Health insurance helps you cover the cost of private hospital treatments as well as some out-of-hospital services, such as benefits for dental. When choosing your health insurance, you can pick hospital, extras cover or a combined policy with both.
There are some key differences between Medicare and private health insurance.
| Medicare | Private health insurance | |
|---|---|---|
| Public hospital services |
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| Ambulance |
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| Private room or hospital |
|
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| Everyday health (dentist, physio, etc) |
|
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Have peace of mind, whether you want choice over your hospital or your surgeon, or you just want to feel safe in the knowledge that you’ve got protection.
Just want a basic policy that means you don’t get penalised? We got you. Health insurance means you can avoid fearing that claim form at tax time.
Don’t want to sit on a public waiting list for surgery? Private health insurance can help. You’ll be able to receive treatment quicker, in a private room and from a doctor that you choose.
If you get regular massages, physio treatments or you just like keeping your teeth in great condition, these out-of-hospital treatments are only covered by private health insurance.
It's up to you to decide what type of private health insurance you'd like cover for:
A hospital policy covers you for hospital procedures and accommodation, you can also choose your doctor. Hospital cover is also what you need to avoid the Medicare Levy Surcharge (MLS).
Health insurance hospital cover
Extras cover allows you to claim for out-of-hospital health services such as dental and physio. Extras pay either a set refund or a percentage refund.
A combined policy includes cover for both in and out of hospital services. They are often labelled as packages such as young couples - but you can also mix and match your own.
If you're visiting Australia to work (OVHC) or study (OSHC), you may need overseas visitor health cover. Whether you want basic visa requirements or comprehensive - there are many options.
Private health insurance is community rated meaning that no matter how old you are or whether you have any pre-existing conditions, everyone pays the same amount for the same cover.
The cost of health insurance comes down to the choices you make. A basic hospital policy can start from $16 a week and an extras policy from just $3 a week with April 2018 pricing.
There are ways that you can save a few dollars:
The Australian Government has introduced a number of schemes to encourage people who can afford private health insurance to take it out. Private health care takes the burden off the public health system so people who really need it can access it when they need to. There are a few schemes that may impact you.
Health insurance in Australia is changing. For more details on the upcoming healthcare reforms and what they mean for you, check out our detailed analysis or watch the 2-minute video below.
Yes, you can. Australian health funds offer a range of cover options for those moving to Australia. These policies are called Overseas Visitors Health Cover (OVHC) or Overseas Student Health Cover (OSHC). 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 a certain level of subsidised treatment from Medicare. Be aware that the benefits are very limited, with anything but the most vital medical services likely not covered.
Reciprocal Health Care Agreement countries
Each health fund is different, policy prices, services covered, annual benefit limits, excess options and sign up offers can vary. Follow these key steps when comparing:
ahm Deals
Get a gift card for up to $200 when you take out hospital & extras
Singles get a gift card of $100 and couples & families can get $200. Offer applies to new members signing up for a hospital and extras policy.
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Deal ends
myOwn Deals
Get free access to AIA Vitality when you sign up for health insurance
Includes up to 50% off Virgin Active and Fitness first gym membership.
Last verified
CUA Health Deals
4% discount on your health insurance premiums
Get 4% discount when paying from a CUA everyday account.
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Do any funds cover the cost of Intraocular Lenses to cure Cataracts please?
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
Please give me health funds which have a policy for NO pregnancy or infertility cover.
Hi Pauline,
Thank you for reaching out to finder.
The page we are on provides you a search box where you could check what cover you would need. As per the cover you want added to your policy, you may want to direct that over to the insurance provider if this is a cover that they could provide as well as how much it would cost to add this up to the policy you would want to purchase. Hope this helps!
Cheers,
Reggie
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.
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
As a couple over 50 we would like private hospital cover with general dental, optical, physio and chiro.. what is the best option?
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
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?
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/pregnancy-health-insurance
– https://www.finder.com.au/health-insurance/waiting-periods
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
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?
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
Hi, are quoted premiums before or after any Govt rebates?
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
What does the question “Do you qualify for a restricted fund?” mean.
Hi Steve,
Thanks for your inquiry. Restricted health funds are funds where membership is restricted to certain people. They are usually operated by industry or employment groups and are not-for-profit, being run solely for the benefit of their members. You can know more information on this page.
Best regards,
Rench
With premiums that keep increasing, I am now paying around $94 a month ($1128 per year) on something that I have never actually used over the last 6 years!
What is the actual consequence if I walked out of heath insurance (don’t mention hypothetical scenarios such as me getting into an accident)?
How much am I actually penalized on my tax?
Hello Shaun,
Thank you for your question.
If you would decide not to take on private health insurance, please be ready to face out-of-pocket costs if you do get hospitalised or need medical care and services. Out-of-pocket costs will vary greatly depending on the hospital you go to and the doctor or specialist they see.
As per being penalised for not taking out health insurance, yes would. Another reason Australians commonly take out private health insurance is to avoid financial penalties. Australia’s tax system encourages high-income earners to take out private health insurance as well as paying the 2% levy to help fund Medicare and the National Disability Insurance Scheme.
If you do not take out private health insurance, you will pay a 2% tax penalty called the Medicare Levy Surcharge.
Hope this helped.
Cheers,
Gru
I am 76 years old. What do I need to cover with private health insurance that I am not covered for as a pensioner? Thank you.
Hi Aleisha,
Thanks for reaching out.
Medicare does not provide cover for the following:
– most dental examinations and treatment,
– most physiotherapy, occupational therapy, speech therapy, eye therapy, chiropractic services, podiatry or psychology services,
– acupuncture (unless part of a doctor’s consultation),
– glasses and contact lenses,
– hearing aids and other appliances
You may, however, arrange private health insurance to cover many of these services. You may compare health insurance for seniors over 70 on this page. Please make sure to click the “More Options” button to select the correct age range, before clicking the “Search Policies”.
I hope this has helped.
Cheers,
Liezl