Choose your provider, no excess for kids and flexible policy choices – is health.com.au right for you?
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.
Sign up deals with health.com.au Health Insurance for August 2020
health.com.au membership benefits at a glance
- No excess for kids. Hospital visits for children don't attract any excess fees.
- Emergency ambulance transport. Ambulance cover is included as standard in every health.com.au policy.
- Choose your provider. You aren't forced to visit a provider affiliated with the health fund to receive full cover.
- Direct-debit discount. Opt to pay using direct debit and receive a 4% premium reduction.
- Refer-a-friend bonus. Recommend health.com.au to a friend and receive a $100 Visa gift card when they sign up
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Health insurance options
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.
- Entry Hospital (Basic+). Starting at around $15 a week, health.com.au's basic policy gives you public hospital cover, paying for the cost of your bed (same day or overnight), meals, nurses, theatre, intensive-care fees and government-approved prostheses.
- Base Hospital (Bronze+). Beginning at $19.93 a week, cover includes the basics as well as removal of wisdom teeth, joint investigations and reconstructions, colonoscopies and more. You can choose a co-payment option, which is the amount you agree to pay for each night that you are in hospital, as well as excesses of $500 or $750.
- Core Hospital (Silver+). You'll pay around $35 a week for Core Hospital (Silver+), depending on the excess you choose, and get cover for joint replacements, spinal fusion, major eye surgery and more.
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.
|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.
What is health.com.au?
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.
How many hospital agreements does health.com.au have in my state?
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)|
Additional benefits of health.com.au
There are a number of other features that might make health.com.au the right insurer for you.
- Cooling off period. You can cancel your health.com.au policy within 30 days of purchase and receive a full premium refund.
- Dependents. health.com.au's family and single parent policies cover children until they reach 21 years of age or 25 years of age if they are studying full time.
- Cover outside of Australia. Your health.com.au policy does not cover you for treatment received outside of Australia.
- Suspension of cover. If you do decide to travel overseas or experience financial hardship, you have the option of temporarily suspending your policy if you meet the eligibility criteria.
- Visitors to Australia. health.com.au offers Overseas Visitors Health Cover (OVHC) for people on a 457 or 485 visa.
- Methods of payment. Premiums are paid by direct debit from your nominated bank account or credit card.
How to make a claim
There are two ways to make a health insurance claim with health.com.au:
- Swiping your membership card. You can swipe your health.com.au membership card on the spot to claim instantly when you visit a service provider.
- Making an online claim. You also have the option of signing into your health.com.au online account and lodging a claim 24 hours a day, 7 days a week.
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.
Does health.com.au offer Overseas Visitor Health Cover (OVHC)?
Yes! If you're coming to Australia and looking for 457 and 485 visa-compliant health insurance, you can find out more here.
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