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Health.com.au hospital and extras insurance

Compare combined hospital and extras packages from health.com.au and get complete protection

Health.com.au provides simple and straightforward health care for all Australians. However, health needs are a very individual thing, and finding the right health insurance cover means getting a plan that focuses on your needs.

As such, health.com.au offers a range of hospital plus extras packages, each of which offers different cover and different options to suit different budgets.

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The combined plans

Starting weekly priceHospital coverExtras coverHospital ExcessExtras reimbursement
Simple Essentials 60$23.54BasicLow-Mid$50060%
Base Pulse$25.52BasicLow$50050% or 60%
Base$27.51BasicSome$50065% or 75%
Base Middle$29.20MidMid$50065% or 75%
Heart Basic$33.43Heartcare coverLow-Mid$250 or $50065% or 75%
Heart Middle$35.08Heartcare coverMid$50065% or 75%
Heart High$36.27Heartcare coverHigh$50065% or 75%
High$51.36HighHigh$0, $250 or $50065%, 75% or 85%

The hospital cover offered by each

The Simple Essentials plan only covers specific treatments, while the other plans cover all Medicare services except the specified exclusions of each.

The following are the only hospital treatments covered by this plan:

  • Accidents
  • Appendix, tonsil and adenoid removal
  • Wisdom teeth
  • Shoulder reconstruction
  • Knee reconstruction
  • yes - covered
  • no - excluded
Base PulseBaseHeart BasicHeart MiddleHeart HighHigh
Covers all non-excluded Medicare services
  • yes
  • yes
  • yes
  • yes
  • yes
  • yes
Excludes any Medicare services?
  • yes
  • yes
  • yes
  • yes
  • yes
  • no
Cardiothoracic
  • no
  • no
  • yes
  • yes
  • yes
  • yes
Podiatric surgeryRestrictedRestricted
  • no
  • no
  • yes
  • yes
RehabilitationRestrictedRestricted
  • yes
  • yes
  • yes
  • yes
PsychiatricRestrictedRestrictedRestrictedRestrictedRestrictedRestricted
Palliative care
  • yes
  • yes
  • yes
  • yes
  • yes
  • yes
Pregnancy
  • no
  • no
  • no
  • no
  • no
  • yes
Assisted reproduction
  • no
  • no
  • no
  • no
  • no
  • yes
Sterility reversal
  • no
  • no
  • no
  • no
  • no
  • yes
Cataract and eye lens
  • no
  • no
  • no
  • no
  • no
  • yes
Dialysis for chronic kidney failure
  • no
  • no
  • no
  • no
  • no
  • yes
Joint replacement, including spine and prostheses
  • no
  • no
  • no
  • no
  • no
  • yes
Bariatric surgery
  • no
  • no
  • no
  • no
  • no
  • yes
Spinal surgery
  • no
  • no
  • no
  • no
  • no
  • yes
Neurostimulators
  • no
  • no
  • no
  • no
  • no
  • yes
Insulin pumps
  • no
  • no
  • no
  • no
  • no
  • yes
Cochlear implants
  • no
  • no
  • no
  • no
  • no
  • yes

The extras cover

Simple Essentials 60Base PulseBaseHeart BasicHeart MiddleHeart HighHigh
General dental
  • yes
  • yes
  • yes
  • yes
  • yes
  • yes
  • yes
Major dental
  • yes
  • no
  • yes
  • yes
  • yes
  • yes
  • yes
Orthodontics
  • yes
  • no
  • yes
  • yes
  • yes
  • yes
  • yes
Optical
  • yes
  • no
  • yes
  • yes
  • yes
  • yes
  • yes
Emergency ambulance
  • yes
  • yes
  • yes
  • yes
  • yes
  • yes
  • yes
Physiotherapy
  • yes
  • yes
  • yes
  • yes
  • yes
  • yes
  • yes
Chiropractic and osteopathy
  • yes
  • yes
  • yes
  • yes
  • yes
  • yes
  • yes
Natural therapies
  • no
  • no
  • yes
  • yes
  • yes
  • yes
  • yes
Travel vaccinations
  • yes
  • no
  • yes
  • yes
  • yes
  • yes
  • yes
Non-PBS medication
  • no
  • no
  • no
  • no
  • yes
  • yes
  • yes
Remedial massage
  • no
  • no
  • yes
  • yes
  • yes
  • yes
  • yes
Dietetics
  • no
  • no
  • no
  • no
  • no
  • yes
  • yes
Podiatry
  • no
  • no
  • no
  • no
  • no
  • yes
  • yes
Psychology
  • no
  • no
  • no
  • no
  • yes
  • yes
  • yes
Occupational therapy
  • no
  • no
  • no
  • no
  • yes
  • yes
  • yes
Speech therapy
  • no
  • no
  • no
  • no
  • yes
  • yes
  • yes
Eye therapy
  • no
  • no
  • no
  • no
  • no
  • yes
  • yes
Healthcare appliances
  • no
  • no
  • no
  • no
  • no
  • yes
  • yes
Health maintenance
  • no
  • yes
  • yes
  • yes
  • yes
  • yes
  • yes
Health screening
  • no
  • no
  • no
  • no
  • no
  • yes
  • yes

What are the benefits of health.com.au combined plans?

There are a range of special features you can get with combined packages from health.com.au.

All extras (except Simple Essentials) reimburse you for health maintenance costs, such as gym memberships, and include emergency ambulance cover. Similarly, even the basic plans cover major dental and orthodontics, and may be a cost-effective way of finding the right extras cover with a cheaper combined plan.

The extras cover reimburses you for the following health maintenance expenses:

  • Gym memberships
  • Weight management programs
  • Yoga
  • Non-clinical Pilates
  • Psychotherapy and hypnotherapy
  • First aid courses

The Heartcare plans are only available as combined packages and include benefits especially suited for those with cardiac issues or who are worried about the ever-present chance of heart disease. This may be one of the more cost effective ways of getting cover for cardiothoracic surgery with even a basic-level hospital plan.

Health.com.au is an online only fund, which may help keep costs down, but you won’t be able to access over-the-counter services. However, live customer support service is available 24/7, and you can access your account online at any time to check your extras limits, make claims or ask questions of the live support team.

Limitations and waiting periods

Each of the cheapest plans has some cover limitations. The Simple Essentials 60 plan only offers a very limited range of hospital cover, but the extras cover extends to major dental, orthodontics, optical and other important inclusions.

With the Simple Pulse plan, you have a much higher level of hospital cover, but can only access some of the most basic extras cover and won’t have major dental or optical cover.

Restricted services also apply to all plans. Psychiatry, in particular, is not effectively covered to the full limits of hospital health insurance with any health.com.au cover level. For this, and any other treatments or services that are restricted under the terms of your policy, you can only claim benefits as a private patient in a public hospital and are not covered at private facilities.

It’s also important to note that hospital cover with all plans only extends to inpatient services. It is possible to find hospital cover for outpatient services with other providers.

Waiting periods also apply to all plans:

  • 1 day: Ambulance cover and accident cover
  • 12 months: Major dental, orthodontics, health appliances, pregnancy and all pre-existing conditions with hospital cover, except psychiatric, rehabilitation and palliative care which are 2 months
  • 2 months: Everything else

How to make claims

To claim in a public or contract private hospital, you can simply present your claims card. For services where this isn’t an option, you can make claims through the Medicare system, which can liaise directly with health.com.au.

To claim extras, simply swipe your membership card at providers with a HICAPS system, or make a claim online through the member’s area of the website.

How to make payments

To keep things streamlined, health.com.au lets you make payments through direct debit from a bank account or credit card and offers a 4% discount for doing so.

You can choose to pay fortnightly, monthly or quarterly, and pick the day on which you will need to make your payments. When you pay premiums, you’re paying in advance for the upcoming period to help ensure you’re covered continuously.

Receive quotes for health.com.au hospital and extras cover

Andrew Munro

Andrew writes for finder.com.au, comparing products, writing guides, sniffing out deals and looking for new ways to help people get the most out of their money.

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