Health Insurance NT

Private health insurance is an extremely useful safeguard for avoiding excessive out-of-pocket expenses in the event your injury or condition requires treatment that is excluded from Medicare's Benefit Schedule. Private health insurance also allows you to select your attending doctor, which hospital you are admitted to and gets you fast tracked for surgeries and procedures. You can also add additional ambulance and extras cover to give yourself even more protection. The three types of private health insurance policies available in the Northern Territory are:

• Hospital cover. Insures you for treatments, services and ancillary costs that you will incur in the event you are admitted to a medical facility.
• Extras cover. Insures you for non-hospital related services such as optical and dental.
• Ambulance cover. Pays for the expense of emergency ambulance transport.

Taking out private health insurance has been made even more attractive in recent years due to the government implementing incentives for policy holders in the form of rebates and exemption from the Medicare Levy Surcharge.

Compare health insurance cover in the Northern Territory

Who are the top performing health funds in the Northern Territory?

This interactive chart displays the largest health funds in the Northern Territory by percentage market share. You can also see who the most popular providers are in each other state and territory in Australia, as well as the top nationwide performers.

How do premiums in the Northern Territory compare?

The premiums you will pay on private health insurance will change depending on what state or territory you reside in. One of the driving factors that determines if premiums increase are the level of benefit payments being made, so if your state or territory has a high claims rate you can expect to have higher premiums than those with low claim rates. This should not dissuade you from considering health insurance however, as the differences in cost are not inordinately skewed and premium rises are overseen by the Private Health Insurance Administration Council (PHIAC), an independent regulator. Currently, the average cost for health insurance in the NT:

• $3,348.05 for families and $1,577.61 for singles who have 100% hospital cover and
• $1,707.55 for families and $789.52 for singles who have 100% extras cover

Is ambulance cover managed any differently?

Unless you have cover or qualify for an exemption, ambulance transport in the Northern Territory will cost you anywhere between $700 to $900. Persons who are exempted from ambulance fees are valid holders of a:

• NT Centrelink Pensioner Concession Card
• NT Centrelink Health Care Card

The cost of taking a St Johns Ambulance is as follows:

Membership & coverage

APRA statistics show that as of 31 December 2016, 46.6% of Australians had hospital cover, which was a decrease of 0.2% from the September 2016 quarter, but an overall increase of 19,048 people since 31 December 2015. In the Northern Territory the proportion was well below the national average, with 40.9% having hospital cover as of 31 December 2016. This is the lowest percentage of cover of any state or territory, with Victoria and Queensland the next highest at 43.9%. As of 31 December 2016, 13,463,257 Australians (or 55.4% of the population) had extras cover, which was 7,759 more than in the September 2016 quarter and 110,093 more since 31 December 2015. In the Northern Territory the percentage was again well below the national average, with only 44.5% having extras treatment cover as of 31 December 2016. This was the least of all states and territories, with the next highest being Queensland with 49.8%. The largest health funds in the Northern Territory are Medibank, with a market share of 41.7%, and Bupa with 38.8%, while HCF comes in a distant third with a market share of just 5.0%.

Out-of-pocket payments

The APRA reports show that as of 31 December 2016 the average out-of-pocket (gap) payment for a hospital visit was $275, which is a 5.8% decrease since 31 December 2015. The average out-of-pocket payment for extras services was $48, which is a 1.4% increase since 31 December 2015. The average gap payment across all services was $18.06, but this was substantially more in the Northern Territory where it was $31.47 and second only to the ACT on $55.58.

Men vs women

When viewed from a gender perspective, as of 31 December 2016 more women than men had health cover in Australia. National statistics show 5,835,238 women holding hospital cover compared to 5,492,274 men. Figures also show 6,324,101 women having extras cover compared to 5,920,939 men. In the Northern Territory, this was also the case, with 50,751 women having hospital cover versus 49,640 men, and 52,460 women having extras cover versus 50,657 men.

Hospital vs extras treatment cover

The APRA reports show that more people hold extras cover in Australia than hospital cover (55.4% extras compared with 46.6% hospital), but that the rate of cover for both is still reasonably healthy. This is also true in the Northern Territory, where 44.5% of the population have extras cover compared to 40.9% with hospital cover.

Who's got cover in the NT?

The proportion of people with health insurance in Australia can be separated into the following age groups:

• 0-14 years. Hospital 17.9% and 18.8% extras cover
• 15-64 years. Hospital 65.0% and 66.2% extras cover
• 65+ years. Hospital 17.0% and 15.0% extras cover

The APRA statistics show the biggest net increase in hospital cover was 5,495 people in the 70 to 74 age group and the biggest net decrease in extras cover was 15,068 people in the 25 to 29 age group. This pattern is consistent across all states and territories including the Northern Territory, with the most noticeable aspect being an under-representation in the younger age categories such as the 25 to 29 age group.

Changes over time

If you compare the 2016 and 2015 APRA statistics, the following observations can be made:

• The amount of people with hospital cover has reduced slightly from 47.2% as of 31 December 2015 to 46.6% as of 31 December 2016.
• There is a clear difference in the claim rates for hospital and extras benefits, with older age groups making more claims for hospital benefits than younger age groups. Extras benefit claim rates on the other hand remain fairly even across all age groups.
• WA and the ACT both have significantly higher health insurance participation rates than other states and territories (54.7% hospital and 68.2% extras in WA and 57.7% hospital and 68.4% extras in ACT), while the Northern Territory has the lowest participation rate (40.9% hospital and 44.5% extras).
• Premium revenue for health insurance taken out by businesses has risen by 5.5% since 31 December 2015 and total fund benefits have gone up by 5.1%.

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