Health insurance Tasmania

Whether you're from Launceston, Hobart or somewhere in between, finding the right private health insurance should be a priority for anyone from Tassie.

Private health insurance can help you with the cost of various hospital an extras treatments from the costs of riding in an ambulance or visiting the dentist, to seeing a physio or being treated as a private patient.

Find out how you might be able to benefit from private health cover, which funds are the most popular in Tassie and a whole lot more.

Find out about the policies available in Tasmania

What is private health insurance?

Private health insurance is divided into two main areas of health care:

• Hospital cover. Depending on your level of cover, hospital cover pays for your accommodation and medical costs as a private patient in a private or shared room in private or public hospital. It allows you to choose your own doctor, hospital and often your time of admission, and it covers the 25% of the Medicare Benefit Schedule (MBS) fee for in-hospital medical costs not covered by Medicare.
• Extras cover. Extras insurance helps to cover the cost of ancillary services such as optical, dental, chiropractic and physiotherapy. You can select the extras you wish to be covered for, but benefit limits apply (i.e. a set benefit amount per year per household), depending on the level of cover you choose.

Which health funds do Tasmanian residents have their cover with?

You can use this interactive chart to see who the most popular health funds are in Tasmania by market share. It is worth pointing out that over half of both St.LukesHealth (86.6%) and Health Care Insurance (65.5%) members are from Tassie.

You can view the top providers in the other states and territories in Australia, as well as the top six national leaders.

Please note this chart only reflects health funds that have a 2% share of the market or higher.

How does the cost of health insurance in Tasmania compare to the rest of Australia?

The cost of health insurance varies from state to state across Australia, with the average policy costing in Tasmania:

• Hospital only: $4,605.61 for families and $2139.78 for singles
• Extras only: $1,826.31 for families and $834.73 for singles

How does ambulance cover vary?

Ambulance cover also varies from state to state across Australia:

• NSW, ACT, Victoria, WA and NT only provide free ambulance transport to holders of certain concession cards (including Health Care and Pensioner Concession Cards and Commonwealth Seniors Health Cards).
• South Australia offers free ambulance services only to Department of Veterans Affairs Gold Card holders.
• In Tasmania and Queensland the state governments provide free ambulance services to all their residents.

This is only for ambulance services within those states, though, so if you wish to be covered while you are interstate, you would need to look at taking out private health insurance that includes ambulance cover.

Membership and coverage

According to APRA statistics, as of 31 December 2016, 46.6% of Australians had hospital treatment 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 Tasmania, the proportion was slightly less than the national average, with 44.5% having hospital cover as of 31 December 2016. This was similar to most other states, however, including South Australia on 45.9%.

As of 31 December 2016, 55.4% of Australians had general treatment (extras) cover, which represented an increase of 7,759 people on the September 2016 quarter and 110,093 overall since 31 December 2015.

In Tasmania, the proportion was again below the national average, with only 51.4% of people having extras treatment cover as of 31 December 2016. This was similar to other states such as Victoria, which had 50.6%, and Queensland on 49.8%.

The largest health funds in Tasmania are Bupa, with a market share of 36.7%, and Medibank with 30.0%, while St.Lukes (a local Tasmanian fund) has the third largest market share of 18.0%.

Out-of-pocket payments

According to the APRA report, 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, and the average out-of-pocket payment for extras medical services was $48, which is a 1.4% increase since 31 December 2015.

The average gap payment across all services was $18.06, while in Tasmania it almost half as much at $9.39, the only lower amount being $6.67 in South Australia.

The gender divide

Comparing statistics from a gender perspective, more Australian women had health cover than men as of 31 December 2016, with 5,835,238 women holding hospital cover compared to 5,492,274 men, and 6,324,101 women held extras treatment cover compared to 5,920,939 men.

In Tasmania this was also the case, with 121,370 women having hospital cover compared to 110,389 men, and 130,985 women having extras cover compared to 117,790 men.

Hospital vs extras cover

The statistics also show that more Australians have extras than hospital cover (55.4% extras compared to 46.6% hospital) but that coverage rates are still reasonably good for both.

This is also true in Tasmania, where 51.4% of the population have extras cover compared to 44.5% with hospital cover.

Who has cover

The overall number of Australians with health insurance can be broken down into the following age groups:

• 0–14 years: hospital 17.9% and extras cover 18.8%
• 15–64 years: hospital 65.0% and extras cover 66.2%
• 65+ years: hospital 17.0% and extras cover 15.0%

The APRA statistics reveal that 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 in the 25 to 29 age group.

This pattern is consistent across all states including Tasmania, with the most notable aspect being a clear under-representation in young age categories such as the 25 to 29 age group.

Changes over time

A comparison of recent APRA reports reveals several interesting trends:

• The percentage of those 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 distinct difference in claim rates for hospital and extras benefits, with older age groups claiming more often for hospital benefits than younger age groups and extras claim rates remaining relatively even across all age groups.
• WA and the ACT have the highest health insurance participation rates (54.7% hospital and 68.2% extras in WA and 57.7% hospital and 68.4% extras in ACT) and the NT has a lower participation rate than any other state or territory (40.9% hospital and 44.5% extras).
• Health insurance business premium revenue has gone up by 5.5% since 31 December 2015 and total fund benefits have gone up by 5.1%.

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