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Health Insurance Reviews

Unsure of where to begin when comparing health insurance reviews? Get some straightforward advice on how to pick the right policy for you.

Health insurance reviews can be useful when comparing policies and insurers. They can tell you at a glance the features and benefits of a policy, and if they are unbiased, they can also point out any shortcomings.

This guide looks at what you need to know before you start reading reviews, what to look for when you do and what the most commonly used terms actually mean.

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What should you think about before comparing?

Before you can begin to compare policy reviews, it’s important to know what kind of health cover you need. This will depend on factors such as:

There are two main types of private health cover available, hospital cover and extras cover, and you will need to decide whether you require one or both and in what proportions. Both are available in three main levels of cover, basic, intermediate and comprehensive, and the level you opt for will depend on your budget and healthcare needs.

Once you have determined the type and level of cover you need, you can then begin comparing health insurance reviews to see which insurer and policy offers you the features you want at the most competitive price.

Are there any specific policy features to look for?

The policy features you value will depend on your individual healthcare needs, but a good combined hospital and extras policy will typically:

In addition, the insurer providing the cover should have a good reputation, a good industry rating, a good claims payment record, high retention rates and few complaints. While a single review may not tell you all this, a quick browse of industry sites and forums will soon reveal whether the insurer is well regarded by consumers.

What traps should I watch out for when reading reviews?

Policy reviews should always be taken with a grain of salt. They provide a general insight into a policy’s features and they may downplay or fail to mention certain other features, depending on who the author is. Things to be aware of when reading a review include:

  • The exclusions. Are they clearly outlined or at least easily accessible via a link to the product disclosure statement (PDS)?
  • The restrictions. Do the restricted benefits, waiting periods and benefit limitation periods overly restrict the extent of cover?
  • The extras benefits. Are there combined annual limits for extras or does the policy ideally pay individual limits as a percentage of the fee?
  • The hospital excess. Is the excess payable once for all hospital admissions in a year or every time you are admitted, and is it in addition to a co-payment (daily fee)?
  • The service providers. Are you required to use an insurer’s preferred provider network and is this practical in your circumstances?

It’s important to be aware of who has written the review, as a negative review may come from a disgruntled customer or competing provider and a glowing review may have come from the insurer themselves or from a writer paid to provide such health insurance reviews. To ensure you get the full picture, you should always read the PDS before committing to any policy.

How do I get the best value for money from my health insurance?

As well as finding the best policy for your needs by reading and comparing health insurance reviews, other ways to get value for money from your health insurance include:

  • Paying your premium annually to avoid paying admin fees.
  • Paying before the annual CPI increase (31 March) to lock in your current rate for another year.
  • Paying by direct debit, which can earn you a discount.
  • Increasing your excess to lower your premiums.
  • Joining a restricted membership fund to enjoy lower premiums and higher benefits.
  • Customising your policy so you only pay for treatments and services you may need.
  • Looking for policies that offer incentives such as loyalty discounts and gap-free extras and no hospital excesses for kids.
  • Avoiding the Medicare Levy Surcharge (MLS) and the Lifetime Health Cover (LHC) loading by taking out adequate hospital cover before you turn 31.
  • Claiming the Private Health Insurance Rebate to reduce the cost of your health insurance.

Health insurance terminology explained

To better understand policy reviews, it’s important to know the health insurance jargon. The following is a summary of the most common terms:

  • Excess. The amount you choose to pay towards your hospital treatment, which is payable at the time of admission. Typically, the higher the excess, the lower your premium will be.
  • Benefit limitation period. An initial period when only limited benefits are payable on some types of treatments.
  • Co-payment. An amount you agree to pay towards your daily hospital care in return for a lower premium.
  • Exclusion. A treatment or service that is not covered by your policy and for which a benefit will not be paid.
  • Gap. The difference between the service provider’s fee and the combined Medicare and health insurance benefit paid (an out-of-pocket expense).
  • Lifetime Health Cover (LHC) loading. A government initiative to encourage you to take out hospital cover early in life. Every year from your 31st birthday that you don’t have cover, your premium cost will increase by 2% up to a maximum of 70%.
  • Private Health Insurance Rebate. An income-tested government rebate for those with private health cover to assist them with the cost of premiums.
  • Medicare Levy Surcharge (MLS). A means-tested, income-based tax of between 1% and 1.5% levied on those earning above a certain amount who don’t have private hospital cover.
  • Pre-existing medical condition. A medical condition you are aware of prior to joining a health fund, which typically attracts a 12-month waiting period.
  • Waiting period. The amount of time you must wait after taking out health insurance before you can receive a particular benefit. The maximum waiting period is usually 12 months.

Compare health insurance policies from Australian providers

Details Features
High 65 / 75 / 85% - $0/$250/$500 Excess
High 65 / 75 / 85% - $0/$250/$500 Excess
Combines High Hospital Cover with its highest level of extras cover.
  • Cover starting from $44.74 weekly
  • 12 month waiting period for pregnancy
  • 65% back on extras
  • Choice of $0, $250 and $500 excess
Enquire Now More info
Premier Package
Premier Package
Top tier combined hospital and extras policy that covers you for an extensive range of hospital and general treatment services.
  • All the benefits of HCI's Premier Hospital policy
  • All the benefits of HCI's Premier Extras policy
  • Cover for pregnancy and IVF treatment
  • Cover for general and major dental
Get Quote More info
Deluxe flexi
Deluxe flexi
Deluxe flexi provides cover for a range of treatments including hip replacement, spinal fusion, dialysis and major eye surgery.
  • No excess for kids
  • All joint replacements
  • Major eye surgery
  • Rehabilitation
Enquire Now More info
GoldStar
GoldStar
Premium hospital cover with complete cover for hospital expenses. Save 4% when you pay for 12 months of your cover upfront.
  • All theatre fees covered
  • Unlimited maternity cover
  • Choose no excess or $200, $400, $500 per admission
Get Quote More info
Smart Combination
Smart Combination
Smart combination provides a high level of cover for both hospital and extras.
  • Claim up to $2725 back on extras
  • Hip and knee replacements
  • General and major dental
  • Physio
Enquire Now More info
Prestige
Prestige
Highest level of combined cover offered by CBHS. Includes the same benefits as Comprehensive Hospital and Top Extras plus more. Restricted fund: Only current or former staff (and their families) of Commonwealth Bank Group and their subsidiaries which include Aussie, Bankwest, Colonial First State and more can join.
  • No excess or co-payments on hospital cover
  • Non-student dependent under 25 can be kept on policy
  • Access to Chronic Disease Management Programs
  • Widest range of extras including orthodontics
Enquire Now More info
Bronze Hospital (no pregnancy) and Bronze Extras Set Benefits
Bronze Hospital (no pregnancy) and Bronze Extras Set Benefits
High level of hospital cover and extras cover for a range of popular services including knee and should reconstructions.
  • Most comprehensive hospital options
  • Cover for general and major dental
  • Shared or single room in a private hospital
  • Intensive and coronary care
Enquire Now More info
Premium Hospital and Silver Extras Cover
Premium Hospital and Silver Extras Cover
Comprehensive hospital cover including pregnancy cover. Also included affordable mid-level extras cover for dental, optical and therapies.
  • Cover from $39.50 per week
  • Pregnancy and birth-related services cover
  • Heart surgery cover
  • 100% cash back on two dental check per year
Enquire Now More info
Top Hospital with Top Extras
Top Hospital with Top Extras
Get comprehensive hospital and extras cover and tailor your policy to your needs.
  • Pregnancy and birth services cover
  • Back surgery cover
  • $1000 general dental annual limit
  • $600 physiotherapy annual limit
Enquire Now More info
Young Couples Combined Cover
Young Couples Combined Cover
Mid-level hospital and basic level Extras package with an excess for young, healthy couples that are not quite ready to start a family.
  • Emergency ambulance cover
  • Cancer-related surgery cover
  • 70% back on extras
  • $300 dental annual limit per person
Enquire Now More info

Picture: Shutterstock

Richard Laycock

Richard is the senior insurance writer at finder.com.au and is on a mission to make insurance easier to understand.

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