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Australia is often said to have one of the best health systems in the world, with the Commonwealth Fund ranking us third overall among 11 high-income countries in a 2021 report. On top of Medicare, private health insurance can give you access to some of the best hospitals and doctors available, among a wide range of other covered benefits.
Savvy can help you compare health insurance policies from a some of Australia's leading insurers in one place. By answering a few simple questions about the cover you’re after, our comparison service can present offers side-by-side with cost, benefits, inclusions outlined for you to compare and choose the right policy in few minutes. Get the process started with Savvy today.
What is private health insurance and how does it work?
Private health insurance is a form of insurance which can assist you with the cost of medical treatment and care and can cover treatments which aren’t included under Medicare. The best policies can also help you avoid long public hospital waiting lists for required treatment, including surgery. It can also offer you options to choose which doctor you see, and which hospital you stay in to receive your treatment, as well as covering you for additional health costs, such as ambulance cover.
There are three basic types of health insurance available in Australia:
- Hospital cover (which can include cover for costs associated with in-hospital treatment)
- Extras cover (which can include cover for out-of-hospital treatments not covered by Medicare, such as dental work)
- Combined hospital and extras cover (which can offer protections for both these types of cover combined)
The cost of your health insurance will depend on the level of coverage you choose to take out and the medical treatments you wish to be covered for (among other factors). If you choose hospital cover, for instance, there are generally four different levels you can choose from, ranging from the cheapest to the most expensive policies. These are:
- Basic cover – which usually offers cover for very limited hospital services, such as psychiatric services, rehabilitation and palliative care
- Bronze cover – which often includes the same cover as a basic policy, with additional cover typically offered for up to 18 further clinical categories
- Silver cover – which is another step up from bronze cover, potentially offering cover for as many as 29 further clinical categories
- Gold cover – the highest level of cover available, which can offer top cover for all clinical categories
Each health insurer may have a different way of describing the tiers of cover they provide, with names such as ‘silver plus’ used to describe their levels. However, the same principle applies to all funds: the more options covered, the higher the cost of the insurance will probably be.
What is usually included and excluded from health insurance?
Hospital cover, as its name suggests, covers treatment from doctors and specialists which are provided in a hospital setting. It may cover the following areas:
- Consultations with doctors, specialists and anaesthetists
- Tests administered whilst you’re in hospital or undergoing surgery
- Cost of surgery or other treatments
- Specified allied health services such as psychiatrists, psychologists and pain management specialists
- Ambulance cover*
*Not included in all hospital cover. Ambulance cover differs between states and territories, with some providing free cover to residents for transport within their state or nationally. Check with your state ambulance provider or health insurer for details of any cover offered.
What isn’t included under hospital cover?
Some of the items which are commonly excluded by hospital insurance include:
- GP visits (for which part of the cost is covered by Medicare, less any gap that is charged)
- Cost of visiting a public hospital emergency department (which is also covered by Medicare)
- Most x-rays, MRIs, CT scans and blood tests which are performed on outpatients
- Medical procedures not considered medically necessary (such as breast augmentation or liposuction purely for cosmetic purposes)
This may offer cover for treatments given outside of a hospital setting which aren’t covered by Medicare. Many preventative and remedial forms of treatment are covered by this type of insurance, which may include:
- Dentistry and major dental surgery
- Orthodontics (such as braces or aligners)
- Optometry (lenses, glasses and frames)
- Non-PBS pharmaceuticals (medicine and drugs not listed under the Pharmaceutical Benefits Scheme, so not subsidised by Medicare)
- Psychology (and other treatments for mental health conditions)
- Dietetics – including assistance with nutrition, diet and weight loss programs
- Gym memberships – offered by some health funds and subject to conditions
- Vaccinations – particularly if you’re travelling overseas and require less common vaccinations such as typhoid
- Supply and fitting of hearing aids
- Physiotherapy, other manual therapies and exercise programs
- Chiropractic treatment to assist with back or spinal issues
- Podiatry (treating any foot or ankle conditions)
What isn’t included under extras cover?
The treatments which aren’t routinely covered by extras health cover will vary between different health insurance providers and the level of cover chosen, but may include:
- Laser eye surgery
- Some alternative medicines and therapies
The amount of benefits or rebates available under extras cover will be limited to a set dollar amount per year. How much that limit is will depend on the level of cover you choose to purchase. For example, under a cheaper extras cover policy, you may be covered for up to $800 for major dental work, but if you choose a more expensive policy, you may be covered for up to $2,500 instead.
All health funds will have different inclusions, exclusions and limits, as well as terms and conditions surrounding the treatment or other expenses you’re claiming for. As such, it’s important to compare health insurance policies carefully before deciding which one is right for you or your family. Savvy makes this process simple by enabling you to receive a range of health insurance quotes online for you to compare side-by-side.
How do I compare health insurance policies?
There are many areas you should compare before deciding which health insurance policy is the most appropriate one for your situation. Look at these different aspects when comparing policies side-by-side with Savvy before making your choice:
What’s covered that you’ll use?
This is the main thing to consider when deciding which form of insurance to buy. Think about the health care treatment you have needed in the past three years and choose a level of cover you feel comfortable with which offers inclusions you may need.
For example, if you have 20:20 vision and are relatively young, you may not wish to pay for laser eye correction surgery cover. If you’re a single male, your interest in pregnancy cover may be very limited! Match the insurance you buy to the services you’ll actually use.
Check for vital exclusions
As well as being sure what is covered by the health insurance policy, also check the exclusions to make sure nothing vital you need is left out. For example, if you live with Type 1 diabetes, you may not want to consider a health insurance policy which excludes cover for the cost of an insulin pump or blood glucose monitoring devices.
How much can you afford?
Your level of income and expenses will determine the level of health cover that you’re able to afford. Not everyone can afford gold hospital cover, which is why there’s a range of policies available to suit different budgets. Balance the cost of health insurance per month against the potential costs you could face if you don’t have cover.
For example, if you don’t have ambulance cover and have to be taken to hospital, you may face a bill for thousands of dollars for your brief ambulance trip (depending on where you live and the nature of the accident).
What health facilities are available in your area?
Those who live in rural and remote areas of Australia may have fewer options for their health care than others who live in one of our major cities. If you’re lucky enough to have a choice of several private hospitals nearby, private hospital cover may allow you to choose where you receive your treatment.
However, if you live in a remote area where there aren’t any private health facilities, this type of cover may be less useful if you wish to have your medical treatment close to home.
Types of health insurance
This can help you pay for medical treatment if you need to be admitted to hospital. It can help cover the cost of your admission or accommodation and the fees charged by doctors, surgeons and anaesthetists. It can also cover other costs associated with a stay in a private hospital.
This helps cover the costs of health care treatments outside a hospital setting which aren’t covered by Medicare. This can include major and minor dental treatment, orthodontics, hearing aids, physiotherapy, glasses, contact lenses and podiatry (in most cases with annual limits).
This is a standard health insurance policy designed for a single person, rather than being tailored to cater to the needs of a couple or family. It may include hospital cover plus extras, or either of these types of insurance on their own, depending on what you're after for your health cover.
A family health insurance policy is designed for a family unit including dependent children who may reach up to 31 years of age with some insurers. It offers private health insurance suitable for the whole family and may include shared limits for all members included in your policy.
A health insurance policy aimed at seniors is designed to appeal to people who are in the second half of their life. These are often specific Silver Plus policies that offer the same cover as other health insurance policies, with the exception that pregnancy and childbirth cover may not be included.
Visitors who are in Australia on a temporary basis for travel, work or study may be able to take out Overseas Visitors Health Cover (OVHC). Many visas issued in Australia come with a requirement to take out this type of insurance, which covers visitors who may not be covered by Medicare.
Ambulance cover is generally available either packaged into your private health insurance or on its own as a separate policy or subscription. By having this protection, you could be covered for all eligible ambulance travel in Australia (subject to your insurer's terms and conditions).
The cheapest and most barebones form of private hospital insurance, this can include cover for rehab, in-hospital psychiatric services and palliative care. Having this policy will enable you to avoid paying the Medicare Levy Surcharge (MLS) and Lifetime Health Cover (LHC) loading.
Bronze hospital cover is a step up from basic insurance, including 18 further clinical categories such as ear, nose and throat, bone, joint and muscle, digestive system, joint reconstructions, gynaecology and chemotherapy, radiotherapy and immunotherapy for cancer.
Silver hospital cover is the second-most expensive type of policy and offers the second-most clinical categories. On top of what's offered by basic and bronze cover, it also includes heart and vascular system, lung and chest, blood, hearing device implantation and dental surgery.
The highest level of private hospital insurance available in Australia, gold policies can offer cover for pregnancy and birth, weight loss surgery, assisted reproductive services and insulin pumps on top of all the categories provided by silver, bronze and basic hospital insurance.
Why compare health insurance through Savvy?
The pros and cons of health insurance
Beat the waiting lists
Having private health cover may offer you the opportunity to skip public hospital queues and get the surgery you need when you want it.
Choose your doctor
As a private patient, you’ll usually be able to choose the doctor you see or the surgeon who performs your operation (subject to availability).
Choose your hospital
The doctor or surgeon you’ve chosen to see may operate out of several locations, so you may be able to choose which hospital you’re admitted to in order to have your treatment or surgery if it’s able to accommodate you.
Save on treatments not covered by Medicare
There are many treatments (for example, dental surgery) which aren’t covered by Medicare, but which could be covered by your private hospital cover, potentially saving you thousands of dollars if you’re covered.
Possibly have your own room
If you have private health insurance, you may be able to choose to have a room to yourself when you go in for your scheduled surgery. However, this will depend on the level of cover you have and the facilities available in the hospital you’re admitted to.
Avoid the Medicare Levy Surcharge
The Medicare Levy Surcharge (MLS) is an additional levy imposed on Australian taxpayers who don’t have private health insurance and earn over $90,000 p.a. for a single person, or $180,000 for a couple. It starts at 1% of your income and goes up to 1.5% on a sliding scale.
Health insurance does cost money each month, which can seem like an additional burden if you don’t need to use your insurance for an extended period.
Private health insurance may not cover 100% of the cost of your medical treatment due to exclusions or limits on your policy or gap fees charged. A gap fee is what your medical practitioner charges over the amount your health insurer and Medicare refunds to you.
If you’re taking out health insurance for the first time or are upgrading to a higher level of coverage, there may be waiting periods which apply before you can make your first claim. For some major hospital treatments, the waiting period may be up to 12 months, while for more minor expenses, such as physiotherapy, it may only be two months. However, from time to time, health funds run offers which waive waiting periods on certain extras. Savvy and our partners can help you find and compare these offers online before you buy.
Excess and co-payments
You can reduce your premiums by electing to pay an excess and/or co-payment if you’re hospitalised. If that’s an option you’ve chosen, each time you make a claim on your hospital cover, you may be required to pay an excess, or daily co-payment towards the cost of your hospital stay.
What factors will affect how much my health insurance costs?
The cover you choose
The cost of your insurance in Australia will depend on whether you wish to have just hospital cover, just extras cover or both. Opting for both will be more expensive than only buying one or the other. It isn’t necessary to have both types of health cover with the same insurance provider, so you could choose to split your coverage across more than one insurer.
Top tips on how to maximise the benefits of your health insurance
If you haven’t looked at your health insurance recently, you may be surprised at how policies have changed since you last gave your health insurance its own health check. Regularly review your level of cover to make sure you’re still getting the best deal.
Most people pay their health insurance premiums per month, so work out what you can afford based on your household income per month, less the regular costs associated with keeping a roof over your head and buying food and essentials.
Think about your family’s health needs and write a list of the types of coverage which it needs as a priority. Make sure each of these priority items is covered in the policy you choose so you don't find yourself without the cover you're looking for.
Comparing health insurance policies is an essential step to take before you buy your coverage. Doing so through Savvy and getting a range of free quotes can help give you a realistic idea of what your insurance may cost and the likely inclusions.
More of your frequently asked questions about health insurance
Helpful health insurance guides
Looking for health insurance to cover your conditions or treatment?
Read one of our helpful guides on a range of different ailments and potential hospital or extras treatments to help you find out if they're covered.
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Savvy’s comparison service is provided by Compare Club. Compare Club compares selected products from a panel of trusted insurers and does not compare all products in the market.
Any advice presented above or on other pages is general in nature and doesn’t consider your personal or business objectives, needs or finances. It’s always important to consider whether advice is suitable for you before purchasing an insurance policy.
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