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What is Private Health Insurance?

There are two types of private health insurance – hospital policies cover you when you go to hospital, while general treatment policies (sometimes known as ancillary or extras) cover you for ancillary treatment (eg dental, physiotherapy). Most health funds offer combined policies that provide a packaged cover for both hospital and general treatment services, or you can buy separate hospital and general treatment policies to ‘mix and match’.

If you’re purchasing cover for the first time or upgrading your plan, you need to serve a waiting period before you can claim your benefits. During the waiting period, you don’t receive any benefits for certain treatments or you receive lower benefits for a period of time. Most Insurers will waiver waiting periods when you sign up around tax time or if you are looking to transfer to a new fund.

You should also take note of what is and isn’t covered on your policy – not all policies are comprehensive. Depending on your level of cover, you may not be fully covered against all costs associated with your treatment and have to pay some out-of-pocket expenses, this is called a “gap payment”.

In Australia you can choose whether to have Medicare cover only, or a combination of Medicare and private health insurance.

Benefits of Private Health Insurance

By taking out private health cover, you are protecting you and your family from having to pay out of pocket for medical treatments. The various benefits you can enjoy by obtaining private health insurance include:

  • The ability to choose the hospital where you’re treated.
  • The ability to choose between being treated in a public hospital or a private hospital.
  • The ability to choose the doctor who will treat you.
  • Shorter wait times at hospitals and doctors.
  • Cover for a range of different fees including doctors’ fees, theatre costs and accommodation costs.
  • A range of additional services such as chiropractic, dental care, optical care, remedial massage, appliances such as hearing aids, acupuncture and more.
  • If you take out private health insurance you can enjoy a 30% rebate.
  • If you’re an older Australian you can enjoy a higher rebate. Australians aged 65-69 receive a 35% rebate and Australians aged 70 and over enjoy a 40% rebate.

Ambulance cover, this saves you any out of pocket expenses if you need a ambulance.