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health.com.au is an online provider that offers straightforward policy options with an emphasis on flexibility and choice. As of 1 April 2020, it has changed its hospital and extras policies to reflect the new government rules. We've broken down its cover below.
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health.com.au offers policies for treatment in and out of hospital. As part of the new government laws, its policies must now meet specific criteria in order to qualify as Basic, Bronze, Silver or Gold. If you see a + next to the policy, it means it offers more than the minimum requirements.
health.com.au currently has four extras policies: Pulse 50, Pulse 60, Extras 50 and Active 60. These let you claim benefits for out-of-hospital services, such as dental (general, major and orthodontics), optical, physiotherapy and pharmacy prescriptions.
health.com.au lets you mix and match hospital and extras cover in the same policy for comprehensive protection.
Here's an overview of health.com.au's hospital policy inclusions and exclusions.
| Basic+ | Bronze+ | Silver+ | |
|---|---|---|---|
| Back, neck and spine | Public cover only | ||
| Blood | Public cover only | ||
| Bone, joint and muscle | Public cover only | ||
| Breast surgery (medically necessary) | Public cover only | ||
| Cataracts | Public cover only | ||
| Chemotherapy, radiotherapy and immunotherapy for cancer | Public cover only | ||
| Diabetes management (excluding insulin pumps) | Public cover only | ||
| Digestive system | Public cover only | ||
| Ear, nose and throat | Public cover only | ||
| Eye (not cataracts) | Public cover only | ||
| Gastrointestinal endoscopy | Public cover only | ||
| Heart and vascular system | Public cover only | ||
| Implantation of hearing devices | Public cover only | ||
| Male reproductive system | Public cover only |
For a full list of what's included, read the PDS.
health.com.au is a relatively new private health insurer, starting in 2012. GMHBA Limited, a nonprofit company, acquired health.com.au in July 2015. It has won several awards since establishing itself and is the first new private health insurer in Australia since 1976.
The benefit you receive from your health fund when you receive hospital services depends not only on the level of cover you choose but also on whether your health fund has an agreement with the hospital where you receive treatment.
Check the table below for details of the number of hospital agreements health.com.au has in each Australian state and territory compared to the maximum of any health fund across the industry:
| State | Private hospital agreements | Day hospital agreements |
|---|---|---|
| NSW | 79 (industry maximum: 98) | 72 (industry maximum: 110) |
| ACT | 6 (industry maximum: 6) | 6 (industry maximum: 9) |
| VIC | 67 (industry maximum: 78) | 57 (industry maximum: 83) |
| QLD | 42 (industry maximum: 57) | 38 (industry maximum: 61) |
| SA | 26 (industry maximum: 29) | 22 (industry maximum: 33) |
| WA | 18 (industry maximum: 23) | 16 (industry maximum: 31) |
| TAS | 8 (industry maximum: 8) | 3 (industry maximum: 8) |
| NT | 1 (industry maximum: 2) | 1 (industry maximum: 2) |
There are a number of other features that might make health.com.au the right insurer for you.
There are two ways to make a health insurance claim with health.com.au:
If you receive a medical bill from a practitioner who does not use health.com.au's medical Access Gap Cover scheme, your claim can only be paid after Medicare has assessed your claim for medical services. If the practitioner does participate in the scheme, they will bill health.com.au directly.
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what is the list of services you provide for extras claims?
Hi Philomena,
Thank you for your question.
You have contacted finder.com.au, a comparison and information service and not actually health.com.au. To check the extra benefit services Please enter your details into the quote comparison tool on the top of the page and for the detailed list of extra services you should consult the helath.com.au’s policy brochure.
All the best,
Zubair