Cancer health insurance in Australia
Both Medicare and private health insurance can play a role in meeting the cost of cancer treatment. Private health plans start from around $85 a month and you'll need to serve a minimum 2-month waiting period before you can claim.
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Receiving a cancer diagnosis can be overwhelming for you and your loved ones. The right health insurance help to ease some of the financial burdens while you focus your energy on your recovery. Private insurance can cover some treatments as well as the option to choose your own doctor and stay in your own private room at the hospital.
Is cancer treatment covered by Medicare in Australia?
Yes, Medicare can pay for all of your in-hospital treatments if you choose to be treated as a public patient. Whether or not you use private health insurance, you'll still rely on Medicare for a large portion of the costs linked to your cancer - generally speaking, Medicare tends to cover anything from around 60% to 90% of the overall cost.
Medicare provides rebates for some outpatient services too, including:
- GP visits
- Specialist visits
- Blood tests
- CT scans
Be sure to check with your health provider about any costs you'll face ahead of time. Similarly, it's good to check in with your health fund before you receive any treatment so that you know exactly what's covered, along with any restrictions or exclusions.
How does private health insurance cover cancer treatment in Australia?
Private health insurance can work alongside Medicare, giving you the benefit of having more control over your treatment and where it occurs. It covers you for:
- In-hospital cancer treatments. Private health insurance will contribute to your in-hospital treatments at a private clinic, including doctor's fees, accommodation, prescriptions and the treatment itself.
- In-hospital psychology. The only level of cover where you'll get this for sure is a Gold level policy, although some policies as low as Bronze Plus will offer it. The good news is, you can upgrade your policy to one that covers psychiatry and skip the waiting period if you find you need this cover at the last minute.
- Prescriptions. Some extras policies cover medication that is not on the Pharmaceutical Benefits Schedule (PBS). Some rare forms of cancer require obscure medications meaning there's a chance you could be prescribed an expensive drug that Medicare doesn't cover.
- Rehab. Some extras policies will cover a host of treatments that help you recover, like physio, exercise physiology, speech therapy and even acupuncture.
- Ambulance. Many policies offer emergency ambulance cover. You can find this on both hospital and extras policies. This is unnecessary in states like QLD and TAS, which provide ambulance cover for residents.
You'll still have out-of-pocket costs with private health insurance, it's important to note.
Compare Private Health Insurance for Cancer Treatment
All prices are based on a single individual with less than $90,000 income and living in Sydney.
We update our data regularly, but information can change between updates. Confirm details with the provider you're interested in before making a decision.
What should I keep in mind when comparing health insurance for cancer?
If you're looking for the best insurance policy, here's a few things to consider:
- Get a Bronze policy or higher. All Bronze policies and above are required to offer treatment for cancer and you're unlikely to find private cover at levels below that.
- Consider your transportation costs. If you have to travel more than a certain distance for your treatment (around 200-250km), some private policies will cover some of your transportation and accommodation costs. This can be a great way to save on some of those costs that often fly under the radar but still add up.
- Don't forget your extras. An extras policy can offer a host of important treatments that can help you cope and recover like physical therapy, speech therapy and psychological counselling. It can even cover medications that Medicare doesn't.
- Look for a large network of agreement hospitals. Most private insurers have a network of private doctors and hospitals that have agreed to lower their out of pocket costs for their customers. Look for an insurer that has a wide network with lots of providers near you.
- Think about other services you might need. You might want to consider a policy with in-hospital psychiatry since cancer can take a toll on you mental health. Or you may have a family history of cancer and want to have children before any possible diagnosis. In that case you may want to consider a policy that covers pregnancy.
Waiting periods to be aware of for cancer treatment
Here are the typical waiting periods you can expect as a cancer patient:
- If you already have cancer. 12 months, since it's a pre-existing condition. It could still worth considering cover since you may have to wait for public treatment.
- If you don't have cancer. 2 months. If you haven't been diagnosed and haven't developed any symptoms, you can get treatment sooner.
How can I work out my out-of-pocket costs for cancer treatment?
Start by working out at all of the various treatments, procedures or consultations that you could encounter as a cancer patient.
Your ability to get public and/or private assistance is slightly different in each case. By looking at the options you have and the financial roadblocks you can encounter in each case, you can develop strategies that will help you minimise your out-of-pocket expenses as a whole.
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