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Our health insurance expert, Steven Spicer, has some tips on choosing the right policy for your needs.
Knowing what’s the right level of cover for you may seem intimidating at first, but there are simple steps you can take to help with the process. Information such as your family history, health needs, what health services you’ll use and how many people need to be covered by your policy will all help narrow down your choices. Choosing the right level of cover will help you get the inclusions you need without paying for services you won’t use.
When deciding on a policy, it’s essential to understand what each inclusion covers. This can be particularly relevant with complex diseases like cancer that often require multiple treatments. For example, if you need radiation therapy and surgery, these cancer treatments fall under different clinical categories. Understanding your inclusions ensures you know what you’re purchasing and helps avoid unexpected out-of-pocket expenses.
Your health needs will change throughout your life, so a policy you bought a few years ago might not suit you like it once did. Checking your policy allows you to see what else is out there and ensure you’ve got the best cover for your needs.
Radiation therapy (also called radiotherapy, radiation treatment or radiation oncology) uses a dose of radiation for targeting cancer that kills or damages cancer cells so they won’t continue to grow.1,2 It can be a very effective means of treating a range of cancers, including breast cancer, prostate cancer and brain cancer among others. Radiotherapy can be used in a few ways including:1
Radiation therapy can be delivered from outside the body (external beam radiation therapy) or inside the body (brachytherapy).1 The total dose of radiation you’ll need will depend on the type of cancer you have and the severity of your condition. Radiation therapy is often an outpatient treatment, which may affect whether your policy covers it.
Radiation requires careful planning as cancer cases vary from patient to patient and your healthcare team will aim to minimise damage to surrounding cells.1,2 If you’re pregnant, your doctor will likely look into other treatment options, as radiation can potentially harm your developing baby.
There are different types of radiotherapy including:1,2
Your doctor or radiation oncologist will discuss the best course of treatment for your cancer care and possible side effects of radiation treatment.
Chemoradiation involves using both chemotherapy and radiotherapy to treat cancer.1 Chemotherapy can make cancer cells more vulnerable to radiation therapy. Chemoradiation is only a treatment option for certain types of cancer, including:1
Treatment costs can vary depending on your cancer diagnosis and other factors, including:2
The total cost of treatment can differ significantly between cancer patients. Your treatment team will be able to provide a quote based on your specific condition. It’s always best to get an estimate for your radiation therapy costs before you start receiving treatment.
Private hospital cover can help with the cost of radiation therapy, provided you have the correct level of coverage and are treated as an inpatient. Your policy will need to include the ‘chemotherapy, radiotherapy and immunotherapy for cancer’ clinical category. This is a minimum requirement for Bronze, Silver and Gold-tier hospital cover.
If you’re having the procedure performed as an outpatient (which is often the case), your health fund may not cover radiotherapy, and you may have to make a gap payment. Radiotherapy is usually performed as part of a treatment plan that includes other treatments such as chemotherapy and surgery, both of which your policy may provide cover for. Just keep in mind that depending on the treatment required, you may need additional clinical categories included on your policy. It is therefore a good idea to speak to a health insurance expert or your health fund when determining what you will need cover for.
There are some key benefits to being treated in a private hospital as a private inpatient including:
Specialists and doctors may charge above the MBS fee for their health services. The difference between the specialist and MBS fees is called a medical gap. Depending on your policy, your health fund may cover some or all of this co-payment or you’ll incur some out-of-pocket costs.
Medicare will cover the cost of radiation therapy performed through the Australian public health system and contribute towards the MBS fee for treatment in private clinics. What financial assistance and Medicare rebates you’ll receive will depend on what Medicare Safety Nets you qualify for.
As the Executive General Manager of Health, Life and Energy, Steven Spicer is a strong believer in the benefits of private cover and knows just how valuable the peace of mind that comes with cover can be. He is passionate about demystifying the health insurance industry and advocates for the benefits of comparison when it comes to saving money on your premiums.
1 Health Direct – Radiotherapy. Accessed February 2025.
2 Cancer Council-Radiotherapy (Radiation). Accessed February 2025.