Private Health Insurance Basics
Private health insurance policies cover you when you go to hospital or when you receive non-hospital medical services that are not covered by Medicare. You can choose from different levels of cover - the higher hospital policies include a broader range of services, and the higher general treatment (extras) policies cover a broader range of services and in some cases higher benefits.
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 (e.g. dental, physiotherapy).
Most health insurers 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'.
What should I consider when purchasing insurance?
- Waiting periods: If you are 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 do not receive any benefits for certain treatments or you receive lower benefits for a period of time.
- What isn't covered on my policy: You should 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 will have to pay some out-of-pocket expenses.
- Your healthcare needs: You should review your cover from time to time to ensure it still meets your needs. If the premium has become a concern for you, there are a number of ways you may be able to manage your policy and lower costs. If you already have private health insurance, you can also consider moving to a different insurer.
- Comparing health insurance policies: every policy available for sale in Australia is summarised on this website in the form of a Private Health Information Statement (PHIS) to make it easier to compare policies. For private hospital cover, standard Clinical categories specify what is and is not covered on each policy.