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Do I need private health insurance?
Take this 1-minute quiz to help you figure out if you need health insurance.
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Health insurance is complicated – and expensive – and Medicare is free and available to all Australians. Figuring out whether health insurance is right for you can be tricky.
That’s why we’ve created this simple quiz to help you figure out whether you would benefit from hospital cover, extras cover, both or neither. If you find it useful, share it with your friends!
Do I need health insurance?
Health insurance is not compulsory for Australian citizens, as we have access to Medicare. Essentially, the decision to take out private cover comes down to where you are in life and what's important to you.
Maybe you're just looking to avoid Medicare Levy government surcharges, or you're tired of public waiting lists keeping you away from a speedy recovery.
There is an option for everyone, so we'll break it down to the basics.
When does it make sense to get health insurance?
There are plenty of cases where insurance will actually end up saving both your body and bank balance in the long term.
Here is when health insurance is typically worth it:
- You’ve passed the salary threshold. Not only does health insurance bring a rebate at tax time, but having an eligible hospital policy (more on that in a second!) will save you from the Medicare surcharge levy of up to 1.5% of your income if you earn more than $90,000 a year.
- You're turning 31. If you think you’ll ever need hospital cover in your life, you should take it out now. Waiting until you’re 31 or older to get health insurance leads to a 2% increase on your premiums for every year you wait. Getting in early saves you from this expense.
- You don't want to wait around. While Medicare is fantastic, it doesn’t cover everything. Elective operations like laser eye surgery aren’t covered by Medicare at all, and even those that are can lead to waiting times of months. Hospital private insurance lets you skip the public queue and claim those necessary elective operations.
- You don't want to be worried about dialling 000. Situations where you’ll need to call an ambulance can be unpredictable and unavoidable. It can also cost hundreds (if not thousands) of dollars. Hospital and extras private insurance can cover it, so you're never stuck with a huge bill.
- You spend money on everyday health needs. Whether it's a new pair of specs, keeping those pearly whites sparkling or even a remedial massage on the weekend, extras cover gives you substantial discounts on paying for a range of treatments.
- You want to have more choice. If you want to be close to home or in a private room being treated by a specific doctor, health insurance can give you that.
- You're thinking about starting a family. Health insurance can give you a cost-effective way to make sure you have a high standard of health care. Top hospital cover can get you your choice of obstetrician, a private room and help with costs like pre and postnatal classes. Keep in mind that there is a 12-month waiting period for pregnancy services on most policies.
When is it not worth it?
If you’ve read this far and thought we haven’t really described you, fantastic! It may make sense to not worry about insurance in the following situations:
- You’re young and healthy. If you’re in your early 20s and the last time you got sick was a cold three years ago, it may make sense to hold off on insurance. You may still want to go for an extras policy though. For example, you may want psychology cover to help with all those tricky questions about existence that have started creeping in!
- You like the public system. If you don’t mind what doctor you see or what hospital room you get, and you can afford to wait for whatever procedure you need, you may not need insurance at this time.
- You wouldn’t get much back. If you’d be paying $500 a year for insurance but only claiming a few hundred on physio or new glasses annually, you might want to cut the extras policy for now.
- You feel like you're being pressured into unneeded cover. Just because the ads on TV say you need a private fund in case anything goes wrong, remember that the public health system will still provide high-quality care in an emergency. Make sure you only buy insurance if it makes sense for you!
How do I find the right cover?
There are three main types of health cover: hospital, extras and combined policies.
- Hospital. This covers all the big medical expenses related to hospital. In an emergency, hospital cover can get you a fast ambulance to a private hospital and get you set up for whatever operation you might need as well as help pay for of it. Hospital cover can help you avoid waiting periods for elective surgeries.
- Extras. This is the tailored part of a health policy. Do you have a back injury? Tricky feet? Expensive prescription medication? Extras policies can help save you hundreds every year for ongoing problems ranging from psychology sessions to chiropractic care. These are highly customisable for your personal needs.
- Combined. This is some combination of the above. Often, bundling these together with a single fund will drive the overall cost down as well as let you pick and choose exactly what you need.
How much does it cost?
Health insurance can cost as little or as much as you like depending on your needs.
| Hospital tier | Average | Treatments included |
|---|---|---|
| Basic | $79.86 | Ambulance cover |
| Bronze | $90.87 | Joint replacements, adenoids and cancer |
| Silver | $126.81 | Dental surgery, lung, chest and heart issues |
| Gold | $170.90 | Pregnancy, IVF and weight loss surgery |
| Extras cover | Average | Included benefits |
|---|---|---|
| Low | $12.85 | One no gap dental check-up Physio |
| Middle | $34.95 | Approximately a $600 dental limit Optical, physio, massage and major dental |
| High | $81 | No waiting periods on dental and optical All the above plus hearing aids, laser eye |
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Ask an Expert
I’m 33 and earn less than $90,000 as a single person. I took out private health insurance before I turned 31, and I’m thinking of cancelling my policy as I find it an unnecessary expense. Is it worth having for someone who earns minimum wage? Thank you.
Hi Emma,
Thanks for reaching out. I hear what you’re saying – health insurance can seem like an unnecessary expense. The good news is, since you earn under $90,000 a year, you don’t NEED to have it, particularly if you’re healthy. Having said that, since you’re over 31, if you cancel your health insurance and decide to get it later down the line, you’ll pay more for it – this is called the lifetime health cover.
It’s also good to remember that while Medicare is free, it doesn’t cover everything (in many states, for instance, you’d have to pay out of pocket for an ambulance in case of an emergency). You might find our guides on public vs private healthcare and facts about Medicare useful as you make your decision.
Hope this helps – best of luck!
Cheers,
Zahra
Just wondering what’s the best cover for families but I need Psycologist and Psychistrist as well dental optical and I’m 53 I’m on Medibank top and extras 70 can’t afford this as it’s going up to $578😖
Hi Bianca,
Thanks for reaching out! Have you had a look through our comparison tool? This will allow you to filter health insurance providers based on what’s a priority for you and your family, or you can simply sort by price across over providers. For example, you may want to prioritize some extras over others or mix and match your hospital and extra policies.
You can find that here: https://www.finder.com.au/health-insurance – it can hopefully give you a bit more insight into the options available – or you can check out our pages on health insurance and psychology or psychiatry for more info.
Hope this helps!
Best,
Nikki
Should I have an insurance at my age?
Hi Giosue,
Thanks for leaving a question on finder.
No one plans to get sick or hurt, but most people need medical care at some point. Health insurance can help cover these costs and offers many other important benefits. Essentially, it’s a safety net to protect you from unexpected, high medical costs. You might find our pages on private vs public healthcare, health insurance in your 20s, 30s or for seniors to be helpful (we’re working on the rest!)
Cheers,
Joel
Does any health provider have a no wait period for extras cover including psychologist/counselling the moment I can’t afford a lot? At the moment do not have health cover.
Hi Josephine,
Thank you for getting in touch with finder.
Yes, they do. For example, please see this link and set to prioritise psychology. If you select view details for the policies you are looking for, you can see the wait periods.
I hope this helps.
Have a great day!
Cheers,
Jeni
Hi being single parent, its very hard for me, with 2 adults age 21 and 23, myself, I pay 226 and then we will have the increase. Not sure what which one to pick
Hi there Reena!
Thanks for your questions – I can understand why it’s important for you to check the cost of your cover to see if you can find a better deal.
The good news is there are lots of options, each health fund offers different combination depending what’s important to you.
Have you had a look through the comparison tool? This will allow you to filter funds based on what’s a priority for you and your kids. Or you can simply sort by price across over 30 funds. For example, you may want to prioritise some extras over others or mix and match your hospital and extra policies.
You can find that here: https://www.finder.com.au/health-insurance – it can hopefully give you a bit more insight on the options available.
Best regards,
Nikki
What is the difference between care at a public hospital and private one
Hi Robin,
Thanks for your question.
If you have private health insurance, you have the option of going public or private.
Public hospitals offer health treatments to all eligible Australians, covered by Medicare, they are catered toward prioritising emergency and acute health treatments and can leave you with a lengthier wait for elective surgeries.
As a public patient in a public hospital, you can’t choose your doctor and are more likely to be in a shared room. If you have private health insurance in a public hospital, you can choose your doctor and have access to a private room.
One of the main benefits of private hospitals is that you can skip the lengthy wait times for elective surgeries. You can also choose your doctor, and find a hospital in a suitable location (ie closer to home).
We’ve got some more information in the public v private guide also: https://www.finder.com.au/public-vs-private-healthcare
Cheers,
Joel
I am 72 yrs old female and doesn’t have covers, how much would be with the loading?
Hi Lisa,
The Lifetime Health Cover (LHC)loading is 2% on top of your premium for every year you are aged over 30 and caps at a maximum of 70%. For a 72 year old, the loading will be 70%. However, once you have held private hospital insurance for 10 continuous years, the loading will be removed and remain at 0% as long as you retain your hospital cover. There are also instances that can exempt someone from premium loading. You can check our LHC guide on this page for the details.
Cheers,
Liezl
We currently have extras cover with Bupa, $130 per month which is about to increase again. All we want is dental optical physio psychology and chiro. No gym memberships no cinema tickets or freebies! Just straight up straight out cover ….. but cheaper
Hey Sandy,
Thanks for the note – happy to help you find a better deal!
The good thing about extras is you can normally prioritise a few treatments to shape the price of your policy. A good place to start would be our comparison tool here -> https://www.finder.com.au/health-insurance/extras-cover
You can tick the treatments you’re looking for in the search results, tor just rank the search results by cost- hopefully this will help you secure a better deal.
Good luck!
May
Not sure on health cover. Retired couple 66 and 63 years old. Currently with HCF. Dr and option of private hospital, along with elective surgeries for any possible ailments
Do you compare HBF as one of your options for health insurance. Thank you.
Hi Annette!
Thanks for contacting finder and for your questions.
Yes, we compare HBF as one options for heath insurance.
To know more about HBF, you may view this link.
Hope this helps!
Thanks and best regards,
Nikki
Hi Margaret,
Thank you for getting in touch with finder.
Kindly check out this link regarding your enquiry since you were advised about getting a cover with elective surgeries. Please input all the necessary info like your postcode to filter which insurers would suit your needs.
I hope this helps.
Have a great day!
Cheers,
Jeni
What is the cheapest cover I can get for me (56) and my dependent sons (twins 16 years)?
With health.com.au which has increased to $140 per month approx.
Hi Karin,
Thanks for your inquiry.
If you are looking to take out health insurance for your family, there are cheap insurance cover on this page you may want to check. Please make use of our panel from that page and click on the orange ‘Search policies’ button to compare your options. Best to contact the insurer directly so you can discuss the level of cover for you and your sons at the right budget.
Cheers,
May