Is It Time To Put Heart Cover On Your Hospital Policy?

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Updated 08/01/2024
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Written by

Francis Taylor

Updated 08/01/2024

What changed?

Heavy rewrite to expand content
Our aim is to help you make better informed decisions. That’s why iSelect’s content is produced in accordance with our fact-checking and editorial guidelines.

Edited by

Laura Crowden

Find out more about how we make money.

View our Privacy Policy.

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I need cover for…

Can Health Insurance cover heart conditions? 
Which heart conditions can Health Insurance cover? 
What should I look at when comparing policies? 
How common is heart disease in Australia? 
What are the risk factors for heart disease? 
Where can I find and compare Health Insurance? 

Can Health Insurance cover heart conditions? 

It sure can! But it depends on the kind of policy you get and the kind of treatment you need. Some types of Hospital Cover include inpatient hospital treatment for heart conditions, but not outpatient or specialist treatments. Hospital Cover falls into four tiers: Basic, Bronze, Silver and Gold. Each tier has to cover particular broad categories of health treatment, which are determined by the Federal Government. So which of these tiers include heart conditions? 

  • Silver and Gold always cover heart conditions 
    It’s mandatory for any Hospital Cover that falls into a Silver or Gold product tier to cover heart conditions. If you have a pre-existing heart condition, there is a waiting period, but once that period ends, you’ll be covered for health treatments related to your heart and vascular system. 
  • Basic Plus and Bronze Plus might cover heart conditions 
    Hospital Cover that falls under the Basic or Bronze tiers doesn’t have to cover heart-related conditions. But insurers have the option to include non-mandatory treatments in a policy and add ‘Plus’ to the title. That means Basic Plus and Bronze Plus policies could potentially offer cover for heart conditions. Just be aware that restrictions could apply in these cases. For instance, under a Basic Plus Policy, if you have restricted cover for Heart and Vascular and you’re admitted as a private patient in a public hospital, you might only be covered for some of the costs.

    To be safe, it’s always a good bet to check out the specifics of any policy you’re considering. This is usually easy enough, though! Just hop on the insurer’s website, check out the information document for their policy, and you’ll see what kind of conditions are covered, and whether any restrictions or exclusions apply. 

Does my Health Insurance cover heart disease? 

Basic Basic Plus Bronze Bronze PlusSilver Silver Plus Gold 
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Which heart conditions can Health Insurance cover? 

As long as you have a Hospital Policy that covers the heart and vascular system, you’ll be covered for a wide range of investigations and treatments for heart conditions. This includes, but is not limited to, treatments for: 

  • varicose veins 
  • heart attacks and heart failure 
  • removal of plaque from arterial walls 
  • occlusive disease 
  • aortic aneurysms. 

Medical techniques and treatments like angioscopy, angioplasty, coronary bypass surgery, valve repair, stents and electrophysiology studies are also included under Hospital Cover. However, you’ll probably still want to check with your insurer exactly which medical treatments and techniques are covered, as well as what out-of-pocket costs you might encounter.

What should I look at when comparing policies? 

Besides the obvious factors – the cost of your premiums and your level of cover – there are a few specific points you might want to look at to make sure you’re getting a suitable policy. They are: 

Waiting periods 

This is the length of time you’ll have to hold the policy before you can actually make a claim for specific treatments in hospital. If you have a pre-existing condition – such as a heart problem you had before you took out the policy – the maximum waiting period insurers can apply stands at 12 months. If you don’t have a pre-existing condition, the maximum waiting period is two months. 

Excess 

An excess is an amount that you agree to pay towards a treatment before your Health Insurance kicks in. When you choose a policy, you can sometimes choose your excess amount. Choosing a higher excess usually means paying lower premiums. 

Hospital network 

Different insurers have specific arrangements with different hospitals. Insurers might provide a different rebate depending on which hospital you use. Also, specific hospitals might be ‘no gap providers’, meaning they won’t charge any extra fees beyond what your insurer covers. If you have a specific hospital in mind for treatments, it’s usually worth checking what kind of arrangement they have with your insurer. 

How common is heart disease in Australia? 

As much as we’d like to keep things light, the statistics about heart disease in Australia are pretty sobering. 

It’s estimated that more than a million Australians are living with heart disease, stroke or vascular conditions.1Department of Health and Aged Care – What we’re doing about cardiovascular conditions  And that’s not the extent of it: ischaemic heart disease (a lack of blood to the heart) is the leading cause of death in Australia.2Australian Bureau of Statistics – Causes of death, Australia 

While the prevalence of heart disease is serious and daunting, the good news is that the simple things you can do to take care of your general health, like eating healthily and exercising, are also good for your heart health. Win win.  

What are the risk factors for heart disease? 

Nine out of 10 Aussies have at least one risk factor for heart disease.3Heart Research Australia – Risk factors  And more than two-thirds of us have three or more risk factors.4Heart Foundation – Are you at risk of heart disease? 

There isn’t one single thing that causes heart disease. Instead, many different risk factors can contribute to it, including: 

  • high blood pressure 
  • high cholesterol 
  • being obese or overweight 
  • physical inactivity 
  • low fruit and vegetable intake 
  • regular drinking 
  • regular smoking 
  • a family history of heart-related issues. 

When reviewing your Health Insurance, it’s always a good idea to assess your risk factors and take them into consideration when choosing your health cover. If you have any of the above risk factors, and getting treated in a private hospital is important to you, then you might want to look at Health Insurance that includes Heart Cover. 

Where can I find and compare Health Insurance? 

If you’re looking for Health Insurance Policies that cover heart conditions, then iSelect can help you out. You can compare policies online from a range of different providers, then weigh up which one best suits your budget and healthcare needs. Or if you’d prefer, you can give our friendly team a call on 1800 784 772

It’s quick, easy to use, and – best of all – it’s free! The policy you find might just make your heart skip a beat (in a good way). 

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