Coverage confusion: 1 in 2 Aussies caught out by their health insurance policy

Millions of Australians are unaware of what their health insurance policy actually protects, according to new research by Finder.
A Finder survey of 1,008 respondents – 438 of whom have health insurance – revealed 1 in 2 (50%) thought they were covered for a medical expense when they weren't.
That's equivalent to 6.3 million people who were unaware that their policy didn't look after them for a specific medical expense.
The research found 1 in 3 (34%) thought their extras policy would cover them for a medical expense which it did not, while 1 in 5 (20%) thought their hospital policy would do the heavy lifting.
Tim Bennett, insurance expert at Finder, said a significant portion of the population is unaware of their health insurance coverage.
"Understanding your coverage can prevent you from facing unexpected out-of-pocket expenses for medical treatments or procedures.
"Otherwise, this could lead you to delay necessary treatments or choose less favourable care options due to financial concerns."
Bennett encouraged Aussies to reassess their health insurance this new year.
"Your life circumstances may have changed throughout the past year.
"Perhaps you've started a family, changed jobs, or experienced a health issue.
"Reviewing your policy ensures that your coverage aligns with your current needs and protects you from unexpected medical expenses."
The average Aussie with health insurance pays $221 on their policy each month.
How much do Australians spend on health insurance per month?
Basic | $141 |
Bronze | $190 |
Silver | $260 |
Gold | $337 |
Average Australian | $221 |
Source: Finder's Consumer Sentiment Tracker of 1418 respondents with health insurance, December 2024 | ![]() |
Those who have an extras only policy fork out $95 each month – or $1,140 per year.
Bennett said extras are great when you use them, but there are also great cheap extras policies to consider.
"You can get great value from a starter extras policy for as little as $13-$17 a month depending on your income level."
More than half (54%) of Australians who hold extras cover don't use their benefit limits in full.
That's almost 8 million people wasting money that could otherwise be claimed against dental, optical and more.
Bennett urged Aussies to take time to ensure you are getting the right policy at the right price.
"In the majority of cases, you can add on and remove different elements of cover to get what suits you best and reduce the cost," Bennett said.
Have you ever had to pay for a medical expense that you thought was covered by your health insurance?
Yes, I thought it was covered by my extras policy | 34% |
Yes, I thought it was covered by my hospital policy | 20% |
No | 50% |
Source: Finder survey of 438 respondents with a health insurance policy, October 2024 | ![]() |
Methodology
- Finder's Consumer Sentiment Tracker is a monthly recurring nationally representative survey of more than 60,000 respondents.
- Figures in this release are based on 1,008 respondents – 438 of whom have health insurance – from October 2024.
- The Consumer Sentiment Tracker is owned by Finder and operated by Qualtrics.
- The survey has been running monthly since May 2019.
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