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This is the part of your cover that pays for your hospital stay, hospital care, and any medications you receive
while in hospital. What treatments you’re covered for, and the extent of that cover depends on the tier of cover
you get. See below:
QLD | VIC | NSW | SA | WA | TAS | AUS | |
---|---|---|---|---|---|---|---|
Couple 50+ | $439.23 | $458.80 | $424.66 | $409.28 | $373.64 | $413.03 | $419.77 |
Singles | $219.61 | $229.40 | $212.33 | $204.64 | $186.82 | $206.51 | $208.89 |
{ "First-Time Buyers": "Being smart when selecting health cover means you get more than just a tax saving. From free dental check-ups to peace of mind you're covered for common hospital procedures, you can balance what you need against your budget.", "Switching Plans": "Reviewing your health cover regularly helps make sure that you're getting value for money. It also means you've got the right insurance for what you need tomorrow at the right price. That's vital at a time when every cent counts." }
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Our experts can help make your journey into Australia as easy as possible by helping you get overseas visitors health cover before you’ve arrived.
We can even help you receive your certificate of insurance online and our OVHC policies meet visa condition 8501.
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Chris Stanley is the sales & operations manager of health insurance at Compare Club. With extensive experience and expertise, Chris is a trusted leader known for his deep understanding of health insurance markets, policies, and coverage options. As the sales & operations manager of health insurance, Chris leads a team of dedicated professionals committed to helping individuals and families make informed decisions about their health insurance needs.
Chris Stanley
- Sales & Operations Manager for Health Insurance
Dental extras cover helps pay for costs associated with dental care, from routine check-ups to complex procedures. With this, you can smile wider knowing your teeth are covered.
Optical extras provide financial help for eye-related health care such as glasses, contact lenses, and eye tests. See life in a clearer light, and keep your eyes healthy with optical extras.
The Medicare Levy Surcharge is a tax for Australians who don't have private health insurance but earn above a certain income. Avoid the surcharge, and benefit from private care by exploring health insurance options.
This cover ensures visitors to Australia receive necessary medical treatment during their stay. If you're travelling to the land Down Under, consider getting overseas visitors cover for peace of mind.
A plan designed to cover both you and your partner's health needs. Simplify your policy management, potentially save costs, and ensure you both receive the care you need with couples health insurance.
These are set timeframes you must wait before claiming benefits after starting a new insurance policy or upgrading your current one. Understanding waiting periods helps avoid surprises when it comes time to use your insurance.
Changing your health insurer could help you find a better fit for your needs or reduce your premiums. If you're contemplating a switch, get informed to make sure the change works in your favour.
Ambulance cover takes care of costs related to emergency ambulance services. Without it, these costs can be hefty - secure this cover and ensure swift medical response when you need it most.
Family health insurance plans provide medical coverage for your entire family under one policy. It's designed to protect those you love most, ensuring your family's health needs are covered without needing separate plans for each member.
Ambulance Cover: Ambulance cover refers to the insurance coverage for emergency ambulance services. In Australia, ambulance services are generally not covered by Medicare (the public healthcare system) and can result in significant out-of-pocket expenses. Having ambulance cover through private health insurance helps protect individuals from the high costs associated with emergency ambulance transport.
It's important to note that ambulance cover requirements and regulations vary between Australian states and territories. Some states provide free or subsidized ambulance services to their residents, while others require individuals to have their own ambulance cover. It's crucial to check the specific requirements and regulations in your state or territory and ensure that you have adequate ambulance cover in place to avoid potential financial burden during emergency situations.
Extras Cover: Additional health insurance coverage that provides benefits for services not typically covered by Medicare, such as dental care, optical services, physiotherapy, and chiropractic treatments. Here are some examples of extras that are commonly covered under private health insurance policies in Australia:
Gap Cover: An arrangement where private health insurers may provide additional benefits to cover or reduce the out-of-pocket expenses (known as the "gap") incurred by policyholders for in-hospital medical services not fully covered by Medicare.
General Dental: General Dental refers to routine dental treatments and preventive care aimed at maintaining oral health. These can include services such as check-ups, teeth cleanings, X-rays, fillings, and basic extractions. General Dental coverage is a common component of extras cover provided by private health insurance policies in Australia. It helps individuals offset the costs of routine dental visits and basic treatments. The level of coverage for General Dental can vary depending on the insurance policy and the specific extras cover chosen by the individual.
Hospital Cover Tiers: Hospital cover in Australia is categorized into tiers, which represent different levels of coverage and benefits. These tiers were introduced to simplify and standardize private health insurance policies. The tiers are as follows:
Hospital Cover: Hospital cover refers to the component of private health insurance that provides coverage for hospital treatments and services. Hospital cover allows individuals to have greater control over their healthcare options by providing access to private hospitals, choice of doctor, shorter waiting times, and accommodation in a private room (depending on the level of cover). Hospital cover typically includes benefits for in-hospital medical procedures, surgeries, accommodation, and related services, such as anesthesia and operating theatre fees.
Lifetime Health Cover (LHC): A loading or penalty applied to the premium of private health insurance policies if an individual takes out cover after the age of 30. It incentivizes individuals to maintain continuous private health insurance coverage.
Major Dental: Major Dental refers to a category of dental treatments that typically involve more extensive procedures and higher costs. These can include treatments such as crowns, bridges, dentures, orthodontics (braces), and oral surgery. Major Dental coverage is a type of extras cover offered by private health insurance policies in Australia. It provides benefits or a percentage of the cost for major dental treatments, helping individuals manage the financial burden associated with these procedures. The specific coverage and limits for Major Dental can vary depending on the insurance policy and level of extras cover chosen by the individual.
Medicare Levy Surcharge (MLS): An additional tax imposed on high-income earners who do not have private health insurance and earn above a certain threshold. It encourages individuals to take out private health insurance and reduce the burden on the public healthcare system.
Medicare: Australia's publicly funded healthcare system that provides basic medical services and subsidized treatments to Australian residents.
Network: A group of doctors, hospitals, and other healthcare providers that have contracted with an insurance company to provide services
No-Gap: No-Gap refers to a situation where a policyholder does not have to pay any out-of-pocket expenses or the "gap" for certain medical services or treatments. It typically applies to in-hospital services where the medical practitioner agrees to charge only the Medicare benefit and the health insurance covers the remaining cost, eliminating or reducing the gap amount that the policyholder would need to pay. No-Gap arrangements can help individuals minimize their expenses for specific procedures or treatments.
Orthodontics: Orthodontics is a branch of dentistry that focuses on correcting misaligned teeth and jaw irregularities. It involves the use of braces, retainers, aligners, and other dental appliances to straighten teeth and improve bite alignment. Orthodontic treatment is typically considered a major dental procedure. Private health insurance policies in Australia may offer coverage for orthodontic treatment under extras cover, specifically under the Major Dental category. It's important to review the specific policy details and waiting periods associated with orthodontic coverage, as there may be limitations and conditions for reimbursement.
OSHC (Overseas Student Health Cover): OSHC is a specific type of health insurance designed for international students studying in Australia. It is a requirement for most student visa subclasses to ensure that students have access to necessary healthcare services during their studies in Australia.
OSHC provides coverage for essential medical treatments, hospital stays, prescription medications, and emergency services. It helps international students manage the costs associated with healthcare while studying in Australia and ensures they have access to necessary medical care.
Out-of-Pocket Expenses: Out-of-pocket expenses refer to the costs that individuals are responsible for paying directly when receiving healthcare services, even if they have health insurance coverage. These expenses can include deductibles, co-payments, and coinsurance, as well as any costs not covered by insurance. Out-of-pocket expenses can vary depending on the type of service, the insurance plan, and any applicable limits or exclusions.
OVHC (Overseas Visitor Health Cover): OVHC refers to health insurance specifically designed for visitors to Australia, including temporary residents, such as international students, working holiday visa holders, and temporary skilled workers. OVHC is a requirement for most visa subclasses to ensure that visitors have access to necessary healthcare services while in Australia.
OVHC provides coverage for essential medical treatments, hospital stays, and emergency services during the visitor's stay in Australia. It helps protect visitors from the high costs of medical care and ensures they have access to necessary healthcare services during their time in the country.
PBS (Pharmaceutical Benefits Scheme): The Pharmaceutical Benefits Scheme is a program by the Australian Government that subsidizes the cost of a wide range of prescription medications, making them more affordable for Australian residents. Under the PBS, eligible individuals pay a reduced price (known as the patient co-payment) for prescribed medications, while the government covers the remaining cost. The PBS ensures access to essential medications at affordable prices for the Australian population.
Pre-existing Condition: A medical condition that existed before an individual took out health insurance. Waiting periods may apply before coverage is provided for treatment related to pre-existing conditions.
Preferred Provider: Healthcare providers, such as doctors or specialists, who have an agreement with an insurance company to provide services at agreed-upon fees. Policyholders may receive higher benefits or reduced out-of-pocket expenses when using preferred providers.
Premium: The amount of money paid to the insurance company at regular intervals (monthly, quarterly, annually) to maintain health insurance coverage.
Private Health Insurance Rebate: A government subsidy provided to eligible individuals to help offset the cost of private health insurance premiums. The rebate amount is based on income and age.
Waiting Period: The specified period an individual must wait after taking out private health insurance before they can claim benefits for certain treatments or services. Waiting periods vary depending on the treatment or service.
Having appropriate private health insurance from an early age means you can avoid the Medicare Levy Surcharge (MLS), avoid Lifetime Health Cover loading and likely get the Australian government health insurance rebate.
The private health insurance rebate is money the government contributes towards paying your private health insurance premiums. Your age and income determine the exact rebate you get.
You can claim the rebate through your health fund or apply it when you lodge your yearly tax return. Learn more about how the private health insurance rebate works in Australia.
If you earn over $93,000 as an individual or $186,000 as a family, you need to take out private health insurance to avoid being hit by the Medicare Levy Surcharge. This can be up to 1.5% of your income, depending on how much you earn.
Lifetime health cover loading, meanwhile, affects people who do not take out private hospital insurance before they are 31. If you decide to take our cover at a later age, you will pay a loading fee.
This is 2% for each year you did not hold cover from the 1st of July following your 31st birthday. So, if you are 35 when you decide to take out private health cover, you will pay a 10% loading fee. LHC is capped at 70%.
How much you pay for private health insurance depends on what level of cover you want and which provider you choose. On average, health insurance policies cost between $2000 to $3000 per year depending on whether you have hospital cover, extras cover, or a mixture of hospital and extras cover (combined policy).
Identify which funds have the features you want, and shop around for value. It sounds simple, but health insurance can be confusing. Start by reading our guide on how to compare and select the right policy. It is worth taking time to note down what health services you and your partner or family need today and in the future. Doing this will make it easier to decide what level of hospital cover you need; Gold, Silver, Bronze or Basic. Look for the health fund package that includes everything you need without including many items you will likely never use.
You should have a clear idea of what kind of policy you are looking for. Factors to consider include:
Doing this will make it easier to decide what level of hospital cover you need; Gold, Silver, Bronze or Basic. Look for the health fund package that includes everything you need without including many items you will likely never use. Then go through the same exercise for your extras. Do you wear glasses? How much are you currently paying for a dental check-up? Are you likely to need physio in the future? There are other things to consider when choosing a health fund. How long will you have to wait before you can access treatment? What rebates can I get? Are there any limits to what I can claim on my extras? Will I get hit by gap fees?
As you can tell, trying to compare health insurance can be a time consuming and confusing process. That is why our specialists can compare policies from our panel of insurers in a matter of minutes and quickly help you find the cover you need at a price you can afford. If you’re looking for a quick and easy health insurance comparison, Compare Club has you covered.
Medicare covers quite a lot of health care costs but there are also a lot of health related expenses that Medicare won’t cover. You can either pay for these out of your own pocket, or take out private health cover to assist you with these costs.
Medicare doesn’t cover dental health:
Dental care is one of the largest expenses not covered by Medicare. The average cost of dental care in Australia was $432 per household member in 2021*. A family with a couple of adults and a couple of kids can really see these expenses skyrocket, particularly if any family member needs orthodontics or major dental surgery. Those costs will rise well above the average! That’s why private health cover makes sense for most families*.
The other limitation Medicare has is public hospital waiting times. Should you need surgery that isn’t deemed an emergency, such as some joint replacement procedures, current waiting periods average at least 40 days in around half of public hospital cases (in 2022) stretching to a year for some orthopaedic sugereies at some public hospitals. That’s a long time to wait if you’re in pain, or need to return to work, or even if you have to factor in a recovery period. Most of us can’t afford to wait 40-plus days for a procedure and take several more weeks to recover. Appropriate private health cover allows you to elect to have the procedure in a private hosital and organise it around your schedule.
Ambulance trips are one type of emergency care that isn’t covered under Medicare. Some states have free ambulance trips for residents of their state only, but others do not. Residents from those states that do not have free ambulance services receive a bill for their emergency care trip. Ambulance cover is a type of private health cover that helps you avoid being stuck with an expensive bill after receiving emergency medical aid, and it’s included in many hospital cover policies.
You can read our ambulance cover guide here.
Seniors can get health insurance in Australia. In fact, private health insurance is community rated, which means that everyone pays the same price for a particular policy, regardless of their age or health status. Some older customers may be affected by LHC if they haven't held hospital cover continuously since 31 or for 10 years (read more here).
A health insurer can't refuse to insure you or sell you the policy you want to buy, and you are guaranteed the right to renew your policy
If you have pre-existing conditions, you may not get immediate cover for what you want and will have to serve a waiting period before you can claim. If you are switching your health insurance policy to one with an equal or lesser level of cover, you will not need to re-serve waiting periods.
All your health insurance questions answered
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Things you should know
As our customer you'll be provided with quotes directly from the insurer for the product you intend to purchase. We manage the application and deal with the administration work and insurer. We do not charge you a fee for the service we provide, the insurer simply remunerates us in return for setting up your policy.
The financial and insurance products compared on this website do not necessarily compare all features that may be relevant to you. Comparisons are made on the basis of price only and different products may have different features and different levels of coverage. Compare Club does not compare all policies available in Australia and our partner insurers may not make all policies available to Compare Club.