.svg)
Health Insurance for Sports Injuries
Health Insurance for Sports Injuries
Written by
Madeline Pettet
Edited by
Laura Crowden
Reviewed by
Andres GutierrezCompare Health Insurance Policies
Save time and effort by comparing a range of Australia’s health funds with iSelect
What are some common sports injuries?
Long story short
Sports injuries can range from minor bruises and cuts to muscle tears and broken bones
Serious injuries aren’t just the domain of professional players; they can happen to anyone.
Treatment could be anything from simply taking some time to rest or getting surgery
Depending on your situation, you may not be able to rely on Medicare to cover everything.
Your health insurance could help cover services Medicare won’t
This can include seeing a physiotherapist or occupational therapist to rehabilitate your injury properly.
What are some common sports injuries?
From pivoting too quickly to simply copping a ball to the face, there are lots of ways to get injured when you’re playing sport.
And it’s not just famous players and professional athletes who need to worry about sporting injuries. Of the almost 18.5 million adult Australians aged 18 or over who played sport in 2023-24, 19% of them were injured as a result.1Clearinghouse for Sport – National data tables – July 2023 to June 2024 And in no surprise to parents, the rate of hospitalisation for sports injuries was highest for Australians aged 15 to 19. Claiming second place on the podium were Australians aged 10 to 14.2Australian Institute of Health and Welfare – Data tables A: Sports injuries in Australia, 2021-22
But it’s not just a case of growing up and making good choices; novice athletes tend to have a higher injury risk, no matter the age.
Depending on your injury and its severity, you might need to sit out the rest of the game or even the season. Some injuries can do more than just wreck your winning streak, they can seriously impact your day-to-day life.
Strains and tears
Strains are a kind of soft tissue injury that are the result of a muscle being overstretched or contracting too quickly. A severe strain, or one that isn’t allowed to recover properly, can partially or completely tear the muscle fibres. Ouch!
Strains are common in sports where you need speed, power, and agility, like soccer, basketball, and tennis.
You might be dealing with a strain if you’re experiencing swelling, and/or bruising in a particular area. Pain is another big indicator. You might only feel sore when you exercise or get up in the morning. A bad strain could hurt all the time, though.
Strains can be pretty serious, like partially or completely tearing your Achilles tendon or hamstring. You won’t be getting back onto the field or court too quickly if you’re dealing with one of these.
Sprains and joint injuries
A sprain is when your joint goes beyond its normal range of movement, like when you were a kid and tried to make your favourite action figure do the splits. Our joints can be pretty complex with tendons, ligaments, and cartilage all involved to allow us to move. A sprain can affect any of these joint parts.
Sprains occur in lots of sports, including football, rugby, basketball, and skiing.
If you have a sprain, the joint may be painful, swollen, and stiff. A serious sprain might even mean you can’t put any weight on the joint.
The human body has lots of joints and lots of opportunities for strains. Some infamous ones include acromioclavicular (AC; that’s a part of your shoulder) joint injuries, anterior cruciate ligament (ACL) injuries, and meniscus (the cartilage in your knee) injuries.
Fractures and dislocations
Fractures and dislocations are often the result of a direct impact, like getting slammed by another player, or applying too much force on a bone, like putting your hands out to break your fall. Fractures can also develop over time – these are stress fractures. Run on a hard surface often enough and your reward might be a stress fracture.
As you can imagine, contact sports, like football, can come with their fair share of fractures. However, you don’t need to be dodging tackles to end up with a fracture. In 2021–22, 16.72% of sporting fractures requiring hospitalisation were from cycling and only 7.55% were from football. The two sports were roughly even for dislocations, though.3As above
It can be hard to miss that you have a fracture since your limb might now have a funny lump or odd bump. You may also not be able to move the affected limb all that much, especially without pain.
Concussions
A knock or bump to the head, even a little one, can give you a concussion. Concussions can be a big deal as they affect your cognitive function and balance. The impact that caused your concussion may also have done damage to other parts of your head or your neck.
Someone with a concussion might:
- have a headache or feel dizzy
- feel foggy, confused, or have difficulty focusing or remembering
- be irritable or overly emotional
- feel fatigued
- feel nauseous or vomit
Concussions can occur in pretty much any sport. You might knock your head tripping on the field or take a hit from a ball or bat. However, cycling, football, and rugby had the greatest share of concussions resulting in hospitalisation in 2021–22 in Australia.4As above
Dental damage
Taking care of your teeth can be about more than brushing and flossing. Wearing a mouthguard when you’re playing sport could save you from dealing with cracked, broken, or even knocked-out teeth.
All it takes is a blow to the jaw to do some serious dental damage. This could happen in contact sports, as well as ones where balls or bats are flying.
Eye injuries
Eye injuries can range from cuts or scrapes around the eye to bruising and swelling to penetration and damage to the eye itself.
What symptoms you’ll be dealing with can depend on what the damage is. You might find that the area around your eye is tender or bruised, or you could discover that your vision has been affected.
Some sports that can be a high risk for eye injuries include badminton, baseball, cricket, and fencing.
How could health insurance help cover the cost of treating my sports injury?
A minor sports injury may only need you to follow the steps for RICER (rest, ice, compression, elevate, refer) and No HARM (no heat, no alcohol, no running, no massage) for up to 72 hours.5Better Health Channel – Sports injuries After that, you could be good to go again.
However, something more serious may require longer-term treatment and greater care. This could include:
- physical rehabilitation to help condition and strengthen the affected area
- immobilisation, like a cast, to give it a chance to heal
- mobility aids to reduce stress on the muscle, joint, or bone
- surgery if you’ve really done a number on yourself
Compared to a few days getting comfy on the couch, severe sports injuries can make quite a dent in your wallet – even if you make the most of Medicare and the public hospital system.
Example sports injury scenarios and out-of-pocket costs
| Injury | Possible treatment program | Potential out-of-pocket costs |
| Broken nose | An initial appointment with a plastic and reconstructive surgery specialist in their rooms to discuss treatment | $122 |
| Total rhinoplasty as an out-patient at a plastic and reconstructive surgery specialist’s rooms to straighten and re-open nasal passages for breathing | At least $303.60 | |
| Follow-up appointment with a plastic and reconstructive surgery specialist in their rooms to discuss treatment results | $61 | |
| Dislocated AC joint | Surgery to relocate joint into correct position | Free through Medicare |
| A 13-week rehabilitation strengthening program with a physiotherapist (30-minute sessions once a fortnight) | $560.39 | |
| Fractured wrist | Emergency department visit to receive cast to immobilise wrist | Free through Medicare |
| Two sessions of physiotherapy to reduce stiffness after cast is removed | $210.49 | |
| Partial meniscus tear | An arthroscopy to investigate and treat damaged cartilage | Free through Medicare |
| A six-week out-patient muscle-strengthening program with an occupational therapist (30-minute sessions once a week) | $639.83 | |
| A six-week out-patient muscle-strengthening program with a sport and exercise physician (30-minute sessions once a week) | $637.51 | |
| Torn ACL | Reconstructive surgery with several days of in-patient rehabilitation | Free through Medicare |
| Seven months of out-patient rehabilitation with a physiotherapist (30-minute sessions once a fortnight) | $1,339.71 | |
| Seven months of out-patient rehabilitation with a sport and exercise medicine physician (30-minute sessions once a fortnight) | $1,546.34 |
Source: Comcare – Rates for medical and allied health treatment, Medical Costs Finder – Follow-up specialist appointment, Medical Costs Finder – Initial specialist appointment, Medicare Benefits Schedule – Item 45641
Note: These are hypothetical treatment programs and fees that may not reflect your personal situation.
Allied health session fees are based on separate national averages for initial and subsequent or standard appointments using available data from February 2025. Costs are calculated for one initial appointment and multiple subsequent appointments. These average fees are based on relevant workers’ compensation schemes. Seeing an allied health professional outside of a workers’ compensation scheme may mean your fees are different.
Specialist fees assume the practitioner does not bulk-bill and the out-of-pocket cost is the typical figure for a patient with an out-of-pocket cost in a private setting in 2022–23. This is the amount patients typically paid for these services, rounded to the nearest dollar. These fees may vary depending on your situation. Not all patients had out-of-pocket costs; those who didn’t aren’t included in this figure. Data retrieved January 2025.
The out-of-pocket rhinoplasty cost assumes a 75% Medicare benefit, and the specialist charges the MBS rate as a minimum.
While it’s possible to still have out-of-pocket costs when you use your health insurance, it may work out in your favour compared to relying solely on Medicare, particularly if you don’t need surgery.
Most serious sports players know that a trip to the physio, chiropractor, or another allied health professional can do a world of good for a sports injury. But Medicare won’t ever cover a cent for these unless you’re eligible for a chronic health care plan from your GP. Even then, you can only claim a total of five allied health sessions each year. This might be fine if you’ve just got a niggling pain, but it may not be enough if you need some serious rehab.
Your private health insurance, though, could help you get money back on allied health sessions without the extra paperwork although it depends on your policy and any limits that come with it. Taking care of these injuries properly could mean you’re less likely to end up severely hurting yourself in a similar way further down the track.
But it’s not just the long recovery where your health insurance could look after your wallet. If you take an ambulance to hospital, whether it’s from the sporting field or your backyard, Medicare won’t cover it. Your state government might not either. However, ambulance health insurance could help pay for some of that trip.
How else could health insurance help if I have a sports injury?
In a true emergency, the public hospital system is likely all you’ll need. Australia’s overall healthcare performance ranks number three globally, after all. But many sporting injuries – even serious ones – aren’t considered an emergency and may require elective, not emergency, surgery. This is where private cover steps in.
Choose your doctor and hospital
Going to hospital for surgery can be scary, but you may feel more comfortable if you can pick your doctor. You might choose someone recommended by friends or family, or who you know has experience with your kind of sports injury.
If your doctor practises at multiple hospitals, you can also pick where you’ll be treated by them. This could mean it isn’t far for family to travel and visit you.
Have a shorter waiting time for elective surgery
Elective surgery is the kind that isn’t to save your life, but it can certainly be life changing! Knee replacements, for instance, can be a necessity to regain mobility and live without pain, but they’re classed as elective surgery.
By going through the private system, you can usually skip the longer wait times that you might sometimes see bemoaned in the newspaper. In 2022–23, the median elective surgery wait for private patients was 24 days, compared to the public patient median wait of 51 days. That’s a difference of almost a month! Plus, close to 10% of public patients were waiting more than a year for their surgery, while that was the case for fewer than 5% of private patients.6Australian Institute of Health and Wellbeing – Admitted patient care 2022–23 6: What procedures were performed?
A shorter wait is incentive enough, but, if the stars align just right, you might even be able to book a time for your surgery that suits you and your schedule.
Enjoy a private room
Did you know that patients who had elective surgery for a sports injury in 2021–22 stayed in hospital, on average, 1.7 days? While that mightn’t sound too bad, you may feel differently if you’re sharing a room with other patients. Not to mention that your average hospital stay may be longer depending on the sport that sent you there – dancers were cooling their heels in hospital for close to nine days on average.7Australian Institute of Health and Welfare – Data tables A: Sports injuries in Australia, 2021-22
A private room doesn’t just mean you get some privacy at a time when you may be feeling vulnerable or just want to be alone with your thoughts. It also means there’s plenty of room for visitors to drop by – although you may want to ask the footy team to figure out a visiting schedule to avoid things becoming crowded.
Of course, a private room is not guaranteed (it can depend on what’s available) but having private cover gives you a sporting chance.
Helpful tip:
Toughing out an injury on the public waiting list could mean no bills from your surgery and hospital stay, but it could come at the cost of serious long-term changes to your everyday life. Having private health insurance could help you recover sooner, reducing the financial and emotional stress on yourself and your family. You’ll just need to pay the out-of-pocket costs on your bill.
Andres Gutierrez
General Manager – Health
What kind of health insurance is good for sports injuries?
When it comes to sport injuries, all three types of health insurance can be a smart choice.
How do I choose health insurance for sports injuries?
If your game is your whole world, particularly come Grand Final or World Cup time, then your health needs extend beyond what damage you might do on the field.
When you’re looking at health insurance, think about the big picture. This could include your family’s health needs, too, if you intend to share a policy. Thinking this through could give you a checklist of priorities to guide your search for an ideal policy.
You can then narrow your options down by deciding on your budget, and if you’re comfortable opting to pay excess and co-payments in exchange for a lower premium. Don’t forget to check if the fund has preferred providers, and if any are near you that you’d be happy to use.
On the topic of budget, remember that there can be tax incentives for taking out hospital cover. For instance, you may be able to get the private health insurance rebate, skip the Medicare Levy Surcharge, and minimise the damage of the Lifetime Health Cover loading.
From here you can review each potential policy, checking:
- waiting periods
- inclusions, exclusions, and restrictions
- annual limits, including what counts towards them and when they reset
- what gap payments you may have
Hopefully, after all this, you’ll have found a policy you’re happy with. But the work isn’t over yet. The final step is to make reviewing your policy a regular habit. You’ll likely find your health needs change over time and that another policy may now be a better fit.
Where can I find and compare health insurance?
Sports can keep us in shape, connect us with friends, and be a great way to blow off steam, but they aren’t without their risks. If you’re worried about pulling a hammy playing footy with your mates, or one of your kids losing a tooth from an overzealous fellow hockey player, health insurance could give you some peace of mind.
With iSelect, it’s easy to compare a range of health insurance options from different providers. You can get back to the action of a live game in a matter of minutes, thanks to our online comparison tool or by speaking with one of our health comparison experts on 1800 784 772.
Compare health insurance policies the easy way
Save time and effort by comparing a range of Australia’s health funds with iSelect
WE’RE HERE TO HELP
Need help with health insurance?
We can help you find a suitable product for your needs
Health Insurance & Tax
Tax Implications on Health Insurance
The Medicare Levy Surcharge
About the Life Time Health Cover Loading
The Private Health Insurance Benefit Codes
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