When choosing health insurance in Australia, you want to find the policy that provides the coverage you need at a price you can afford. With the many options available from public and private insurers, it can be challenging to determine the best plan for your circumstances.
Doing thorough research enables you to make an informed decision. This article guides you through the key factors to weigh when evaluating health insurance policies in Australia. It discusses public versus private cover, levels of coverage, examining inclusions and exclusions, assessing costs, understanding excess and co-payments, looking at rebates and discounts, and finding a reputable provider.
Health Insurance in Australia
Health insurance in Australia aims to help citizens pay for private hospital cover, medical services, and other healthcare costs.
Private Health Insurance
Private health insurance provides coverage for private hospital care, medical services and extras not covered by Medicare like dental, physiotherapy and optometry. Most Australians take out private health insurance to avoid paying extra tax and to have more choice over their healthcare.
Public Health Insurance
Australia has a public health insurance scheme called Medicare which provides free or subsidized health care for citizens and permanent residents. Medicare covers most medical services like doctor visits, some tests and surgeries. However, it does not provide full coverage for private hospital stays, ambulance trips or dentistry.
How Much Does Health Insurance Cost?
Health insurance premiums vary based on factors like your age, location, level of coverage and insurer. Basic combined hospital and extras cover for a family starts around $200-$300 per month. Premiums are higher for older individuals and those living in remote areas with less choice and competition. Most insurers offer discounts for bundling multiple policies or choosing higher excess levels.
Factors to Consider When Choosing Health Insurance
When selecting health insurance coverage in Australia, several key factors should be considered to determine the policy that best suits your needs.
Type of Policy
The primary types of health insurance policies in Australia are hospital cover and general treatment cover. Hospital cover provides coverage for hospital stays and selected hospital treatments.
General treatment cover provides coverage for a range of out-of-hospital treatments such as dental, optical, physiotherapy, and alternative therapies. Some insurers offer combined hospital and general treatment policies. Determine what types of treatments and services are most important for you and your family to have covered.
Premiums and Out-of-Pocket Costs
Evaluate how much you can afford to pay in monthly premiums and potential out-of-pocket costs like copayments or deductibles. Health insurance premiums vary based on the level of coverage and policy inclusions. Policies with higher premiums typically have lower out-of-pocket costs, while lower-premium policies usually come with higher out-of-pocket costs. Find a balance between premium and out-of-pocket costs that fits your budget.
Approved Providers and Facilities
Check which healthcare providers, hospitals and treatment facilities are covered under different policies. Look for a policy with a robust network of providers and facilities so you have options to choose from. Some insurers allow coverage for out-of-network providers but often at a higher cost. Make sure any providers or facilities you frequent regularly are within the network of any policy you’re considering.
Policy Exclusions and Restrictions
Carefully review what is excluded or restricted under each policy. Common exclusions include pre-existing conditions, cosmetic surgery, infertility treatments, and experimental therapies. Consider your health background and family medical history to ensure any pre-existing or potential future conditions would be properly covered under a given policy. The right policy for your needs will have restrictions and exclusions that you can acceptably live with.
By evaluating these key factors thoroughly and objectively, you can determine the health insurance policy in Australia that provides you the best and most comprehensive coverage for your needs at an affordable and reasonable cost. The ideal policy will give you confidence and security that your essential health needs and those of your family will be met.
Top Health Insurance Providers in Australia
Medibank Private
Medibank Private is Australia’s largest health insurer, providing coverage to over 3.9 million members nationwide. They offer three levels of hospital cover as well as extras cover for services like dental, optical and physiotherapy. Medibank has a reputation for affordable premiums and a wide choice of products. They frequently run promotions offering discounts for new members.
BUPA Australia
BUPA is a leading international healthcare group operating in over 190 countries, including Australia. BUPA Australia provides health insurance to over 4 million customers. They are known for their quality customer service and comprehensive range of products including basic and premium hospital covers as well as a variety of extras packages. BUPA frequently receives high customer satisfaction ratings.
HBF Health
HBF Health is Western Australia’s largest health insurer, providing coverage to over 1 million West Australians. Although based in WA, HBF also provides health insurance in other states. They are known for very affordable products and high quality service. HBF offers three tiers of hospital cover as well as a range of extras products including dental, optical and other ancillary health services.
Australian Unity
Australian Unity is one of Australia’s largest health insurance providers, covering over 770,000 lives nationwide. They are known for innovative, flexible products and a strong focus on preventative health and wellness. Australian Unity offers a range of hospital covers at varying price points as well as comprehensive extras packages. They are also the only health insurer to provide coverage for natural therapies like massage, naturopathy and acupuncture.
GMHBA
GMHBA is a leading health insurer based in Victoria, providing coverage to over 530,000 Victorians. Although predominantly based in Victoria, GMHBA does provide health insurance in other states as well. They are known for very affordable premiums, flexible products and high quality service. GMHBA offers four tiers of hospital cover as well as a range of extras products including dental, optical and physiotherapy. They frequently offer generous discounts for members who pay premiums in advance.
Read also: What Is Insurance and How Does it Work?
Comparing Health Insurance Plans and Features
When choosing a health insurance plan in Australia, you need to compare the coverage, benefits, and costs of different policies to find one that suits your needs and budget. Some of the main factors to consider are:
Type of Coverage
The first decision is what type of coverage you need – hospital, extras or combined. Hospital cover pays for hospital stays and surgeries. Extras cover subsidizes things like dental, physio and optical. Combined or packaged policies provide both hospital and extras cover. Evaluate your priorities and anticipated health needs for the year to determine the right coverage type.
Included Benefits
Compare the specific medical services and treatment options covered under different policies. All hospital policies will cover the basics like surgeries, X-rays and emergency room care, but can vary in coverage for things like rehabilitation, mental health and palliative care. For extras, check what dental, optical and other services are covered and if there are any annual limits or exclusions. The more comprehensive the inclusions and the higher the coverage limits, the higher the premium.
Out-of-Pocket Expenses
Consider the out-of-pocket costs for different policies like co-payments, deductibles and the Medicare levy surcharge. A higher excess or co-payment means lower premiums but higher upfront costs when you use services. Make sure any out-of-pocket expenses are affordable for your budget.
Premiums and Discounts
Compare the total annual premium for each policy as well as any available discounts like those for couples, families, students or income levels. The premium is the amount you pay for your insurance each month. While lower premiums may be tempting, make sure the policy still meets your coverage needs before choosing a plan solely based on price.
Choosing the right health insurance plan is a balancing act between getting the coverage you need at a premium you can afford. Do your research, understand your options and priorities to find the best value policy for your situation. Your health and financial wellbeing depend on it.
FAQs
What types of health insurance are available in Australia?
Australia offers private health insurance through open and restricted membership insurers. Open membership insurers offer coverage to all applicants. Restricted membership insurers, such as some nonprofit funds, only offer coverage to certain groups. The two major categories of private health insurance in Australia are hospital coverage and general treatment coverage.
How much does private health insurance cost in Australia?
Private health insurance premiums in Australia vary depending on the level of coverage, health insurer, and number of people covered. According to recent data, the average cost of basic hospital insurance in Australia is about AU$1,800 per year for a single adult or AU$4,800 per year for a family. Extras cover for things like dental, physiotherapy and optical averages AU$600 to AU$1,800 per year for a single or AU$1,400 to AU$4,800 for a family. Premiums are also usually higher if you take out coverage later in life.
Do I have to have private health insurance in Australia?
Health insurance is not mandatory in Australia. However, if you earn above a certain income threshold, you may have to pay an extra tax levy if you do not have private hospital insurance. The government also provides incentives like tax penalties and rebates to encourage people to purchase private health insurance.
Even though health insurance is not mandatory, most Australians do carry private health insurance to cover health costs not funded by Medicare and avoid potential out-of-pocket medical expenses.
What does private health insurance cover in Australia?
Private health insurance in Australia covers hospital stays and procedures as well as extras like dental, physiotherapy and optical. The level of coverage depends on the specific policy. Hospital coverage typically includes fees for overnight and same-day stays, in-hospital doctor visits, surgeries, and childbirth.
Extras coverage typically includes preventive care like dental checkups, physiotherapy, chiropractic services and eye exams as well as optical appliances like glasses and contact lenses. Most insurers offer policies with different levels of coverage and limits to suit individual needs and budgets.