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    • How Health Insurance Works

      How Private Health Insurance works in Australia.

      • Overview of Health System

        An overview of what is covered by private health insurance and what is covered by Medicare for hospital, medical services (general treatment), pharmaceutical benefits and ambulance.

        • What is covered by Medicare?

          Describes what is and what is not covered by medicare for hospital, medical and pharmaceutical benefits.

        • What is covered by private health insurance?

          Describes what is covered by private health insurance for ambulance, hospital and general treatment (also known as ancillary or extras) cover. Also covers what may not be covered owing to exclusions, restrictions or benefit limitation periods on your policy.

        • Ambulance

          Depending on which state you live you may need to organise ambulance cover to cover the costs of using an ambulance.

      • Private Health Insurance Basics

        Describes how health insurance works, the different levels (categories) of cover for both hospital and general treatment (ancillary/extras).

        • Product tiers

          Four new tiers of hospital cover will begin rolling out from early 2019 and will become mandatory from 1 April 2020. All hospital insurance policies will be classified as Gold, Silver, Bronze or Basic. All hospital treatments are now listed under clinical categories to describe what is and is not covered under each policy.

        • Clinical categories

          Details of what is and is not covered by the clinical categories, with links to their MBS item numbers.

        • General Treatments

          Definitions of some services covered under General treatment private health insurance in Australia.

        • Registered health insurers

          Overview of the operation of health insurers registered under the Private Health Insurance Act 2007 in Australia

        • Private Health Information Statements

          Private Health Information Statements provide a summary of the services covered under private health insurance policies in Australia.

        • Waiting periods

          Most private health insurance policies will have a waiting period associated with the services it covers, this means that when you take out the insurance you will have to serve the waiting period before you claim especially if you are claiming for treatment for a pre-existing condition.

        • Out of pocket costs

          Explains what a 'gap' or out of pocket cost is for both hospital and medical treatment and what you can do

        • Managing your policy

          You may be eligible for a discount on your premium or some insurers offer rate protection policies. You may be able to lower your premiums by choosing to not be covered for certain services (exclusions), receive limited benefits (restricted benefits), or to pay a set amount towards the costs of treatment (excess or co-payment).

      • Government Surcharges & Incentives

        Australian government incentives and surcharges for private health insurance.

      • Overseas Visitors & Overseas Students

        Students and visitors from overseas may be required, or should consider, to take out private health cover whilst visiting Australia.

        • Overseas Visitors Health Cover

          Visitors to Australia on a temporary visa are generally not eligible for free health care as resident of Australia are, you should consider taking out Overseas Visitors Health Cover to cover any medical costs while you are in Australia.

        • Overseas Student Health Cover

          Students from overseas may be required, or should consider, to take out private health cover whilst studying in Australia.

        • Working visa applicants

          Applicants for working visas - such as 482 and 485 visas - may be required to hold Overseas Visitors Health Cover.

      • Private Health Insurance Changes

        In 2019 the Australian Government introduced rules to help make private health insurance simpler including Gold, Silver, Bronze and Basic hospital tiers, and standard clinical categories to describe what is and is not covered. Further changes were introduced in 2021.

    • Health Insurers

      Policies, contact details & performance.

    • Compare Policies

      Find policies that match your needs.

    • Contact Us

      Got a question? Contact us today.

    • Frequently Asked Questions

      Frequently asked questions.