category known as Ambulance Cover is also available, although this is sometimes included in Hospital Cover or Extras Cover depending on your policy.
As Private Health Insurance is not risk rated, providers can’t refuse to insure any eligible person. They must also charge everyone the same base premium for the same level of cover. Therefore, to help mitigate some of the risk for Health Funds, most treatments incur a waiting period. Waiting periods must be served when you take out a new Private Health Insurance policy, or when you upgrade your policy to include services and treatments not previously covered.
The government sets the maximum waiting periods that Health Funds can impose for hospital treatment. They are:
- 12 months for pre-existing conditions
- 12 months for obstetrics and IVF
- 2 months for psychiatric care, rehabilitation or palliative care, even for a pre-existing condition
- 2 months in all other circumstances.
For Extras Cover, waiting periods are determined by your individual Health Fund, and the length can vary depending on the treatment and your level of cover. If you’ve already served a waiting period for a specific service and switch to a different provider with the same level of cover, the waiting period you’ve served will most likely carry over.
To receive benefits, you must have a policy that covers the treatment you’re receiving and have served your waiting period. Some clinics and hospitals will be able to automatically apply your benefit by scanning your Health Fund membership card during the payment transaction. In some cases, you may need to make the benefit claim after paying up front, which you can do by contacting your Health Fund directly. How much you have to pay towards your treatment ultimately depends upon your policy and level of cover.
What does Private Health Insurance cover?
Private Health Insurance can cover a range of health treatments depending on your individual policy and provider. It can also depend upon whether you’re claiming a benefit for Hospital or Extras Cover.
On 1 April 2019, the Australian Government made changes to how Hospital Insurance was classified to help policyholders better understand their cover. These classifications are divided into the following tiers:
- Basic: A Basic Policy will allow you to be treated as a private patient in a public hospital for the following treatments:
- rehabilitation
- hospital psychiatric services
- palliative care
- Bronze: A Bronze Policy will allow access to the above, as well as treatment as a private patient in a private hospital for:
- brain and nervous system
- eye (excluding cataracts)
- ear, nose, and throat
- tonsils, adenoids, and grommets
- bone, joint, and muscle
- joint reconstructions
- kidney and bladder
- male reproductive system
- digestive system
- hernia and appendix
- gastrointestinal endoscopy
- gynaecology
- miscarriage and termination of pregnancy
- chemotherapy, radiotherapy, and immunotherapy for cancer
- pain management
- skin
- breast surgery (medically necessary only)
- diabetes management (excluding insulin pumps)
- Silver: A Silver Policy will cover you for all of the above, plus treatment as a private patient in a private hospital for:
- heart and vascular system
- lung and chest
- blood
- back, neck, and spine
- plastic and reconstructive surgery (medically necessary only)
- dental surgery
- podiatric surgery (provided by a registered podiatric surgeon)
- implantation of hearing devices
- Gold: A Gold Policy will offer unrestricted cover for all treatments above, as well as for treatment as a private patient in a private hospital for:
- cataracts
- joint replacement
- dialysis for chronic kidney failure
- pregnancy and birth
- assisted reproductive services
- weight loss surgery
- insulin pumps
- pain management with device
- sleep studies
These are the minimum categories a provider has to cover under each tier, however they can choose to include additional services if they wish. These are often referred to as ‘Plus’ policies, which offer the required services, but also some extra services that set them apart. For example, a Silver Plus policy will include all of the services in a Silver policy but may also include cover for joint replacements or cataracts. They can be viewed as ‘in-between’ policies for when you want a bit of extra cover, without jumping up to the next tier.
Under some policies, certain services may be ‘restricted’, meaning you can only be covered as a private patient in a public hospital. For restricted patients, you can usually choose your doctor, but not necessarily your hospital, and you may still be subject to waiting lists.
In regards to Extras Insurance, what you’re covered for and how much benefit you receive can vary significantly depending on your provider and the policy you’ve selected. Depending on the policy, this may include services like:
- dental treatment
- optical, including glasses and contact lenses
- physiotherapy and osteopathy
- chiropractic treatment
- occupational, speech, and eye therapy
- hearing aids and audiology
- diet and nutrition
- psychology
What is excess and ‘the gap’ in Health Insurance?
Excess charges in Health Insurance work similarly to other forms of insurance. It’s an amount that, when taking out your policy, you agree to pay towards your hospital treatment in the event of an in-hospital admission. And, similarly to some types of Car Insurance Policies, you may have the option to increase the cost of your Excess in order to reduce the overall cost of your premium. Depending on your policy, you may be required to pay an Excess every time you are admitted to hospital, or just once per year.
To further clarify, when you are admitted to hospital, Medicare will cover 75% of the Medicare Benefits Schedule (MBS) fee for the treatment you’re receiving. Provided you have the appropriate Private Health Insurance Policy and have served your waiting period, your Health Fund will cover the remaining 25%.
While the Australian Government determines the fees for the MBS, they do not set the costs doctors choose to charge for their services, which can lead to additional expenses if your doctor charges above the MBS. This is often referred to as ‘the gap’. Depending on the extent of your hospital stay, further charges may also apply to cover the costs of drugs and pharmaceuticals, dressings and diagnostic tests.
To avoid a large bill for private health patients, some Health Funds offer what is known as ‘Gap Cover’. This means they have agreements with particular doctors which can reduce your gap or potentially avoid it altogether.
Do pensioners need Private Health Insurance?
When retirement age rolls around, most Australians start to consider lowering their expenses. This could include downsizing their homes, reducing the amount of cars they own – and even reducing or cancelling their Private Health Insurance. This is especially true for pensioners who have lived a healthy lifestyle and seldom needed to take advantage of their insurance.
That said, reaching your senior years may be the time you need your private health insurance the most. Getting older leaves you more susceptible to a range of health issues, and while a healthy diet and exercise will certainly help reduce your risk, there are no guarantees. Health Insurance could provide you invaluable peace of mind.
Whether for an injury, an illness or another health ailment, typically the older you are, the more likely you are to need medical treatment. While you’ll have access to the public healthcare system, this could potentially lead to substantial waiting times for treatment depending on the severity of your health concern and where you are located.
If you choose to attend a private hospital without Private Health Insurance, Medicare will still cover 75% of the Medicare Benefits Schedule (MBS) fee for the treatment you’re receiving. However, you’d need to foot the other 25%, along with a myriad of other potential charges depending on the length of your stay and the type of treatment you’re receiving.
There are other benefits to maintaining your Health Insurance as a pensioner as well. If you do require medical treatment, you can skip the waiting lists of the public healthcare system and choose which doctor you want to see. Depending on your level and type of cover, you’ll also have access to a variety of preventative treatment options.
Best of all, Australians over the age of 65 receive a higher rebate percentage from the government than their younger counterparts, and it increases again once you turn 70.
Does Medicare cover ambulances?
Ambulance services are not covered by Medicare. Instead, cover varies from state to state.
- ACT: People who live in the ACT and hold a Health Care Concession Card or Full Aged Pensioner Concession Card are entitled to free emergency ambulance services. If you’re not eligible for a concession, you can purchase insurance from a Private Health Fund.
- NSW: If you live in NSW and you hold a Health Care Concession Card, Pensioner Concession Card, or Commonwealth Seniors Health Care Card you’re entitled to some free ambulance transport services.
- NT: If you hold a Health Care Card or NT Centrelink Pensioner Concession Card, you are entitled to free ambulance transport services. Otherwise, you can purchase Ambulance Cover from a Private Health Fund or through the state ambulance service
- QLD: If you’re a Queensland resident, ambulance costs are covered by the state government.
- SA: If you’re an SA resident, you can purchase ambulance cover from a Private Health Fund or through the state ambulance service.
- TAS: Ambulance costs for Tasmanian residents are usually covered by the state government.
- VIC: If you’re a VIC resident and you hold a Pensioner Concession Card or a Health Care Card, you’re entitled to clinically necessary free ambulance transport services. Otherwise, you can purchase insurance from a Private Health Fund or through the state ambulance service.
- WA: If you’re a WA resident and you hold a Pensioner Concession Card, you’re entitled to free medically necessary ambulance transport services. If you’re ineligible, you can purchase insurance from a Private Health Fund or through the state ambulance service.
- All of Australia: People who hold a Veteran Gold Card or a Veteran White Card might be eligible for free emergency ambulance services to their nearest clinical facility and certain non-emergency services might also be covered.
It’s important to note that if you’re travelling interstate, your cover may vary. For example, residents of Queensland and Tasmania who have free Ambulance Cover in their state may not be covered when in Victoria or another state. So it’s recommended you check with your state ambulance service, concession card provider or Health Fund prior to travelling.
What does Private Health Insurance cover that Medicare doesn’t?
The differences between what Medicare covers and what Private Health Insurance covers varies depending on the type of service you’re reviewing.
Hospital Cover: Medicare covers 75% of the Medicare Benefits Schedule (MBS) for associated medical costs. The remaining medical costs may be covered by your Health Insurance Provider depending on your level of cover. This can include:
- the remaining 25% of the MBS fee
- hospital accommodation
- theatre fees
- intensive care
- drugs, dressings, and other consumables
- protheses (surgically implanted)
- diagnostic tests
- pharmaceuticals
- any additional doctors’ fees above the MBS fee (if doctor has agreed to Gap Cover).
Extras Cover: When it comes to services outside of your GP’s scope, Medicare benefits are extremely limited: For example, Medicare doesn’t provide benefits for the following:
- most dental services
- glasses and contact lenses
- hearing aids and other appliances
- ambulance services
- services provided through the private health system
- services not on the MBS.
When it comes to pharmaceuticals, if your prescription medication is not listed on the Pharmaceutical Benefit Scheme, Medicare does not contribute to any of the cost. In this case, you may be able to arrange for your Private Health Insurance to cover part of the cost, depending on your level of cover and the medication required.
Ambulance Cover is another service not covered by Medicare. It can be purchased as part of your Private Health Insurance fund depending on your location or through a state based subscription service.
How can I find the cheapest Health Insurance Policy in Australia?
Shopping around is a good strategy here. Comparing policies from different providers can give you a clear overview of which one has the lowest premiums.
However, keep in mind that a policy with cheaper premiums may not always be cheaper in the long term. A policy with a higher excess might cost you less each month, but when it comes time to claim on that policy you may end up paying much more out of pocket.
Price is also just one consideration among many. It’s also worth thinking about the level of cover you’ll need – whether you want a basic policy or something more comprehensive. This is why it’s important to compare policies with the same level of cover, excesses and benefits. This can give you a better picture of which one offers more value.
Meet our Health Insurance expert
‘I love working with our insurance partners to bring great policy options to everyday Aussies’
Mark Pangrazio
Executive – Commercial
Mark is the Executive – Commercial at iSelect, where he’s been working since 2018. Mark also loves a chat. Ask anyone in the iSelect team and they’ll tell you how you can always stop for a yarn with Mark – whether it’s about work, footy, what you’re up to or the weather. Mark’s also passionate about helping people find the insurance they’re looking for at the price point they can afford. He firmly believes that suitable Health Insurance can provide an affordable way for people to have more choice and control over their healthcare. That’s why he loves working with our insurance partners to bring great products to everyday Aussies.
Mark’s top tips for getting a good deal on your Health Insurance
1. Don’t set and forget. Our health needs and financial circumstances change throughout our lives. Ask yourself, ‘What do I need to be covered for?’ Review your policy regularly to make sure you’re not paying for things you don’t need and that you’re covered for the things you do.
2. Could a higher excess save you money on your premium? Generally, the higher the excess or co-payment you are willing to pay, the lower your monthly premium will be. If you think it’s unlikely you’ll be admitted to hospital in the near future, opting for a higher excess could help bring down the cost of your premiums.
3. Offers, deals and freebies. Funds may offer incentives at different times of the year, which can be a good time to shop around for a better deal. But don’t be distracted by a one-off discount or promotion. Make sure the policy is suited to your needs and provides ongoing value for money.
4. The Extras. There is a wide variation between funds on what services are offered and what you’ll get back under Extras Cover. Do you even need Extras? If the answer is yes, it may be worth considering a flexible policy that combines your separate Extras limits into a single annual limit for you to spend on services you use the most.
5. Waiting periods are protected. Did you know that any Hospital waiting periods you’ve already served will be protected by law if you switch to an equivalent or lower level of Hospital Cover? Many people stick with an outdated or expensive policy because they mistakenly believe they’ll have to re-serve waiting periods if they switch, but it simply isn’t true!
Want to know more about Health Insurance?
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Read MoreCompare Health Insurance
Health Insurance in Australia can be pretty complicated. Let our comparison experts
simplify the process and help you find a policy that suits you.
iSelect does not compare all health insurance providers or policies in the market. The availability of policies will change from time to time. Not all policies available from its providers are compared by iSelect and due to commercial arrangements, your stated needs and circumstances, not all policies compared by iSelect are available to all customers. Some policies and special offers are available only from iSelect’s contact centre or website. Click here to view iSelect’s range of providers