Is It Time to Put Heart and Vascular System Cover on Your Hospital Policy?

What are heart and vascular conditions?  

Heart and vascular conditions refer to diseases and conditions that affect the heart and blood vessels. You might also hear them referred to collectively as cardiovascular disease or CVD for short. Some of the most common forms of CVD include coronary artery disease (which causes heart attacks), strokes and heart failure. While many people tend to refer to these kind of conditions as simply heart or cardiac disease, for health insurance purposes they are referred to as ‘heart and vascular system’.  

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 and vascular conditions, but not outpatient or specialist treatments. Hospital Cover falls into four tiers: Basic, Bronze, Silver and Gold. Each tier has to cover particular categories of health treatment, which are determined by the Federal Government. So which of these tiers include heart and vascular conditions? 

• Silver and Gold always cover heart and vascular conditions 
  It’s mandatory for any Hospital Cover that falls into a Silver or Gold product tier to cover heart and vascular conditions. If you have a pre-existing heart or vascular condition, there is a waiting period (usually 12 months for pre-existing conditions), 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 and vascular conditions
  Hospital Cover that falls under the Basic or Bronze tiers doesn’t have to cover heart or vascular-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 or vascular 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 and vascular disease? 

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 inpatient hospital investigations and treatments for heart and vascular 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. 

Helpful Tip:

Waiting until you need treatment for heart or vascular conditions may be too little too late when it comes to Health Insurance.  If you have a pre-existing heart or vascular condition, you’ll likely have to wait 12 months before you can make any related claims. It is helpful to think about the stage of life you’re at, your health condition and your family history as it may be worth adding cover for your heart and vascular sooner rather than later.

Dr. Jill Gamberg

GP, Coach and Lifestyle Medicine Coach

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 are heart and vascular diseases in Australia? 

As much as we’d like to keep things light, the statistics about heart and vascular 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 flow to the heart) is the leading cause of death in Australia.²Australian Bureau of Statistics – Causes of death, Australia

While the prevalence of heart and vascular 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 regular physical activity, are also good for your heart and vascular health. Win win.  

What are the risk factors for heart disease? 

Nine out of 10 Aussies have at least one risk factor for heart and vascular 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 and vascular 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 and vascular cover. 

Where can I find and compare Health Insurance? 

If you’re looking for Health Insurance Policies that cover heart and vascular conditions, then iSelect can help you out. You can compare private health insurance 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).