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Why compare private health insurance with Finder?

  • We don't ask for your phone or email to see prices.
  • With one click you can open up your results to nearly every fund in Australia.
  • You pay the same price as going direct, we charge no fees.

What is private health insurance?

Private health insurance helps towards the cost of healthcare. It's split into two sections – hospital cover and extras – which both do different things.
  • Hospital cover pays toward certain treatments you receive in a private hospital, such as joint reconstructions, hernia operations and even childbirth.
  • Extras cover helps towards out-of-hospital healthcare, such as dentists, opticians and physiotherapists.

Just remember though – not all private health insurance policies are created equal. Some will only cover a few treatments while others will cover lots. That's why it's so important to compare policies and make sure you're getting good value for your money.

How does private health insurance work?

Hospital and extras work in different ways, so it's a good idea to start thinking of them separately. Here's a rundown of how they each work:

In the public system, prices are set according to the Medicare Benefits Schedule (MBS) and Medicare pays 100% of the cost. You won't be left out of pocket, but you won't get your choice of hospital, doctor or appointment time either.

In the private system, prices are usually higher than those listed in the Medicare Benefits Schedule and Medicare will only pay 75% of what it would have, had you gone public. Your private health insurance covers the remaining 25%.

If your private doctor charges more than a doctor in the public system, which is usually the case, you'll have to cover the extra expense.

Remember, with hospital insurance, you'll also have to serve waiting periods. For example, if you have a pre-existing medical condition, you'll have to hold your policy for at least a year before your health insurance would chip in towards the cost of treatment.

Extras insurance helps towards non-hospital-related healthcare, such as dental work, new glasses and physiotherapy appointments.

Usually, an extras policy will pay a percentage of your bill – this could be anywhere from 50% to 90%. In other cases, they will cover the whole bill, up to a certain amount.

Extras policies also have waiting limits. For example, you often need to hold a policy for a year before you can claim for orthodontics.

How much does private health insurance cost?

That depends on the level of cover you get. Most health funds in Australia offer budget, mid-range and premium options for both hospital and extras health insurance.

We crunched the numbers from over 10 Australian health funds to give you an idea of what you can expect to pay each month, depending on the level of cover you choose.

Hospital tierAverageTreatments included
Basic$79.86
Ambulance cover
Bronze$90.87
Joint replacements, adenoids and cancer
Silver$126.81
Dental surgery, lung, chest and heart issues
Gold$170.90
Pregnancy, IVF and weight loss surgery
Extras coverAverageIncluded benefits
Low$12.85
One no gap dental check-up
Physio
Middle$34.95
Approximately $600 dental limit
Optical, physio, massage and major dental
High$81
No waiting periods on dental and optical
All the above plus hearing aids, laser eye

Prices quoted are based on a single policy in Sydney, earning less than $90,000 with a $500 hospital excess from August 2020.

How do I compare health insurance plans?

Almost every health insurance policy is different, so it's not a case of comparing apples for apples. Instead, you have to look at the bigger picture.

✅ Look at the tiers. If you want hospital insurance, look at what's covered by the different tiers. This is the best way to figure out which tier is right for you. If you're just looking to avoid tax, your needs will be very different from someone who is planning on starting a family.

✅ Consider hospital and extras separately. It's easy to go for a combined package, but choosing policies separately means you can mix and match your level of cover. You can also go with different funds if you prefer.

✅ Look at the benefits. This seems obvious, but look at the specific benefits that are included in your policy. If you're choosing extras, run through exactly what you can claim for. If you want hospital, look out for extra benefits in 'plus' policies.

✅ Look at the limits. Extras policies will have annual limits on the amount you can claim. A higher limit may mean a more expensive policy, but not always.

✅ Look at waiting periods. Both extras and hospital policies will come with waiting periods. That means you won't be able to claim instantly. Look for policies with shorter waiting periods or offers which let you skip certain waiting periods.

✅ Switch and use deals. There are no real downsides to switching funds, as you can carry over your waiting periods and potentially save money too. Make sure you check out any sign-up deals every time you switch.

4 benefits of health insurance

Hospital
Choose your hospital

Pick where you go and enjoy a private room while you're there. You can even choose your preferred doctor.
Waiting list
Skip waiting lists

Public waiting lists can stretch months or even years. Go private, and be seen in a matter of days or weeks.
Percentage
Save on tax

If you're earning over $90k, private hospital insurance is a quick way to shave money off your annual tax bill. Easy.
Heart
Peace of mind

Rest easy knowing you'll be top of the list if anything goes wrong, so you can get back to normal in no time.

Compare types of private health insurance

It's up to you to decide what type of private health insurance you'd like cover for. Here's how many Australians have health insurance in 2019.

Hospital

44.5%

of Australians have purchased hospital cover.

Molar

53.8%

of Australians have purchased extras cover.
Heart

Hospital only

This covers private hospital procedures, performed by a private surgeon. It's also what you need to avoid the Medicare Levy Surcharge (MLS).

Learn more

Ambulance

Extras only

Extras cover will give you rebates for treatments you have outside of the hospital. For example, visiting the dentist or getting a new pair of prescription glasses.

Learn more

Combined

Combined

A combined policy includes both hospital and extras. These are often labelled as packages such as "healthy start".

Learn more

Public vs private health insurance comparison

Not sure if private health insurance is worth it? Here are some key differences between the public and private healthcare systems in Australia:

Public system Private health insurance
DoctorA public hospital will allocate a doctor for you. You don't get to choose.You can choose which doctor you see.
Private roomYou'll likely end up in a shared room in a public hospital.Insurance gives you access to a private room if there's one available.
Waiting listsWaiting lists for elective treatments can range from a few weeks to a few years.Private insurance usually involves a shorter wait. For some procedures, you may even be able to pick your date.
Treatment typesMedicare doesn't cover most dental, hearing aids or other out-of-hospital treatments.Extras can give you cashback on out-of-hospital services such as optical, dental, psychology and hearing aids.
Ambulance costsIn most cases, Medicare won't pay for your ambulance except in Queensland and Tasmania.Most health funds include cover for an emergency ambulance, even on Basic policies.

What impacts the cost of health insurance?

Health insurance is community rated which means you don't have to pay more for pre-existing conditions and the price you pay isn't impacted by your age.

However, here are a few things that can impact your quote:

  • Lifetime Health Cover (LHC) loading. If you haven't taken out private health cover by the time you turn 31, you'll have to pay 2% extra for each year you were uninsured when you do eventually take it out.
  • Medicare Levy Surcharge (MLS). This is an additional tax penalty ranging from 1–1.5% of your annual income, depending on how much you earn, and is applied every year that you do not have an adequate private health insurance policy.
  • Private health insurance rebate. One of the major benefits of having private health insurance is being able to claim the private health insurance rebate. The rebate is determined by your age, your relationship status and your income.
  • Your excess or co-payment. When you take out insurance, you can agree to take some responsibility for the health cover costs in return for lower premiums – this is your excess. You only pay it if you go to hospital. The higher your excess, the lower your premiums will be.
  • Your location. If you live in a regional area of Australia, your insurance might cost you more due to poorer access to health facilities as well as potential travel and accommodation expenses.
  • Which fund you choose. Use the new tiered structure – Basic, Bronze, Silver and Gold. If you shop around, you can find more affordable providers and better value for money.

Not an Australian resident? Here's what you need to know.

Without health insurance, you could end up facing huge medical bills should you need the hospital during your stay. The type of cover you need will depend on your visa. However, people from countries that Australia has a Reciprocal Health Care Agreement with can access some treatment from Medicare.

Reciprocal Health Care Agreement countries

RHCA countries that don't require health insurance

Live sign-up deals for health insurance

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HCF members can get loyalty rewards and discounts across Australian stores

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Questions you may have about health insurance

Who offers health insurance in Australia?

How many Australians have health insurance?

There are just over 13.5 million Australians with private health insurance. That's over half (54%) of the country's population.

How do I find health insurance for specific treatments?

Thanks to the most recent PHI reforms, which have introduced Basic, Bronze, Silver and Gold tier policies, finding cover for a specific service is easier than ever. Every tier is required to provide cover for specific services so you can check out what is included in each and select the one that covers the treatment you require.

Compare your options in our guides designed for specific treatments:

What happens if I cancel health insurance?

If you cancel your health insurance, you won't be entitled to the services you would have otherwise had access to. This means you would have to pay out of your own pocket for a trip to the hospital.

Do I have to re-serve waiting periods if I switch?

You often won't have to re-serve waiting periods if you had similar or equivalent cover with another provider. However, if you're upgrading or didn't previously have cover for a service that your new policy includes, you will probably have to serve a waiting period.

Is health insurance tax-deductible?

The Medicare Levy Surcharge (MLS) is a rebate based on your and your family's income and any dependants. Depending on your income, you may be entitled to a private health insurance offset at tax time or reduced insurance premiums.


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43 Responses

    Default Gravatar
    MaureenNovember 7, 2019

    What is the best health insurance that pays well for natural therapies that is needed weekly

    Reply
      Default Gravatar
      NikkiNovember 8, 2019

      Hi Maureen,

      Thanks for your comment and I hope you are well! You can compare and choose health insurance options for natural therapies on our page HERE. While choosing, don’t forget to read each insurer’s limit, type of policy, price and etc. You will see the green GO TO SITE button which actions to bring you to the provider’s official page to get a quote and start your application. The following table shows the amount of cover offered by each for natural therapy service. If you need more options, you may utilize the online form that can be found further down the page. An insurer will contact you upon receipt of your inquiry. At this point, you can also let them know that you would need a weekly therapy.

      As a friendly reminder, carefully review the Product Disclosure Statement of the product before applying. You may also contact the insurance provider should you have any questions about their policy.

      Hope this helps and feel free to reach out to us again for further assistance.

      With care,
      Nikki

      Reply
    Default Gravatar
    MariaJuly 13, 2019

    Is there any available private insurance package that covers beauty and plastic surgeries? What package is the most applicable for those procedures?

    Reply
      Avatarfinder Customer Care
      JoshuaJuly 14, 2019Staff

      Hi Maria,

      Thanks for getting in touch with Finder. I hope all is well with you. 😃

      That’s an interesting question, Maria.

      In most cases, elective cosmetic procedures are not covered by health insurance policies. However, reconstructive plastic surgery is more likely to be covered.

      We do have a guide about health insurance covering cosmetic surgery. Please check this page. On that page, you will know which health funds cover medically necessary plastic surgery.

      However, if you are after health insurance that covers elective surgery, your options might be limited. You may still want to fill out the form found on this page to get in contact with health insurers. From there, you can ask them directly whether they cover elective cosmetic surgeries or not.

      I hope this helps. Should you have further questions, please don’t hesitate to reach us out again.

      Have a wonderful day!

      Cheers,
      Joshua

      Reply
    Default Gravatar
    SURINDERMarch 10, 2019

    Hi there , is there a health fund which allows me to use my total benefit where ever i like to spend ,instead of their own set breakdown ?

    Reply
      Avatarfinder Customer Care
      JohnMarch 11, 2019Staff

      Hi Surinder,

      You can look for a combined limit on many extras, as an example, AHM just give you one year limit to use. If you use the comparison above, you can see an individual breakdown of every funds policy limits – hope this helps!

      Cheers,
      Reggie

      Reply
    Default Gravatar
    DavidFebruary 19, 2019

    Do any funds cover the cost of Intraocular Lenses to cure Cataracts please?

    Reply
      Default Gravatar
      NikkiFebruary 20, 2019

      Hi David,

      Thanks for getting in touch! Here is our page that talks about health insurance for major eye surgery. Hope this was helpful. Don’t hesitate to message us back if you have more questions.

      Best,
      Nikki

      Reply
    Default Gravatar
    PaulineFebruary 10, 2019

    Please give me health funds which have a policy for NO pregnancy or infertility cover.

    Reply
      Avatarfinder Customer Care
      JohnFebruary 11, 2019Staff

      Hi Pauline,

      Thank you for reaching out to finder.

      Yes – it’s only top-level hospital cover (Gold or the occasional Silver Plus) that include pregnancy in the policy, by comparing Silver policies, or below – these won’t include pregnancy.

      Cheers,
      Reggie

      Reply
    Default Gravatar
    NikkoJune 20, 2018

    How to combine two existing top (premium) health cover policies from adult single to a couples when both are with separate insurers? Wish to compare which of these two insurers would best cover the two of us as a couple whilst neither one loses benefits or has a waiting period. We both have been with our respective health providers for over ten years continuously.

    Reply
      Avatarfinder Customer Care
      JeniJune 21, 2018Staff

      Hi Nikko,

      Thank you for getting in touch.

      If you’re currently on separate policies, the first step would be to see if you can save any cash by combining your policies – we’ve added a bit of info on that here https://www.finder.com.au/health-insurance/couples – it doesn’t always work out cheaper and it’s probably worth a closer look.

      With your waiting periods, they are different for hospital cover and general treatment (extras) cover. All of your hospital waiting periods that you’ve already served travel with you to the new policy – so if you do decide to combine your policies, you should be covered.

      Keep in mind, you’ll still have to serve waiting periods for any new benefits that you didn’t have before (such as pregnancy cover and also extras).

      If you already have a preferred health fund from your two options – it may be worth giving them a call as they can move you onto one package.

      I hope this helps. Please feel free to reach out to us if you have any other enquiries.

      Thank you and have a wonderful day!

      Cheers,
      Jeni

      Reply
    Default Gravatar
    SusanMay 25, 2018

    As a couple over 50 we would like private hospital cover with general dental, optical, physio and chiro.. what is the best option?

    Reply
      Default Gravatar
      NikkiMay 25, 2018

      Hi Susan,

      Thanks for getting in touch with finder.

      You may view this page to check on health insurance for over 50s.

      Hope this was helpful.

      Cheers,
      Nikki

      Reply
    Default Gravatar
    KevinMay 24, 2018

    Hi there. My wife is already pregnant and the pregnancy insurance waiting period is 12 months!! So how does PHI work to cover her when she is giving birth? What is the solution around this?

    Reply
      Avatarfinder Customer Care
      JhezMay 25, 2018Staff

      Hello Kevin,

      Thank you for your comment.

      To be qualified for the private health insurance you’re advised to take out the policy in advance before attempting to conceive. Most Australian private health funds have a 12 month waiting period for obstetric services.

      This is explained on these pages:
      – https://www.finder.com.au/health-insurance/pregnancy-health-insurance
      – https://www.finder.com.au/no-waiting-period-health-insurance

      I am afraid that no PHI will consider your wife’s condition as she is already pregnant, however, you can still contact the insurer directly and see what options they can offer you. I hope this helps.

      Regards,
      Jhezelyn

      Reply
    Default Gravatar
    JoApril 19, 2018

    How does Defence Health compare to other health funds in terms of value for money – cost of premium to rebate received. The mo they premium certainly appears a lot higher than other funds but do the rebates reflect that?

    Reply
      Avatarfinder Customer Care
      JeniApril 22, 2018Staff

      Hi Jo,

      Thank you for getting in touch with finder.

      Defence Health offers a range of health insurance options to more than 235,000 Australians with Defence connections. With hospital and extras cover to suit everyone from the young and healthy to those who need comprehensive protection, it provides affordable cover and peace of mind.

      You may want to know more by clicking on this link.

      I hope this helps.

      Have a great day!

      Cheers,
      Jeni

      Reply
    Default Gravatar
    MarcoMarch 19, 2018

    Hi, are quoted premiums before or after any Govt rebates?

    Reply
      Default Gravatar
      NikkiMarch 26, 2018

      Hi Marco!

      Thanks for your question and for visiting finder.

      Quoted premiums are before government rebates. Rebate rates are subject to change based on the cost of living and the average health insurance premium amount. It would be helpful to check with your health insurance provider on their ongoing rates as well.

      Hope this helps!

      Thanks and best regards,

      Nikki

      Reply
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