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What are the benefits of private health insurance?

How do I find health insurance that’s right for my individual needs?

Why does my life stage matter when choosing health insurance?

When should I buy health insurance?

What should I consider when choosing a health insurance policy?

Am I eligible for a government rebate on health insurance?

How does private health insurance help at different life stages?

Where can I find and compare health insurance?

Long story short

Health cover comes with lots of benefits

Private health insurance makes being a private patient easier, helps cover services Medicare doesn’t pay for and can even save you tax.

Look for cover based on your health needs and life stage

Consider your health needs, budget and where you are in life to get a better sense of your ideal health insurance policy.

Save with age-based discounts or by avoiding loadings

Getting hospital cover while you’re young could help you qualify for age-based discounts and avoid paying additional loadings later on.

What are the benefits of private health insurance?

The benefits of having private health insurance include greater flexibility and choice in your health care, reduced out-of-pocket costs as a private patient, and possible tax savings. What you could get out of private health insurance depends on your situation, including your health needs and your chosen policy.

• Choose your doctor and hospital: Private patients can choose their preferred doctor and hospital for in-hospital treatment, like elective surgeries.
• Have Medicare and your hospital policy cover your surgery theatre fees and hospital costs: Get private hospital treatment with little to no out-of-pocket expenses, assuming your health fund has an agreement with your doctor and hospital.
• Likely have a shorter wait for elective surgery: Avoid long public hospital waiting lists and be seen sooner as a private patient.
• Get money back on services Medicare doesn’t cover: Claim out-of-hospital services, like dental check-ups, optical, physio and alternative therapies, up to your extras policy‘s annual limits.
• Avoid the Medicare Levy Surcharge at tax time: Skip paying an additional 1%–1.5% of your taxable income, depending on your income, by taking out hospital cover.
• Claim the private health insurance rebate on your tax: From 1 July 2026, get up to 32.158% off your health insurance premium as a tax offset (or have it deducted directly from your premiums), depending on your age and income.
• Avoid expensive emergency ambulance transport fees: Health insurance policies with ambulance cover can help pay for an ambulance if you’re not eligible for discounted or free ambulances in your state, depending on your policy.

How do I find health insurance that’s right for my individual needs?

You’ll need to think about your health needs, including any plans for the near future like having kids, and your budget so you can compare options across health insurance providers and policies. Use your health needs as a guide to help you decide what type of cover you want, like hospital or extras or both, and which inclusions you’d like, like the relevant clinical categories if you have any pre-existing conditions that could need treatment sometime soon.

With your preferred policy and budget in mind, you can start comparing what’s available. iSelect can help you quickly compare a range of options.

Why does my life stage matter when choosing health insurance?

Your life stage informs the kinds of health care services you’ll need. This helps you avoid taking out cover you don’t need and make sure you have cover for services you want. This includes the type of health insurance you want – like hospital or extras cover – and membership type – like single, couples or family cover.

For instance, if you’ve just moved out of home at the tender age of 18 and are generally healthy, you might only need a lower-tier hospital cover, like basic or bronze, to avoid the Medicare Levy Surcharge if you’re earning well and to avoid having Lifetime Health Cover loading added to your health insurance premium when you turn 31.

When should I buy health insurance?

There are lots of good times to buy health insurance, including before you turn 30 to lock in an age-based discount, before 1 July after you turn 31 to avoid having Lifetime Health Cover (LHC) loading added to your premium, at least 12 months before you intend to become pregnant or simply when you can afford it.

Key events or moments that can mean it’s time to get health insurance (or review your existing policy) include:

• When you move out of home: As an independent adult, you might not count as a dependant on your family’s policy anymore, depending on your age and circumstances.
• Before you turn 30: If you take out hospital cover before you turn 30, you can get an age-based discount of up to 10% on your health insurance (and even keep it until you’re 40).
• Before 1 July after you turn 31: If you don’t have hospital insurance by this point and you take out cover later on in life, you’ll have a 2% LHC loading added to your premium for each year you haven’t had cover (up to 70%).
• At least 12 months before you become pregnant: To claim private hospital obstetric services, including giving birth in a private hospital, you’ll need to serve a 12-month waiting period first.
• When you have a child: Private cover can make it easier to access healthcare services for your kids, like dental check-ups, orthodontics, podiatry and optometry.
• When you retire: Health cover can be handy if you need common elective procedures for older Australians, like cataract surgery and joint replacements, and don’t want a long wait in the public system.
• When your income increases: If you earn over the income threshold, unless you have appropriate hospital cover you might need to pay an additional 1%–1.5% of your taxable income at tax time, known as the Medicare Levy Surcharge.
• When you can afford it: Having and using your private health insurance helps ease the strain on the public system, so those who can’t afford private health cover can also receive timely, quality medical treatment.

What should I consider when choosing a health insurance policy?

Consider your health needs and budget, as well as policy factors like cover type, waiting periods, annual limits, out-of-pocket costs and health fund agreements with practitioners and hospitals. It can help to have a rough idea of what you’d like from a policy, so you can quickly skip over any policies that won’t be a good fit.

When reviewing health insurance policies, check:

• cover type, like whether it’s hospital cover, extras cover or combined cover, and whether ambulance cover is also included
• waiting periods, including what these are for pre-existing conditions
• annual limits, to understand how much you could claim back on a given service
• out-of-pocket costs, including any excess and co-payments
• agreements with doctors and hospitals, including whether your health fund has an agreement with your preferred specialist or hospital.

Helpful tip:

The Australian Government sets fees for medical services in the Medicare Benefits Schedule (MBS). For in-hospital medical services, Medicare and your private health insurer will usually only cover up to the MBS fee. If a doctor charges more than the MBS fee, you may need to pay the difference, known as the ‘gap.’

If you want to reduce or avoid paying a gap, it’s worth checking whether your doctor participates in your health fund’s gap cover arrangement. Depending on the arrangement, you may pay a reduced gap or no gap at all.

Dr. Jill Gamberg

GP, Coach and Lifestyle Medicine Physician

Am I eligible for a government rebate on health insurance?

You’re eligible for the private health insurance rebate from the Australian Government if your annual income is under the relevant threshold ($164,001 for single incomes and $328,001 for combined incomes from 1 July 2026). Your rebate rate is then determined by your income tier and age. For instance, as of 1 July 2026, people aged 70 or older with a single income of $105,000 or less or a combined income of $210,000 or less get a rebate rate of 32.158%.

The rebate rate applies to both hospital cover and extras cover. You can opt to have it as a premium reduction or to claim it back on your tax.

How does private health insurance help at different life stages?

Depending on your life stage, health cover could help you by making it easier to access health care services, including those not covered by Medicare; making being a private patient more affordable, so you can enjoy private patient benefits; or helping you save on tax if you’re a high-income earner.

Everyone’s life is different, but health insurance can help when:

• You’re young and single: Basic hospital insurance can be enough to help you get an age-based discount and avoid Lifetime Health Cover loading later in life.
• You’re looking to grow your family: Hospital cover with obstetrics included means you can have your baby in a private hospital.
• You have kids: Extras cover can help you manage everyone’s preventative and out-of-hospital care, like physiotherapy, chiropractic, braces and psychology.
• You’re getting older: Hospital cover can mean a shorter wait for common elective surgeries, like joint reconstructions and replacements, while extras cover can help keep you in good shape or recover sooner after surgery.

Where can I find and compare health insurance?

Choosing health insurance doesn’t have to be hard. Talk with iSelect’s health insurance comparison experts about what you’d like out of a health insurance policy, and they’ll help you compare a range of policies from different providers. Simply call 1800 784 772. Or you can use our online comparison tool and adjust the filters to make your search easier.