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Health Insurance Finder® helps you compare policies from 30+ funds in Australia.
Private health insurance helps towards the cost of healthcare. It's split into 2 sections – hospital cover and extras – which both do different things.
Just remember, 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 find the best health insurance for you and your family.
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.
The cost of private health insurance varies, but we crunched the numbers from 10+ Australian funds to see what you'll have to pay for hospital and extras cover per month, depending on the level of cover you choose.
Tier | Average | Treatments 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 cover | Average | Included 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 Cover for 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.
Store | Discount | |
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Want 6 weeks free? Plus 2&6 month waits on extras waived? New members only. Offer ends May 31. T&Cs apply. Last verified |
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Get 6 weeks free on eligible Hospital and Extras cover with HBF Join HBF by 3 July 2022 on eligible Hospital and Extras cover and get 6 weeks free after 4 months. T&Cs apply. Last verified |
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Want 6 weeks free? Plus, any 2&6 month waits on extras waived New joins on eligible hospital & extras by June 30. Find out how. Last verified |
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Join and earn up to 110,000 Qantas Points Quality health cover, plus rewards? Join Qantas Health Insurance and it could all be yours. Eligibility criteria and T&Cs apply. Last verified |
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Get 6 weeks free + Waive 2 & 6 months waiting periods Join hospital only or combined hospital & extras cover by 30 June 2022 for new members. Last verified |
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Get $100 gift card + 10% off on extras premium (with combined cover) Join hospital only or combined hospital & extras cover for new members. T&Cs apply. Last verified |
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Get up to $200 cash card. PLUS 2-month waits on extras waived Offer applies for new joins on hospital and extras by 31 May. T&Cs apply. Last verified |
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Get one month free Plus waive 2 & 6 month waits on extras when joining on combined cover by June 30. T&Cs apply. Last verified |
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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 | |
---|---|---|
Doctor | A public hospital will allocate a doctor for you. You don't get to choose. | You can choose which doctor you see. |
Private room | You'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 lists | Waiting 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 types | Medicare 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 costs | In 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. |
Almost every health insurance policy is different, so it's not a case of comparing apples with apples. Instead, you have to look at the bigger picture.
✅ Look at the tiers. Hospital cover comes in tiers: Gold, Silver, Bronze and Basic. This can help you decide what's best for you. If you're just looking to avoid tax, a basic policy might be enough, but for treatments like cataracts, you'll need a gold policy.
✅ Consider hospital and extras separately. While a combined health insurance policy might be simple, you could save money and get better suited cover by taking out separate extras and hospital policies – maybe from different funds!
✅ Look at the benefits. This seems obvious, but look at the specific benefits that are included in your policy. For example, if you need health insurance for pregnancy, you'll need a hospital policy that includes it. If you're choosing extras, run through exactly what you can claim for. If you want hospital, check the treatments you care about are covered.
✅ 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 health 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.
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:
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Hi,
Are there any such plans that cover foreign hospital treatments for people seeking treatment for cancer? I have pre-existing medical conditions and looking for health cover for overseas treatment. Please advice.
Hi John,
Unfortunately, most domestic health insurance policies don’t offer cover for treatment needed outside of Australia. However, travel insurance that specifically covers overseas medical expenses may help.
Make sure you read each policy’s Product Disclosure Statement (PDS) with care so that you know what cover is available.
Also, check to see if there are any reciprocal healthcare agreements in place between Australia and each country you’re intending to visit.
Regards,
James
Hi John,
Unfortunately, most domestic health insurance policies don’t offer cover for treatment needed outside of Australia. However, travel insurance (https://www.finder.com.au/travel-insurance) that specifically covers overseas medical expenses may help. Make sure you read each policy’s Product Disclosure Statement (PDS) with care, so that you know what cover is available.
Also, check to see if there are any reciprocal healthcare agreements in place between Australia and each country you’re intending to visit.
Regards,
James
I would like a real time answer to my request for cover .
Hi Robert,
Can which cover you are referring to, please? I’ll wait for your response. If possible, please return to our website and click on the chat button found on the lower right corner of our to chat with us in real-time.
Moreover, please feel free as well to get in touch with the specific insurer you have chosen. They should be able to provide you with more details of the cover you’re interested in.
Regards,
James
What is the best health insurance that pays well for natural therapies that is needed weekly
Hi Maureen,
Thanks for your comment and I hope you are well!
You can compare and choose health insurance for natural therapies. You can use our comparison table that shows the amount of cover offered by each for natural therapy service. While choosing, don’t forget to read each insurer’s limit, type of policy, price and etc. You can press the ‘Go to site’ button which brings you to the provider’s official page to get a quote and start your application. 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 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
Is there any available private insurance package that covers beauty and plastic surgeries? What package is the most applicable for those procedures?
Hi Maria,
Thanks for getting in touch with Finder. I hope all is well with you. 😃
In most cases, elective cosmetic procedures are not covered by health insurance policies. However, reconstructive plastic surgery is likely to be covered. We do have a guide about health insurance covering cosmetic surgery. On the page, you will know which health funds cover medically necessary plastic surgery.
If you are after health insurance that covers elective surgery, your options might be limited. You may want to fill out our health insurance search form. You can ask the insurers directly whether they cover elective cosmetic surgeries or not.
I hope this helps. Should you have further questions, please don’t hesitate to reach out again.
Have a wonderful day!
Cheers,
Joshua
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 ?
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