Looking for the best* health insurance?

Compare policies from 30+ funds for 2017 to find the best* value cover that actually meets your needs

Are you looking for the best* health insurance policy? While it may seem a simple task, getting the best* private health insurance in Australia is a matter of perspective.

Why? Because what you think of as the best* medical insurance may not be the right cover for someone else. You might value a policy that provides you with comprehensive extra cover, while someone else may just be looking for cover to help them avoid paying the Medicare Levy Surcharge if you earn over a certain income.

Continue reading this guide to find out what to look for in a policy to make sure you're getting the best* value for your chosen health fund.

Compare policies from 30+ Australian health funds

What’s the best* type of health insurance?

The ideal health insurance policy is the cover that is best* for you, your family and your circumstances. In general, the fund should:

  • Have low or no gaps between what is covered by Medicare and what your insurance will pay
  • Come from a fund with a good industry rating, high retention rates and few complaints
  • Have only minimum waiting periods
  • Cover more procedures with no out-of-pocket expenses
  • Include lots of extras, benefits and discounts
  • Have lower management expenses as a percentage of premiums
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How do I choose the right health insurance policy?

The first question to ask yourself when choosing private health insurance is "Do I need it?". As an Australian, you already have hospital cover under the Medicare public health system. Whether you need more cover than this will depend on whether you want:

  • Treatment at a hospital of your choice
  • Your own doctor to treat you
  • A private or semi-private room
  • Elective surgery when you need it, rather than joining a waiting list
  • Cover for ancillaries not covered by Medicare

If you decide you do need private health insurance, choosing the right cover involves determining your needs and the level of cover each policy provides:

  • If you are young and single, hospital cover may not be a high priority, so you will need to find a policy with the best* cover for ancillaries such as optical and dental
  • If you have dependants, you will need to find a policy that provides the best* family cover, preferably with individual rather than overall capped benefit limits
  • If hospital cover is important to you, you will need to find a fund who has agreements with hospitals in your area and a policy that covers a high percentage of costs, so you don’t end up paying a large gap
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What type of extras cover do I need?

While hospital cover is there for when you need it, extras cover is an area where you can actually get something back on what you have paid out for things such as dental, optical and chiropractic services.

  • The benefit paid on such extras varies considerably with funds and you need to look carefully at what the benefit limits are on a policy to decide whether it offers good value for money. Basically, if you are paying out a lot more than you are getting back, you may need to look at adjusting your cover or finding another fund.
  • If you use one service more than most, such as requiring regular dental treatments, then you may want a policy that pays higher benefits in this area, rather than just paying a fixed premium for a range of services you barely use.
  • Also rather than paying a set amount for a service, look for policies that cover a percentage of your bill, the higher the better, as this provides better value, particularly if your healthcare fund charges above-average prices.
  • When shopping for the best* extras cover, also look for funds who offer discounts for using their preferred service funds, as this can work out much cheaper and also look for policies that include lifestyle cover, which can give you access to a range of health and lifestyle-related discounts.
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Can I switch health funds to find the best* cover?

Switching health insurance funds is easier than most people realise. Given that the cost of health cover is on the rise in Australia, there’s never been a better time to shop around and switch if necessary. If your current policy no longer meets your needs, if you’ve found a better deal or if your personal circumstances have changed, switching funds makes good sense. And you won’t be penalised for doing so. Providing your current policy is paid and up-to-date at the time of switching, your existing benefits will travel with you to the new fund. These include:

  • Your Lifetime Health Cover status. Your level of age loading will remain unchanged.
  • Your government rebate. Providing your level of cover isn’t changing, you will receive the same government rebate as you received previously.
  • Your waiting period exemption. If you have already served your waiting period, your new fund cannot make you serve a further waiting period.

The process of switching is fairly straightforward. Once you have found the fund and policy you want to switch to, you simply notify your current fund of your intention to switch. They will then send a Transfer Certificate to you or your new fund, which will confirm your level of cover and current waiting period and age loading status.

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How does my age affect my health cover?

 Your medical insurance needs change as you get older, which means that the best* health cover for you when you were 20 may not be the best* policy when you're 40

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How do I get the best* value for money?

The best* way to get value for money on your health insurance is to shop around. Comparing policies can reveal a variety of money-saving opportunities. Other ways to save include:.

  • Paying your premium in advance to avoid the administration fees associated with monthly payments
  • Paying by direct debit, which will earn you a discount with some funds
  • Paying a higher excess to lower your premium
  • Joining a restricted membership fund if you are eligible, as the premiums are usually lower and benefits to members higher
  • Taking out health cover through your super fund, as many negotiate discounts with health funds.
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Private vs public health insurance comparison


If you live in New South Wales or Australian Capital Territory, you may want to get ambulance cover as the only people that are provided with free ambulance cover are low income earners and pensioners. Emergency ambulance services are provided free by the State Governments of Queensland and Tasmania.

Private or public?Is ambulance covered?
Private health insurance
  • You can get ambulance cover from your health fund
  • Not covered


Private or public?What is or isn't covered?
Private health insurance
  • Choice of public OR a private hospital
  • Choice of your own doctor
  • Choice of hospital
  • Choice as to when you are admitted to hospital
  • Medicare will cover you for 75% of the Medicare Benefits Schedule (MBS) fee for associated medical costs
  • Treated at no charge
  • Treatment in public hospital by a doctor appointed by the hospital
  • Treated as a public patient
  • Private patient hospital costs
  • No choice of doctor or hospital
  • Medical and hospital costs incurred overseas
  • Medical services which are not clinically necessary
  • Surgery solely for cosmetic reasons

Extras (general treatment)

Medicare will reimburse 100% of the MBS fee for a general practitioner and 85% of the MBS fee for a specialist if you visit a doctor outside a hospital. If your doctor bulk bills then you wont pay a cent.

Private or public?What can you get benefits for?
Private health insurance 
    • Acupuncture
    • Chiropractic services
    • Eye therapy
    • Most physiotherapy
    • Speech therapy
    • Home nursing
      • Most dental examinations and treatment
      • Glasses and contact lenses
      • Occupational therapy
      • Hearing aids and other appliances
      • Podiatry or psychology services
    • Consultation fees for doctors
    • Most out of hospital surgery
    • Tests and examination
    • Some surgical procedures performed by approved dentists
      • Specific items under the Cleft Lip and Palate Scheme
      • Specific items under the Enhanced Primary Care (EPC) program
  • Other therapeutic procedures performed by doctors


Thanks to the Pharmaceutical Benefits Scheme (PBS), you only pay for a portion of the cost of prescription medications. The amount varies depending on the medication up to a standard maximum.

Private or public?Are pharmaceuticals covered?
Private health insurance
  • Private health insurance can cover non-PBS prescription medicines but you'll still need to make a co-payment towards the cost
  • Only those included listed on the PBS
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Important considerations

Remember it's important to compare your options and other financial avenues before applying.
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Health cover tips

In keeping with the theme of finding best* health cover for your needs, here are some tips you may find useful in your search:

  • Review your existing cover at least once a year, as a better deal may have come along in the meantime or your circumstances may have changed
  • Don’t be afraid to switch, as legislation now ensures your benefits and current status will travel with you
  • Mix and match your hospital and extras cover, as two different funds may have the best* offers on each
  • Select a higher excess if you can afford it and you feel you are unlikely to need hospital treatment in the near future, as this will reduce the cost of your premium
  • If insuring your family, look for a policy with individual benefit limits rather than overall capped limits on extras
  • Avoid hospital cover that has both an excess and a co-payment, otherwise you could end up paying a lump sum on admission and a further amount for every day you are in hospital
  • Make sure your policy includes full ambulance cover, not just emergency ambulance cover
  • To avoid paying a gap, make sure your preferred doctor and hospital both have agreements with your health fund

Compare policies from 30+ health funds and get the best* cover for you 

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2 Responses to Looking for the best* health insurance?

  1. Default Gravatar
    Michael | February 15, 2017

    Which private health insurance companies offer the best reimbursement of the cost of hearing aids?

    • Staff
      Zubair | February 16, 2017

      Hi Michael,

      Thank you for your question.

      If you would like to review the cover limits of Australian funds for hearing aids please head over to our health insurance for hearing aids article.


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