Health.com.au health insurance

health.com.au Health Insurance

Compare health.com.au policy options online and get cover that's right for you.

If you want to ensure you can get the health care you need when you need it, private health insurance covers a wide range of treatments and procedures and allows you to choose your doctor and your hospital. health.com.au is an online health insurance provider that offers cover for singles, couples, single parents and families. From entry and mid-level cover through to policies that provide comprehensive protection, it offers covers to suit a range of requirements and budgets.

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Complete the form and you'll be contacted by a health.com.au consultant for an obligation free discussion about your health insurance options.

The consultant will work with you to compare policies available from health.com.au and assist with your application if you wish to apply.

Joining health.com.au

Membership of health.com.au is open to anyone who meets the basic requirements for private health insurance. This means you must:

  • Be 16 years or older in order to take out your own policy. If not, you will be deemed a dependant under a family or single parent policy.
  • Not hold the same policy with another insurer and health.com.au concurrently.
  • Meet Medicare’s residency and eligibility requirements.

It’s also worth noting that health.com.au does not offer any cover for those who are visiting Australia temporarily on a 457 visa. If you’re eligible to join, health.com.au offers a huge range of cover options from budget right through to comprehensive. The available options are: Extras 50, Simple Essentials 60, Base Hospital, Base, Base Middle, Heart Basic, Heart Middle, Heart High, High Hospital and High. Having won the ServiceRage Customer Award for the happiest health insurance customers in 2014, health.com.au prides itself on customer service. As an online company, it’s open 24/7 and offers a wide range of other benefits to its customers.

health.com.au insurance options

Extras 50

  • This basic level of extras cover sees health.com.au pay for 50% of the cost of a wide variety of general treatments including general dental, major dental, orthodontics, optical, physio, chiro, osteo, massage and natural therapies, non-PBS prescriptions, dietetics, health maintenance and emergency ambulance transport.

Simple Essentials 60

  • This policy offers a combination of entry-level hospital and extras cover for young singles and couples. A $500 hospital excess applies and you will receive cover for 60% of your extras bills, while services like wisdom tooth removal, knee reconstructions and appendix removal are all included.

Base Hospital

  • This standalone hospital cover covers the essentials for healthy people, including everything from tonsil removal to knee and shoulder reconstructions. Emergency ambulance transport is also covered and you can choose between an excess of $500 excess.

Base

  • Combining basic hospital and extras cover, this entry-level policy has all the same features of Basic Hospital listed above. It also adds basic cover for treatments like dental, major dental, orthodontics, physio, chiro, osteo, natural therapies and remedial massage.

Base Middle

  • This policy also features Basic Hospital Cover and 65% or 75% Extras back on a wide range of extras at your choice of provider. Dental, major dental, orthodontics, physio, chiro, osteo, natural therapies and remedial massage are all covered.

Heart Basic

  • This option combines basic extras cover (65 or 75% back on a wide range of treatments) with a range of commonly claimed hospital services including accidents, tonsils, wisdom teeth and knee reconstructions. Cover for cardiothoracic surgery is also included.

Heart Middle

  • This offers the same range of hospital cover as the above policy but combines it with cover for a wider range of extras. You can receive 65 or 75% back on everything from dental and optical through to travel vaccines and occupation or speech therapy.

Heart High

  • HeartCare Hospital is once again included in this policy but is combined with a much broader range of extras cover. You can enjoy cover for 65 or 75% of your bills for everything from optical and dental to speech therapy, eye therapy and psychology.

High Hospital

  • This standalone hospital cover offers a high level of protection to members. It includes pregnancy cover and assisted reproductive services, as well as cover for everything from knee reconstructions to dental surgery, cataract procedures and spinal fusion.

High

  • This final policy option combines health.com.au’s High Hospital Cover with its highest level of extras cover. You can choose to receive 65, 75 or 85% back on a wide range of extras, including everything from dental, optical and physio to dietetics, podiatry and healthcare appliances.

Are there any additional benefits?

  • Every health.com.au policy features emergency ambulance cover to offer extra peace of mind.
  • 24/7 customer support. Email, phone and live chat customer support are offered 24 hours a day, seven days a week.

General exclusions and waiting periods that may apply

health.com.au will not pay your claim if:

  • It is for a service for which no Medicare benefit is payable, for example cosmetic surgery.
  • It is for treatment received more than two years prior to the date you lodge your claim.
  • It is for services received outside of Australia.
  • It is for a service or procedure specifically excluded from your policy.
  • It is for treatment received from your business partner or relative.
  • It is for benefits which you are eligible to claim from another source, such as workers’ compensation insurance.
  • It is for treatment from a provider that is not in private practice.

Waiting periods

It’s worth remembering that you will need to serve a waiting period before some benefits can be paid. The following waiting periods apply:

  • 1 day: There is a 1 day waiting period for waiting period for accidents and ambulance cover
  • 2 months: There is a 2 month waiting period for all services except those listed below.
  • 12 months: There is a 12 month waiting period for pre-existing conditions, pregnancy-related services, major dental, hearing aids, blood glucose monitors and other health appliances.

Excess

The excess is the amount you pay to contribute to the cost of your hospital stay, and health.com.au gives the option of choosing a higher excess in order to receive lower premiums. Base and Heart Hospital covers allow you to choose between a $250 and a $500 excess, while health.com.au’s High suite of policies add the choice of a $0 excess. No excess is payable for dependents, while if you are discharged from hospital and then readmitted within seven days for a related issue, you will not have to pay another excess.

Do claim amounts vary depending on treatment?

Yes, like most other health funds, health.com.au pays different amounts for different conditions and treatments. The data below, courtesy of the Australian Medical Association, shows the dollar figure health.com.au will pay for 22 common hospital procedures. For the purpose of comparison Medicare's (MBS) benefits are also listed. Health.com.au is a member of the Australian Health Services Alliance (AHSA), and is listed here under their title. AHSA rates will only be paid in instances where the doctor participates in Access Gap. You can find more information on the AHSA at the bottom of this table:

ProcedureMBSAHSA*
Appendicectomy$445.40$632.10
Basal cell carcinoma or squamous cell carcinoma removal from nose, eyelid, lip, ear, digit or genitalia$221.35$366.10
Breast, benign lesion surgical biopsy of excision$260.05$356.40
Carpal tunnel release$276.80$440.20
Cataract surgery$760.65$1,239.70
Cholecystectomy$739.35$1,091.90
Colonoscopy$334.35$435.00
Complicated delivery (of baby)$1,629.35$1,855.90
Coronary artery bypass$2,200.00$3,783.30
Craniotomy$1,586.75$2,420.80
Cytotoxic chemotherapy$97.95$107.80
Femoral on inguinal hernia$464.50$909.70
Haemorrhoidectomy$367.75$602.90
Hip replacement$1,317.80$2,214.50
Knee replacement$2,047.60$2,563.40
Overnight investigation for sleep apnoea$588.00$682.20
Tonsils or tonsils and adenoid$295.70$513.90
Uncomplicated delivery (of baby)$693.95$1,484.50
Vaginal hysterectomy$674.70$1,066.20
Varicose veins$109.80$164.80
Vasectomy$229.85$343.80

*NSW, #AHM

I recognise most of these funds except for the AHSA, what is that?

The Australian Health Service Alliance is a management services organisation that represents a number of small to medium sized health insurance funds, allowing them to combine resources to deliver a higher quality of service to their members. The funds represented by the ASHA are:
  • ACA Health Benefits Fund
  • Australian Unity Health Limited
  • CBHS Health Fund Limited
  • CUA Health Limited
  • Defence Health
  • GMF Health
  • GMHBA
  • Budget Direct Health Insurance
  • Frank Health Insurance
  • GU Health
  • HBF Health Ltd
  • Health Care Insurance Limited
  • health.com.au
  • Health Insurance Fund of Australia Limited
  • Health Partners
  • Navy Health
  • onemedifund
  • Peoplecare Health Insurance
  • Phoenix Health Fund
  • Police Health Limited
  • Queensland Country Health Fund Limited
  • Reserve Bank Health Society Ltd
  • rt health fund
  • Teachers Health Fund > UniHealth Insurance
  • Teachers Union Health
  • The Doctors' Health Fund Pty Ltd
  • Transport Health
  • Westfund

How do I make a claim?

Hospital claims are paid directly to the hospital by health.com.au. All you need to do is hand over your health.com.au Claims Card when you are admitted to hospital and the insurer will pay your bill directly. health.com.au also offers a handy guide to going to hospital on its website to help you understand how hospital claims are managed and paid. In terms of medical claims, if your treating doctor or specialist doesn’t use health.com.au’s Access Gap Cover Scheme, claims can only be processed after Medicare has assessed your claim. But if your medical practitioner does use the scheme, they will bill health.com.au directly. If you wish to make an extras claim, there are two ways you can do so:

  • In person. Scan your health.com.au Claims Card at more than 45,000 providers across Australia.
  • Online. Visit health.com.au and complete the details of your claim.

Who can take out a policy with health.com.au?

In order to take out cover you must:

  • Be 16 years or older (if you are younger than this you can be covered as a dependant on a family or single-parent family policy)
  • Meet the residency and eligibility requirements of Medicare

What types of policy are available?

You can take out a single policy, couples policy, single parent policy or family policy.

Is there a cooling-off period?

Yes. You have 30 days after purchasing a policy to decide whether or not cover is right for you. If you cancel your policy during this time your premium will be refunded.

Who is classified as a dependant by health.com.au?

A dependant is the policyholder’s spouse/partner or child. Dependant children are covered until they reach 21 years of age, but they can also be covered as a dependant up to 25 years of age under a single parent or family policy if they are studying full-time.

How long will I need to wait before I can access a benefit for pregnancy?

A 12-month waiting period applies to pregnancy-related services.

Am I covered for treatment overseas?

No. health.com.au policies only provide cover for treatment received in Australia.

How can I pay my health.com.au premiums?

Premiums are paid by direct debit from your nominated bank account or credit card.

Am I covered for accidents as soon as I join?

No, a 1 day waiting period applies for treatment in hospital as a result of an accident as defined by health.com.au. A two-month waiting period (or longer) applies to all other benefits.

Which policies cover assisted reproductive services?

Any policy which features health.com.au High Hospital Cover includes cover for the cost of assisted reproductive services, including IVF.

What customer support is available?

Health.com.au offers 24/7 customer support via phone, email and live online chat.

How can I pay my health.com.au premiums?

Premiums are paid by direct debit from your nominated bank account or credit card.

Can I suspend my health.com.au policy for a limited period?

Yes, you have the option of suspending your policy if you experience financial hardship or you are taking an overseas holiday. Qualifying criteria applies. 

Compare health insurance options today

The health.com.au range of health insurance covers is worth considering if you’re in the market for private health insurance, but you should always make sure to compare your options before deciding on a health fund. This will ensure that you end up with the right type and level of protection for you and your family.

Compare policies from health.com.au

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