Written by Joshua Malin
Reviewed by Lana Hambilton
Last updated 18/12/2023
Choosing private health insurance can feel like a complicated process, but with some research and planning, you’ll usually be able to find a health insurance policy that works for you. Here are some tips to help you find insurance that suits your needs.
There’s no one-size-fits-all product when it comes to private health insurance, so it’s essential to find a policy that offers medical services you’ll use or think you might need.
With the introduction of hospital insurance tiers, Australia‘s private health insurance reforms have made it easier than ever to understand the inclusions and exclusions of your private hospital insurance policy. You may find that the services you need are included on a Bronze level of cover, which could have significantly lower premiums than higher-tiered products.
The lowest level of hospital cover available is called Basic cover. While this may be the cheapest, be careful, as it also only covers a few services, typically on a restricted basis.
Gold and Silver products are more comprehensive private hospital cover options that you could consider if you want peace of mind knowing you‘ll be covered for a broader range of medical treatments as a private patient.
You may also like to consider the level of extras cover (sometimes called ancillary cover) you need. While extras can be beneficial if you use them, you could be wasting money if you’re paying for services you don’t use. It might be worth making a list of the health services you think would be the most beneficial to you (e.g. dental check-ups, physiotherapy consultations, orthodontics) and the services you don’t think you’ll need (e.g. podiatry). Then, look for a policy that includes the services you will use, excluding most (if not all) of the ones you won’t.
You also have the option of a combined policy, which includes both hospital and extras cover.
An excellent place to start is to talk with your doctor to discuss what type of private health insurance you should consider for your healthcare needs.
If you’re taking out private health insurance for the first time or upgrading to a higher level of cover, you’ll be subject to waiting periods. This is to stop people from claiming on their policies immediately after signing up, and then cancelling before they pay any premiums (which would drive up premiums for everyone).
Both extras and hospital policies are subject to waiting periods, so consider this when choosing a health insurance product. These are:
You’ll also need to enquire about any limits your extras policy may be subject to. For example, items subject to an annual limit means that for each service you can only claim up to a certain amount which resets every 12 months.
The Australian Government wants you to take out hospital insurance because it eases the burden on the public healthcare system if you’re being treated in a private hospital. Because of this, there are incentives to entice you to sign up for private cover:
Conversely, there are also levies imposed on people who don’t have appropriate levels of cover:
Where you are in life can have a big impact on the type of cover that will best meet your needs.
Here are some questions to ask yourself which could help you determine which policy you choose:
Private health insurance is all about giving yourself more options for treatment when you need them. As such, you’ll need to ask yourself these questions again in the future to make sure your cover still works for you.
You can usually tweak aspects of your private health insurance to make your insurance premium more affordable. Consider the following:
In some cases, a policy may have an excess and a co-payment. It is therefore important to consider the different options available when joining or switching your private hospital insurance.
Did you know that ambulances aren’t free in all Australian states and territories? While the Queensland and Tasmanian state governments cover residents in these states, Australians elsewhere will require specific ambulance cover to avoid footing the whole bill.
This means you could be left with significant out-of-pocket expenses if you require an ambulance but don’t have ambulance cover. This is another thing to think about when choosing health insurance. Keep in mind though that ambulance cover may also be taken out separately to private health cover, which may be more comprehensive.
Whether it’s an industry-wide premium rate rise or you’ve been with your health fund for a while and aren’t sure if it’s still the best option for you, it’s always a good idea to reassess your cover. In addition to making sure you still require the services your health insurance covers, it’s an opportunity to assess whether you could pay less for the same or similar products elsewhere.
This can be achieved through research or using useful tools like our health insurance comparison service. It allows you to compare policies, extras, benefits and costs from a variety of health insurance providers in one convenient location. It’s simple to use, free and takes just minutes to reach a result.
Curious how private health insurance compares to Medicare? Learn more about the difference between the public and private health system with our guide.