PrivateHealth.gov.au

Questions to ask your insurer

You are here: PrivateHealth.gov.au > Health insurance explained > Managing your insurance > Questions to ask

You should know as much as possible about the private health insurer you have already joined or are thinking of joining, and the policy you wish to take out. The following questions will help you to understand what your health insurance will provide, and may help you compare specific policies to find the best one for your needs.

• Does my policy include hospital treatment, general treatment or both?
• Does my policy exempt me from paying the Medicare Levy Surcharge?
• Who is covered under my policy?
• What type of hospital accommodation is covered under my policy - public hospital only or both public and private?
• What are the waiting periods that have to be served before I can claim benefits?
• Will my hospital cover provide benefits for all hospital procedures and treatment?  If not, which hospital treatments will not be covered by this policy?
• Are there any other circumstances when I will not be eligible to receive benefits?
• If I have paid my premiums in advance and there are increases in rates, will I have to pay these increases?
• Do I have to pay any excess or co-payment if I go to hospital? If so, how much and are there any exemptions?
• What other out-of-pocket expenses am I likely to have to pay? 
• Which hospitals have agreements with this insurer?
• Which doctors participate in this insurer's gap cover arrangements?
• Is the cost of prostheses and medical implants covered under my policy?
• Is ambulance cover included with my policy?
• Are there limits to the benefits I can claim under my general treatment cover? If so, what are they?