Private Health Insurance Frequently Asked Questions

Private Health Insurance covers a wide range of costs associated with medical care and treatments. Depending on the policy, it can include surgeries in a private hospital, ambulance fees and out-of-hospital medical services known as Extras. These Extras can include things like physiotherapy, dental care, prescription lenses and more.

There are four forms of coverage offered: 

1. Ambulance Cover helps with the cost of some ambulance rides. In some states, your ambulance costs are covered by the government. If they’re not, you could take care of it through the same provider you get your other forms of Health Insurance from. 
2. Hospital Cover can help with hospital treatment costs when you’re admitted as a private patient.  
3. Extras Cover can help you out with other forms of healthcare generally not covered by Medicare (such as physiotherapy, dental and optical).  
4. Hospital and Extras Cover (combined) is when you get both your Hospital Cover and your Extras Cover from the same provider under one policy. 

Let’s cut to the chase – there is no ‘best’ Health Insurance Policy. Because everyone has different healthcare needs and circumstances, no one policy can give every Australian perfect coverage. 

So, instead of looking for the best insurance, it’s a good idea to compare different policies to find the one that best suits you and your individual needs. At iSelect, we compare Health Insurance Policies from a variety of Private Health Funds and provide side-by-side results, allowing you to select the policy that suits your needs and circumstances. Check out our Private Health Funds: 

1. AHM 
2. Australian Unity 
3. AIA 
4. Bupa 
5. Frank Health Insurance  
6. GMHBA 
7. HCF 
8. Latrobe Health Services 
9. NIB 
10. TUH Health Fund 

Even though Aussies have a great public healthcare system, Private Health Insurance can still offer some nifty benefits. Hospital Cover gives you more choice over the medical professional who will treat you, it can shorten the wait for elective surgeries, and it can also allow you to be treated as a private patient in both private and public hospitals. Extras Cover can assist with the costs of medical treatments that fall outside of Medicare; things like dental and optical. On top of all that, there can be some tax benefits to having Private Hospital Cover (more on that later).

In Australia, there are 30 Private Health Funds who each offer different Health Insurance Policies. You can get a policy directly from any one of these funds, or you can compare a range of policies through iSelect.

According to the Australian Bureau of Statistics, in 2022–23, more than half (58.1%) of Australians had Private Health Insurance. The most common type of cover was Hospital and Extras Cover, held by 46.9% of the population.¹Australian Bureau of Statistics – Patient Experiences

Australia’s healthcare system is made up of two forms of insurance: private and public. 

• Public health insurance is provided through Medicare. Medicare provides free treatment in public hospitals for anyone with a valid Medicare card. Most vital medical treatments are covered by Medicare.
• Private Health Insurance allows you to be treated in both public and private hospitals as a private patient, expedites your elective surgery wait times, and, in some circumstances, allows you to choose the medical professional treating you. 

The Commonwealth Ombudsman generates an annual statement to help consumers understand the performance of their chosen Health Fund and the delivery of their service. It’s also a great source to see how your fund is performing compared to others.

Private Health Insurance isn’t legally required in Australia, but there are some ways the Australian Government encourages Aussies to give it a go. 

Lifetime Health Cover (LHC) Loading dictates that once you turn 31, if you don’t have Private Hospital Cover, your future premiums will increase by 2% for each year you’re not covered. 

The Medicare Levy Surcharge (MLS) encourages high-income earners to take out Private Health Cover. If they don’t take it out and they fall into certain income brackets, then they could begin paying the MLS. The MLS is an extra tax of 1% to 1.5% that is ‘levied’ on your total income. It’s paid in addition to the Medicare Levy. 

Private Health Insurance in Australia is community rated. That means that everyone pays the same price for the same policy, regardless of your state of health or history. However, there are certain rebates and loadings, plus a variety of other factors, that can affect what you pay. These include: 

• Lifetime Health Cover Loading (LHC) 
• the Medicare Levy Surcharge (MLS) 
• the Private Health Insurance Rebate 
• your chosen policy and Health Fund 
• your chosen excess amount 
• the number of people covered on the policy. 

Depending on your level of coverage, you can use Extras Cover to claim on health aids. These aids can include (but are not limited to): 

• CPAP devices 
• orthotics 
• compression garments 
• nebulisers 
• hearing aids. 

Some Health Funds might also allow you to claim benefits for gym classes or memberships, weight management programs, breastfeeding support and other initiatives to improve your health up to a certain limit. You’ll want to speak to your insurer beforehand and find out what you’re allowed to claim. That way, you’ll know exactly what costs your policy can cover.

A Private Health Information Statement (PHIS) provides an overview of the broad features available in your Private Health Insurance Policy. The benefit of a PHIS is that it allows you to review your current policy and compare it more accurately against other products available in Australia. It’s required by law that a PHIS is accessible to anyone with a Private Health Insurance Policy in Australia. 

There are three types of PHIS: 

1. Hospital: Explains the clinical categories the policy will cover. Also provides information on any waiting periods and any potential additional payments, such as an excess.
2. Extras: Explains the benefits, waiting periods and limits of your General Treatment Cover in your chosen Health Insurance Policy.
3. Combined: Combines Hospital and Extras Cover to explain both their benefits, limitations, waiting periods and exclusions. 

Fund Rules are the set of rules that govern your Private Health Insurance Policy. They cover the overall terms and conditions of your membership.  

Fund Rules can alter over time due to governmental changes or other factors determined by your fund. If this happens in a way that affects you adversely, your provider will let you know.

A recognised provider is a provider of Extras treatments that your Health Fund has agreed to pay benefits for. Generally, you can only claim benefits when using a recognised provider. Recognised providers must work in private practice and have professional qualifications recognised by the Health Fund in question. This commonly relates to health professionals such as optometrists, physiotherapists, and dentists.

Hospital Cover can help pay some of the cost of your medical expenses when you’re admitted to hospital as a private patient. The types of services covered depend on the level of Hospital Cover you choose – each of the Gold, Silver, Bronze and Basic tiers have minimum treatments they have to cover. Hospital Cover can help cover some or all of hospital accommodation and operating theatre costs.

In many cases, Hospital Cover can give you more choices when it comes to hospital admission. Generally, it gives you your choice of hospital, surgeon and treating specialist. Another big advantage of Private Healthcare is that it might help you avoid lengthy waiting lists in the public system.

As regulated by the Australian Government, Hospital Insurance Policies must be categorised into one of four tiers. These tiers help customers understand the minimum number of services and treatments covered on their respective policies. 

The tiers are: 

• Gold 
• Silver 
• Bronze 
• Basic. 

If your policy includes coverage for additional treatments beyond the mandated minimums, it might be labelled as a ‘plus’ policy (e.g. Silver Plus). 

If you’re admitted to hospital as a private patient, there could be costs you need to pay to be admitted. 

An excess is a lump sum you pay to the hospital upon your admission. Most excesses are capped per membership year depending on the policy you chose. 

A co-payment is an amount you agree to pay each day when receiving treatment in hospital or day surgery. It’s usually limited to a certain number of nights (e.g. you might pay the fee for the first seven nights.) 

There could also be other charges on top of an excess or co-payment. These are known as gap payments.

Potentially. When you’re admitted to hospital as a private patient, there are times you have to contribute towards the cost of your treatment above the excess. The Medicare Benefits Schedule (MBS) lists set fees for medical treatments, but specialists often charge more than the MBS fee. If this occurs, the difference in price is known as a gap. Unless your insurer has a gap arrangement with the medical provider, you’ll need to pay the gap.

For hospital care, each type of treatment has a listed fee on the Australian Government’s Medicare Benefits Schedule (MBS). In some cases, a surgeon might charge the exact amount set on the MBS, which means there’s no gap you need to pay (outside of any applicable excess). In other scenarios, your Health Fund might participate in a ‘no gap’ scheme where they cover some or all of the gap payment. It’s important to check with both your surgeon and your Health Fund to understand any potential gap.

A pre-existing condition is a health condition, illness or ailment that existed within the six months before you became insured. You can be considered to have a pre-existing condition if you had symptoms in that time period, whether or not the condition was formally diagnosed. If you’re considered to have a pre-existing condition, you might need to wait for 12 months before you can claim benefits for that condition.

Sometimes – it depends on your fund and policy. For funds that have provisions for at-home care, this care might include rehab, chemotherapy, intravenous infusions, palliative care, nursing, and meal provisions. The benefits can include having more control over your recovery and recovering in a comfortable environment. But it’s important to check with your fund whether your policy can cover these benefits.

It depends on your level of Hospital Cover. Each tier of Hospital Cover – Gold, Silver, Bronze and Basic – has mandatory minimum treatments it has to cover. Any Gold Plan generally includes coverage for weight loss surgery. Policies labelled ‘plus’ contain extra treatments beyond the minimum requirements, so it’s possible you could find weight loss surgery on a lower tier ‘plus’ plan. But keep in mind that weight loss surgery would be considered treatment for a pre-existing condition, and therefore a 12-month waiting period could likely apply before you could make a claim. 

For Health Insurance purposes, the category of weight loss surgery includes gastric bypass, gastric banding, and sleeve gastrectomy. It can also include excess skin removal after weight loss.

Yes! As of 2019, insurers can offer people aged between 18 and 29 discounts of up to 10% on their Private Hospital Cover premiums. This discount is calculated based on the number of years under thirty you are when you take out a policy, with an extra 2% discount for each year. You may be able to retain this discount until you reach 41 years old.

Extras Cover can help cover part or sometimes all of the cost of some treatments and services that aren’t covered by Medicare. It can include cover for a range of services including dental and optical – though this can vary depending on your insurer and plan. 
 
Extras can be purchased as a standalone policy or combined with Hospital Cover. And if you do decide to take out both Hospital Cover and Extras Cover, both policies don’t have to be with the same provider.

Some insurers cover a whole range of dental procedures on their Extras Policies. They generally break them down into different categories. Those might look something like: 

• Preventative and routine: Check-ups, X-rays, cleans, tooth removal, fillings and other minor restorative services.
• Complex: Includes periodontics (root canal planning, oral surgery for prostheses, and jaw injuries) as well as endodontics (filling of a root canal).
• Major: Crowns, veneers, bridgeworks, and implants and dentures.
• Orthodontics: Braces, plates, retainers and other dental procedures to align the teeth and jaw. 

Just remember that different insurers might put different treatments in different categories, and it’s always a good idea to check what each one includes. Similarly, procedures might come with different benefits, annual limits and waiting periods. 

That depends on your policy. Braces and other major orthodontic procedures are generally covered on some of the more comprehensive Extras Policies. It’s important to note that, depending on the policy and the provider, there’s often a 12-month waiting period for orthodontic treatments and you’re likely to have some out-of-pocket expenses. Also, orthodontics often comes with a lifetime limit, meaning the limit won’t refresh the next year like it does for most services.

Some insurers offer Extras Cover that covers part of the costs of an Invisalign device, but it depends on the specific policy. As Invisalign is a teeth alignment product that functions similarly to dental braces, it could be covered under orthodontics.

Yes, dental implants can be covered under some Extras Policies. They’re classified as major dental services, and therefore coverage is typically found on Top policies.

In most cases, Medicare doesn’t cover dental treatment. But if you’re receiving government benefits, your children could be eligible for some Medicare-subsidised services. And if you have a Health Care Card or Pensioner Concession Card, you might be eligible for emergency dental treatments through the state you live in. Because Medicare offers very limited public dental treatment and costs for dental treatment can be very expensive (especially for major dental work), you might find that Extras Cover is a suitable option when it comes to your dental needs. Because Medicare offers very limited public dental treatment and costs for dental treatment can be very expensive (especially for major dental work), you might find that Extras Cover is a suitable option when it comes to your dental needs. 

Health Funds often only cover a portion of the cost of certain health services. The difference between the total charge and what your Health Fund covers is referred to as a gap, which you’re required to pay out of pocket. 
 
When it comes to dental services, though, some funds offer Extras Policies with gap-free preventative dental services if you use one of their preferred providers. Depending on your policy, your fund, and their relationship with their preferred providers, you could have gap fees waived for preventative dental work.

If you have an Extras Policy that includes pharmaceutical benefits, you might be able to claim for some scripts. The scripts need to be approved by the Therapeutic Goods Administration. They also can’t be listed on the Pharmaceutical Benefits Scheme, because medications listed there are subsidised by the government. Each fund could have different rules around what you can and can’t claim, so it’s important to check in with them. Some vaccines could also be covered, such as travel vaccines and flu vaccines that aren’t covered by Medicare.

Potentially. Wellness programs and gym memberships are generally covered by Extras Cover. However, they’re usually claimable only when they’re part of a program that’s designed to improve or manage a diagnosed condition. Additionally, some Health Insurance Funds have membership programs that give you discounts and benefits at selected partner gyms.

The implantation of hearing aids is covered by Silver and Gold tier Hospital Cover Policies. You’ll also see costs related to hearing aids covered by some Extras Policies. But keep in mind that there is typically a 12 month waiting period before you can claim on hearing aids through your Hospital Cover – and to claim on Extras, it could be even longer.

When it comes to Health Insurance, a waiting period is the period of time at the start of your membership before you can claim some of the benefits and services of your policy.  

You might need to wait for a particular procedure or service when you: 

• take out Health Insurance for the first time 
• renew a lapsed membership 
• upgrade your cover to include new benefits. 

For Extras Cover, the government hasn’t imposed any specific requirements for waiting periods, so funds are free to set their own rules . However, for Hospital Cover, the waiting periods are government mandated, and the maximum waiting periods are:  

• 12 months for pre-existing conditions, pregnancy and birth 
• two months for all other services, including psychiatry, rehab and palliative care (even if pre-existing). 

If you’re signing up for coverage you didn’t previously have, you generally can’t avoid waiting periods. The exception to this is psychiatry. If you have existing Hospital Cover and you add psychiatric care, normally there’s a two-month waiting period. You’re able to apply for an exemption to this waiting period, but only once in your lifetime. 

It’s worth keeping in mind that if you’re switching plans or providers, you don’t need to re-serve waiting periods you’ve already served; the waiting periods you’ve served will move with you to the new policy. This means you should only have a waiting period if you’re signing up for a higher level of coverage.

Any Hospital Cover waiting periods you’ve served are protected by law when you switch to the same level or a lower level of cover, even if you’re switching to a different provider. For Hospital Cover, you’ll only be asked to serve waiting periods if you upgrade your cover to include new services or if your coverage has lapsed. 

With Extras, most funds will also honour any waiting periods already served, although, unlike Hospital Cover, they’re not bound by law to do so.

The government doesn’t mandate the maximum waiting periods for Extras Policies. That means the amount of time you’ll need to wait before accessing treatments like dental and optical can vary. 

That said, here’s a loose guide to the waiting periods you might see: 

• two months for general dental treatment and physiotherapy 
• six months for glasses or contact lenses 
• 12 months or more for hearing aids and major dental procedures like crowns, bridges and orthodontics. 

Health Insurance that includes Pregnancy Cover can offer a number of useful benefits. For one, as a patient in a private hospital, you’ll usually get to choose your own obstetrician and have them provide ongoing support throughout your entire pregnancy. 
 
Comfort and privacy are other deciding factors for private patients. Private hospitals generally allow for better accommodation and facilities, such as private rooms and the ability to stay in hospital for longer (even if you have no complications). If these options are important to you, then Private Cover could be worth considering. It’s also worth keeping in mind that even with Pregnancy Cover included on your policy, you’d still likely face considerable out–of–pocket costs associated with your pregnancy and delivery, which would likely be covered if you went through the public system.

The waiting period for pregnancy– and birth–related services is 12 months. You’ll have to serve this waiting period if you’re taking out Pregnancy Cover for the first time or upgrading your cover to include pregnancy.

You’ll need to select a Hospital Cover Policy that includes pregnancy- and birth-related services. Having this service on your policy will help cover a portion of your medical fees and give you the choice of a private obstetrician and private hospital. 

Gold Hospital Cover will always cover pregnancy and birth. In rare cases, Silver Plus Policies or other ‘plus’ policies might also cover it. It’s always a good idea to check with your Health Fund prior to getting pregnant. That way, you can plan around the waiting period you need to serve and think through which hospitals have a gap arrangement with your insurer if you’d like to minimise your out of pocket expenses.

Most policies that include Pregnancy Cover don’t automatically cover your baby after they’re born. To ensure your new bub has sufficient cover, it’s important to check out your Health Fund’s specific rules about placing your newborn on your policy. Some providers might require you to add cover for them within two months of their birth; others might have different conditions.

There’s a 12-month waiting period before you can claim on obstetrics. That means if you want to claim, you’ll need to do some advance planning. It’s a good idea to take out cover for pregnancy at least six months before you plan to conceive. This means once the baby is born, even if they’re premature, you’ll have served the 12-month waiting period and you’ll have full access to your benefits for pregnancy and birth.

Yes, IVF treatments are included in Gold Hospital Cover Plans. It’s possible you could also find them on a ‘plus’ plan. Keep in mind, though, that IVF falls under a different clinical category from pregnancy and birth. That means, if a policy covers pregnancy, it doesn’t necessarily also cover IVF. For those benefits, you’ll want a policy that includes coverage for ‘assisted reproductive services’. 

A small portion of IVF treatments might also be covered by Medicare. But if you don’t have Private Cover, you could be required to pay large out-of-pocket costs for your treatments. Even with Private Health Cover for IVF, it’s likely there’ll be some out-of-pocket costs, which will vary depending on the clinic, the treatments and your level of insurance.

The Medicare Levy Surcharge (MLS) is an extra tax some Australian taxpayers have to pay if they earn above a certain amount and don’t have an appropriate level of Hospital Cover. The MLS was introduced to encourage higher income earners to take out Private Hospital Cover to help take the demand and strain off the public health system. 

The MLS is calculated at between 1% and 1.5% of your taxable income, and it’s payable in addition to the Medicare Levy that most taxpayers pay, even if they’re not high income earners. This means that the more you earn, the more you are likely to pay in tax if you don’t have Private Hospital Cover.

You might have to pay the Medicare Levy Surcharge (MLS) if you:  

• don’t have suitable level of Hospital Cover with a registered Health Fund  
• have a taxable income greater than the annual threshold.

Most taxpayers pay the Medicare Levy, whether they have Health Insurance or not. It’s 2% of your taxable income and it helps to fund Medicare. You pay the Medicare Levy on top of the tax you pay on your taxable income. 

The Medicare Levy Surcharge is an extra amount you might have to pay on top of the Medicare Levy. You pay the Medicare Levy Surcharge if you earn above a certain threshold and you don’t hold an adequate level of Private Hospital Cover.

If your income level makes you eligible to pay the Medicare Levy Surcharge, the simplest way to avoid it is by taking out suitable Private Hospital Cover. It doesn’t need to be top cover (i.e. Gold) – even a Basic or Bronze policy will do!

Lifetime Health Cover (LHC) Loading is a government initiative designed to encourage Australians to take out Private Hospital Insurance earlier in life. If you take out Hospital Cover before the 1 July following your 31st birthday, you won’t have to pay LHC Loading for as long as you continue to hold eligible Hospital Cover. 

If you don’t have eligible Hospital Cover by 1 July following your 31st birthday and you decide to take out Hospital Cover later in life, on top of your premium, you’ll have to pay 2% loading for every year you were without cover and keep paying it for 10 years. The maximum loading is 70%, which means you’d be paying a lot more for the same cover than if you’d held continuous cover.

No, the government does not pay the Private Health Insurance Rebate on the LHC Loading component of a policy. 

Private Health Insurance is optional in Australia. Our public health system, Medicare, allows you to access treatment you need, but keep in mind that in the public system, you might have long waits for elective surgery and no control over where or who you receive your treatment from.  

Taking out Hospital Cover could help reduce your risk of paying the Medicare Levy Surcharge, depending on your income. And if you maintain continuous coverage from age 31, you can avoid paying Lifetime Health Cover Loading on your premiums down the track. 

Yes, you can. If you’ve just become a permanent Australian resident and you’re over 31, you’ll have one year from the date you register for your first interim (blue card) or full (green card) Medicare benefits to purchase Hospital Cover without incurring a loading. If you’re under 31, the same rules apply to you as to Australian permanent residents, which means you have until 1 July following your 31st birthday to purchase Hospital Cover without incurring the loading.

If you’ve recently turned 31, you might have received a letter from the Department of Health to inform you about Lifetime Health Cover Loading.   

If you decide not to take out Private Hospital Cover before the 1 July following your 31st birthday and you decide to take it out down the track, you’ll generally face a 2% financial loading for each year after 30 you weren’t covered . The older you are at the time of purchase, the higher the cost.

The Medicare Levy helps fund Medicare, Australia’s public health system. It’s a 2% charge on most Australians’ taxable income, and it’s paid in addition to your regular income tax.

Private Health Insurance premiums aren’t tax deductible, but there are certain rebates and surcharges that might affect what you pay for Private Health Cover. 

• Private Health Insurance Rebate: The Australian Government offers a rebate to help many people with the cost of their Private Health Insurance premiums. The rebate is income tested, which means that the size of your rebate is smaller the higher your income is, and that if your income is high enough, you become ineligible for the rebate. You can claim the rebate on Hospital Cover or a combined Hospital and Extras Policy.
• Medicare Levy Surcharge: Higher income earners who don’t have a suitable level of Private Hospital Cover pay this surcharge in addition to the Medicare Levy. 

The Private Health Insurance Rebate is a rebate eligible Australians receive on their Private Health Insurance premiums. The rebate is income tested, meaning the size of your rebate, and whether or not you’re eligible, are affected by your income level.

If you have Private Health Insurance, when you lodge a tax return you’ll automatically be assessed for the Private Health Insurance Rebate. You can choose to have your Health Fund apply the rebate directly to your premiums (so you pay less month to month), or to have the ATO factor it in when assessing your tax return. The rebate is income tested, so if you’re a high–income earner, your rebate could be reduced or eliminated.   

There are two main ways eligible Australians with Health Insurance can claim the Private Health Insurance Rebate: 

• Directly through your Health Fund (they’ll apply the rebate to your premiums) 
• Via your tax return at the end of the financial year (as a refundable tax offset)

The income tier you select for the Private Health Insurance Rebate is only based on an estimation of your earnings for the financial year, so if your income ends up being higher or lower, it’s okay.
 
If there’s a discrepancy between the rebate tier you select and your taxable income for the financial year, your rebate amount gets adjusted when you do your taxes. For example, if you earn more than your chosen tier, you might need to repay the difference through your tax return. On the other hand, if you earn less than your selected rebate tier, you might receive a higher rebate when you lodge your tax return.

If your income changes, the ATO will adjust your Private Health Insurance Rebate based on the income information in your tax return and rectify any discrepancies. 
 
For example, if your income comes in lower than your chosen rebate tier, you could receive a higher rebate, and if your income comes in higher, you might have to pay back some of your rebate at tax time.

If you have Family Cover and your spouse passes away, the family threshold will continue to apply for the rest of the financial year.

The Savings Provision Entitlement is government legislation designed to keep people on the same Private Health Insurance Rebate amount when someone leaves their policy. Specifically, if people have been eligible for the 35% or 40% rebate because someone on their policy was 65 or older, they can often keep the same rebate amount even if the older person leaves the policy.

Ambulance Cover can cover some or all of the cost of emergency transport to and from hospital. Depending on the state you live in and whether you’re a pensioner or have a Health Care Card, your ambulance costs might be covered by your state government. If they’re not, you can purchase a Private Health Insurance Policy that includes Ambulance Cover.

Medicare doesn’t cover ambulances, but, depending on your state and whether you’re a pensioner or have a Health Care Card, your ambulance costs could be covered by your state. For example, in Queensland, all emergency pre-hospital ambulance treatment and transport costs are covered by the state government, and if you live in Tasmania, then all ambulance costs are typically covered by the government. 
 
If you aren’t in either of these states and don’t meet the additional criteria, you might find that you need to foot the bill for ambulance transportation, unless you have Ambulance Cover.

Making a claim should be a simple, straightforward process. If you receive a treatment that’s covered by your policy, you can begin to make your claim. Depending on your provider, you can either claim online, over the phone, via post, or on the spot using HICAPS (where the fund is charged directly and you only have to pay the gap, if there is one).

Some Private Health Insurance Policies reset at the start of every calendar year (1 January) while others reset at the start of every financial year (1 July). To learn when your policy resets, refer to your policy’s product guide.

If you’re thinking of cancelling your policy, there are two main things to keep in mind: 

• You could be negatively impacted by the Medicare Levy Surcharge or Lifetime Health Cover Loading. These are both designed to incentivise you to take out and maintain Health Insurance, so if you don’t have it, you might pay more when tax time comes around. 
• If you decide to take out Health Insurance again later, you might need to re-serve any waiting periods you’ve already completed.

Adding your partner to your Health Insurance Policy is a straightforward process, and can often be done over the phone or online. Keep in mind that your partner might have to serve waiting periods and your premiums might be higher.

Absolutely! For instance, you can take out Extras Cover with one fund and take out Hospital Cover with another. In some cases, it could even be cheaper than a combined policy, or it could suit your individual needs better.

Your excess can affect the cost of your premium . Generally, if you were to raise your excess, then you’d likely pay less in premiums. This is because by raising your excess, some of the risk would be transferred back to you, which would mean your insurer would end up paying less.  This can be a good option if you think you’re unlikely to need hospital care. But if you’re someone who’s more likely to be admitted into hospital, a lower excess might be a better idea for you.

Choosing a Health Insurance Policy often involves considering your current life circumstances. It can be helpful to consider your immediate (and future) possible health requirements to determine the level of cover you want. It’s also useful to consider how many people (like partners or dependents) will be covered by your policy and what your budget requirements are. 

Want a hand? Our comparison experts are ready to help you compare policies. You can give it a go either online or by calling 1800 784 772.

When comparing Health Insurance Policies, there are a few things to consider:  

1. Are you currently with a Health Fund? If you’re currently with a fund but want to switch, then it’s a good idea to check what your current policy offers and whether it’s still relevant to your current circumstances. 
2. What level of coverage would you like? There are three types of Health Insurance to choose from: Hospital Cover, Extras Cover or combined Hospital and Extras Cover. 
3. What’s your budget? Your financial situation might affect the level of coverage or premium amount you choose. 
4. How many people do you want covered? If you have a partner, dependents or both, you can choose combined or separate policies. 

Once you’re ready, our comparison experts can help you compare from a range of policies and providers.

Hospital Cover helps with costs related to hospital treatments, while Extras Cover helps with out-of-hospital treatments that Medicare generally doesn’t cover.

There are four tiers of Hospital Cover: Basic, Bronze, Silver and Gold. Each tier includes the same minimum treatments, no matter which plan or provider you choose. There are also variations of each tier, called ‘plus’ plans (such as Silver Plus), which include additional cover for a range of procedures.

Extras Cover doesn’t have set tiers, so if you’re wondering whether a particular plan includes a particular treatment, it’s best to check.

While there’s no ‘right’ age to get Private Health Insurance, you might want to keep Lifetime Health Cover (LHC) Loading in mind. If you don’t have Hospital Cover and you’re about to turn 31, once you eventually get it, LHC Loading will add 2% to your premiums for each year after 30 you didn’t have Private Health Cover. For example, if you got cover for the first time at age 39, you could pay 18% more than someone who has held continuous coverage.

The level of coverage you want likely depends on your specific circumstances. Factors that affect your choice might include: 

• your age 
• your budget 
• your lifestyle 
• any existing medical conditions.

To ensure that it’s available to all Aussies, Health Insurance is community rated. That means everyone pays the same price for a particular policy, and your price won’t be affected by your health status, claim history or lifestyle.

Your age could affect your Health Insurance costs if your fund provides age-based discounts, or if you’re impacted by Lifetime Health Cover Loading. The government rebate you might be entitled to can also be affected by your age, which can ultimately determine what you pay month to month.

The premiums for Private Health Insurance typically increase each year. In 2024, premiums increased by an average of 3.03%. It’s also important to keep in mind that different insurers apply different increases, with some higher and some lower.

Each year, Health Funds make the case to the Federal Minister for Health to adjust the cost of their annual premiums based on the rising cost of providing Health Insurance.   

Factors that can contribute to premium increases include:   

• wages for healthcare professionals 
• the cost of medical equipment and technology 
• the number of people making claims.

There’s no exact timeframe for switching Health Insurance. That being said, some providers can organise it for you within a day.

Changing your Health Insurance provider or policy can be daunting, but we’re here to help. We can help you compare from a range of policies and providers. Give our comparison experts a call on 1800 784 772 or compare online. 

Our lives are continuously changing and so are our healthcare needs. This is why it’s so important to review your Health Insurance Policy every now and then. 

It’s worth doing an annual check to see if your policy needs an update to reflect your life changes. There could be features you’re paying for that you no longer use (such as Pregnancy Cover), as well as things you might like to add. If you’d like some help finding a policy that suits your lifestyle and budget, give us a call on 1800 784 772 or take a squiz online.

The cost of your Family Health Insurance Policy will vary depending on your provider, your level of cover, the number of people on the policy and your excess amount. For example, combined Hospital and Extras Cover will generally cost more than an Extras-Only Policy. If you’re unsure which level of cover suits your family’s needs and budget, we’re happy to help you compare a range of different policies and providers. Try it out online or give us a call on 1800 784 772.

In 2021, the government increased the maximum age of dependents for Private Health Insurance Policies from 24 to 31 and removed the age limit for dependents with disabilities. This means, depending on your policy and provider, your dependents might be able to stay on your Family Policy until aged 31. Any dependents with a disability can potentially remain on your policy for as long as they need. 

Keep in mind, though, that this change wasn’t mandatory for Health Funds to implement. That means that some funds might provide extended coverage for dependents, others might not. You can give us a call on 1800 784 772 for a better understanding of which funds (that we compare) provide this level of cover. 

Family Health Insurance can help cover the cost of medical treatment for your entire family. It can be a great way to help protect your family and also give you access to benefits that might help you save money. 

There are three types of Family Health Insurance to choose from: 

• Hospital Cover: This type of cover is for in-hospital treatments at a private or a public hospital. It can help cover surgeon fees and hospital accommodation. 
• Extras Cover: This type of cover could help the family with the cost of health services Medicare doesn’t pay a rebate on, such as dental and physio. 
• Combined Cover: This means combining Hospital and Extras Cover on the one policy.

No one policy can be considered the ‘best’. It varies from family to family, based on your budget, preferences and health needs.

For example, if your family just consists of you and your partner, then you might be interested in a Couples Policy. But keep in mind that, under this kind of policy, you and your partner will receive the same level of cover. If you each have different medical needs, then you might prefer to keep separate Singles Policies customised to your individual health situations.

If your family is made up of you and your child, a Single Parent Policy  might be a good choice, since it offers cover for one adult and one dependent.