Private Health Information Statements
Private Health Information Statements (PHIS) provide a summary of what each policy covers. You can use the PHIS to more easily compare policies when purchasing private health insurance or checking your cover.
Private Health Information Statements (PHIS) are available for all private health insurance policies sold in Australia. Health insurer are required by law to provide these Statements so you can review your existing policy or compare private health insurance policies. You can find a PHIS for every available policy on this website.
There are three types of Private Health Information Statements:
- Hospital - describes the clinical categories covered by the policy, identifying those with restrictions, plus waiting periods and any additional payments (excesses, co-payments and gaps),
- General Treatment - describes the features and limitations of general treatment cover, including which services are covered, waiting periods, benefit limits and example benefits for each type of service, and
- Combined - describes the features and limitations of a combined hospital and general treatment cover, with details as above.
A Private Health Information Statement only gives a summary of the key product features. However, it does allow you to see if your broad needs are covered and where products differ in both price and features. You will need to contact the health insurer to get all the details about the product.
Hospital product tiers
Some of the hospital product statements you can find on the website will include information about the policy's Hospital Tier - Gold, Silver, Bronze or Basic.
These tiers are currently optional, but will become mandatory from 1 April 2020 when all hospital insurance policies will be classified under one of these tiers.
What is, and is not, covered in these tiers will be based on new minimum standard categories of treatment called Clinical Categories. These standard categories are simply groups of what hospital treatments are, and are not, covered under each policy.
For more information about what is included in each tier, see Product tiers.
For detailed information about each of the standard categories, see Clinical categories.
Tips for comparing private health insurance statements
The PHIS is a starting point for you to compare different policies. However, they are provided for general purposes only. For more information, you will need to ask the insurer which provides the policy.
As with all types of insurance, conditions will apply, so don't just rely on the Statement - once you have full details from the insurer, make sure you read your policy information carefully before signing up and paying your premium.
- Please note that if the insurer includes "Other services (see insurer for detail)" it means that more services, other than the ones listed in the PHIS, may be restricted in some way or not covered and you need to contact the insurer to find out what those services are.
- You should not rely on the dollar amounts for premiums or benefits on the Statement as they are provided for comparison only. The actual premium may vary depending on your circumstances, for example, your age and your age when you first got health insurance.
- Benefits will vary depending on the details of your policy, the treatments you are having, the hospital you visit and who treats you.
- Note that some words used in the Statement may not be exactly the same as those that your insurer uses. Your insurer will be able to explain any differences. The Glossary also explains terms used on this site and many alternate terms used by health insurers.
- For definitions of the medical terms used on the hospital PHIS, see Clinical categories.