Health Insurance for Athletes and Active Individuals

Whether you’re a casual gym-goer, a weekend warrior, or a competitive athlete, maintaining your health and recovering quickly from injuries is essential. While staying active is great for your overall well-being, it also comes with risks of injury and wear and tear on your body. Health insurance designed with athletes in mind can provide peace of mind, faster access to care, and financial protection for treatment and recovery.

This guide explores how private health insurance benefits physically active individuals, what to consider when choosing a policy, and which options offer the most value for athletes.

Why do athletes need sports insurance?

The Australian institute of Health & Welfare report (last updated in July 2024) recorded 56,000 hospital admissions due to sports injuries in 2021/22. Athletic participation often results in both acute and chronic injuries. Common sports injuries requiring immediate medical attention include:

• Fracture: A partial or complete break in a bone.

• Soft-tissue Injury: Damage involving the sprain or strain of muscles, ligaments, or joints.

• Open Wound: A break in the skin such as a cut, puncture, or bite.

• Intracranial Injury: Damage occurring within the skull, often resulting in a concussion.

• Dislocation: The displacement of bones from their normal position at a joint.

• Superficial Injury: Damage affecting the surface of the skin, such as abrasions, bruising, or blisters.

Fractures accounted for over half of all sports-related injury admissions in 2021/22. Given that athletes are more prone to injuries than the general population, having robust health insurance cover is essential.

How Can Private Health Insurance Benefit Athletes?

Athletes and active individuals face unique challenges, including higher risks of acute injuries (e.g., sprains, fractures) and ongoing musculoskeletal wear. Appropriate health insurance tailored to these needs offers:

1. Access to Faster Treatment

Public healthcare systems often involve long wait times for elective surgeries, such as reconstructive procedures for torn ACLs or cartilage repairs. With appropriate private hospital cover, athletes can:

• Skip public hospital waitlists and access private hospitals sooner.

• Be treated by specialists or surgeons of their choice

• Reduce downtime after an injury, so they can return to training faster.

2. Support for Recovery and Rehabilitation

Many active individuals need extra help to recover fully and prevent recurring injuries. With extras cover, you get rebates for services crucial to recovery, such as:

Physiotherapy: Essential for strengthening and restoring mobility after injuries.

Remedial Massage Therapy: Beneficial for relieving muscle strain and improving flexibility.

Chiropractic Care: Ideal for alignment issues or back pain caused by high-impact sports.

Orthotics: Customised solutions to alleviate foot, ankle, or knee problems.

3. Preventative Healthcare

Preventative measures such as regular physio or remedial massage can help maintain optimal performance and reduce the risk of common issues like repetitive strain or joint deterioration.

4. Financial Protection for Major Medical Costs

Private hospital stays and surgical procedures, such as fixing a torn rotator cuff or ligament reconstruction, can cost thousands of dollars without insurance. The right health insurance ensures financial protection, so you don’t have to sacrifice physical health for financial stability.

Isn’t Medicare enough for athletic injuries?

While Medicare will usually cover you in an emergency injury situation, it’s important to note that as many as 33% of sports-related injuries are classified as non-emergency. Surgeries and treatments for sports injuries often fall under the category of elective (non-emergency) procedures, resulting in extended wait times in the public hospital system - sometimes over several months. 

Athletes may find themselves in a precarious position, facing both injury and long wait times for treatment, even for concussions, which often have long-term effects on your brain that may not be obvious immediately.

Concussion doesn’t just occur in contact sports.  In 2021-22, almost 2,300 hospitalisations from concussions related to sports were recorded. Of these, 

• Around 1,600 were in men, 700 were in women

• About 760 occurred while playing football

• Around 425 occurred while cycling

For athletes, relying solely on Medicare could mean delayed treatment and recovery times. Considering private health insurance could help you get the care you need, when you need

Can private health cover protect you when you play sport?

Appropriate private health insurance can bridge the gaps in Medicare, ensuring that you’ll receive timely health care while you play sports. When evaluating your health insurance options, it’s worth considering the following:

• Type of sport: different sports carry varying risks. Contact sports like rugby and football typically have higher injury rates compared to non-contact sports like swimming.

• Frequency of participation: more frequent participation increases your exposure to potential injuries. Assess how often you train or compete to gauge your coverage needs.

• Travel for sport: if you travel to compete, you may encounter unexpected medical issues. Many international locations do not fall under Reciprocal Health Care Agreements (RHCAs).

• Past injuries: previous injuries can influence your current and future health needs. When you’re comparing health cover options, think carefully about your medical history to ensure you receive adequate cover.

Some insurers even offer specialised policies for sports, such as Personal Accident Cover, which can provide financial support if you're unable to work due to injury. Below is a quick comparison of options:

Note: Medicare and private hospital cover don’t include out-of-hospital services like physiotherapy, remedial massage, podiatry, or dietetics. If you need help covering the cost of these services, extras cover is worth considering.

What Type of Health Insurance is Best for Athletes?

Athletes can generally benefit from combining hospital cover and extras cover . Here’s how each type of insurance works for active individuals:

Hospital Cover

Designed to cover major medical services involving hospitalisation, such as:

Surgeries for Sports Injuries: Knee reconstructions, shoulder dislocations, or fracture repairs.

Private Hospital Treatments: Specialist surgeons and shorter wait times.

Diagnostic Imaging: MRIs, X-rays, or ultrasounds often required for injury assessments.

Most policies categorise these treatments under orthopaedic surgery, available with Silver Plus or Gold-level hospital cover.

Extras Cover

Extras policies are especially useful for managing everyday and preventative care needs, including:

• Routine physiotherapy visits to maintain strength and flexibility.

• Chiropractic adjustments for posture or spine-related issues.

• Remedial massage for muscle recovery.

• Podiatry services and orthotics to address foot or knee pain.

Pro tip: Check if your extras policy provides high annual limits for physiotherapy, as sessions can add up quickly.

Real-Life Example: Why Insurance for Athletes Matters

Scenario:

Katie, a 28-year-old triathlete, suffered a torn ACL during a training session. As a private health insurance holder with Silver Plus hospital cover and extras for physiotherapy, her health insurance allowed her to:

Access a private surgeon within 2 weeks instead of waiting 6–12 months in the public hospital system.

Reduce out-of-pocket hospital expenses for the surgery to under $500.

Use her extras policy to claim physiotherapy sessions post-surgery.

Katie was able to begin recovery and return to training months earlier than if she had relied on the public system alone.

Ready to Find the Right Policy?

As an athlete or active individual, staying healthy and recovering quickly from injuries is essential to doing what you love. Appropriate private health insurance can give you access to faster treatment, preventative care, and financial protection.

Contact Compare Club today to find a policy tailored to your fitness goals and healthcare needs#. Let us do the hard work so you can focus on your performance.

Frequently Asked Questions

Does Health Insurance Cover Sports Injuries?

Yes, many private health policies cover sports injuries such as fractures, ligament tears, or dislocations. Hospital cover is needed for surgeries, while extras cover applies to physiotherapy or out-of-hospital rehabilitation services.

Should I Get Extras Cover for Physiotherapy?

If you’re prone to injuries or rely on regular physio for recovery and performance maintenance, extras cover is a valuable addition. Look for policies with higher annual physio limits to maximise your benefits.

What Does a Gap Fee Mean for Athletes?

Gap fees are the difference between what your insurer covers and what your specialist charges. Check if your health fund has no-gap or known-gap agreements with certain providers to reduce your costs.

Will Insurance Cover Me for All Sports?

An appropriate policy will cover you for all sports and recreational activities. Nevertheless, you should always review your policy for specific details.

Sources

• https://www.icare.nsw.gov.au/employers/take-out-a-policy/sports-insurance

• https://www.qbe.com/au/business-insurance/accident-health/qbe-sports-injury

• https://www.flipinsurance.com.au/activities/sports

• https://www.gowgates.com.au/sport-programs/athletics

• Australian Government Department of Health

• Private Health Insurance Ombudsman

• Sports Medicine Australia

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.

Meet our health insurance expert, Chris Stanley

Chris's top health insurance tips

• 1

  Australia’s public health system is world-class, but wait times for public hospitals can be long, inconvenient - and leave you living in constant pain while you wait.

• 2

  An appropriate private health insurance policy can speed up your surgery, relieving your pain sooner.

• 3

  Family health cover means your children are covered under the same policy as you.

• 4

  Many health insurance policies come with a 12-month waiting period for pregnancy-related cover, so it’s a good idea to get a family policy organized well before starting your family. This means your child will be covered from birth until at least their early twenties (depending on which health fund you select).