Health Partners Health Insurance Review

When health.com.au established their "online only" health fund in 2012, they were the first new private health insurer in the Australian market since 1976. In 2015, they were acquired by GMHBA.

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by Gary Andrews

Last update 15 Apr 2021

Overview

From 1 July 2021, health.com.au will become part of Frank – another GMHBA brand. You won’t be able to buy a new policy from health.com.au from this date but you can see what policies they used to offer below.

Health.com.au isn't on our panel but we're confident we can get you a great deal on your health insurance.

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Hospital cover

Nobody chooses to go to hospital.

But when you do, hospital cover will help you get the treatment you need, where and when you want it.

It also helps to pay the bills, as fees for hospital rooms and specialists can add up.

Think about what services you're likely to need, in line with your budget.

If you earn over $90,000 individually or $180,000 as a couple, you could avoid paying the Medicare Levy Surcharge.

Health.com.au offers four hospital policies, ranging from no-frills Entry Hospital cover to comprehensive Core Plus Silver cover.

All hospital policies include:

  • Emergency ambulance transport‌
  • No excess to pay when kids are admitted to hospital

Entry Hospital (Basic+)

This is health.com.au's budget option.

All covered same day and overnight admissions are limited to public hospital cover.

This cover does allow you to avoid the Medicare Levy Surcharge.

Key inclusions:

  • Avoids the Medicare Levy Surcharge
  • All covered services are restricted and you may incur costs in a private room or a private hospital.

Base Hospital (Bronze +)

The Base Hospital plan covers a range of standard hospital services.

It's available with a co-payment, a $500 excess or $750 excess.

Key inclusions:

  • Dental surgery
  • Joint reconstructions
  • Digestive system
  • Gynaecology

Bronze Plus Essential Hospital

This plan provides Bronze cover with a few added items that aren't in the Base Hospital plan.

It's available with a $500 or $750 excess.

Key inclusions:

  • Lungs and chest
  • Pain management
  • Chemotherapy, radiotherapy and immunotherapy
  • Kidney and bladder

Core Plus

Health.com.au's Core Hospital cover is their most expensive hospital cover.

It's a Silver Plus policy and doesn't cover pregnancy services or weight loss.

If you want top tier Gold cover with these items included, you'll need to compare other insurers.

Key inclusions:

  • Joint replacements
  • Sleep studies
  • Cataracts
  • Palliative care

Ambulance Cover

Every health.com.au policy includes emergency ambulance cover, meaning you are covered when you could not have been transported to hospital any other way.

You may also receive additional cover depending on which state or territory you live in.

For example, in NSW and the ACT you are covered for all ambulance services, whilst in VIC, SA, WA and the NT, you are only automatically covered for emergency ambulance transport.

Read our ambulance cover guide for a state-by-state breakdown of how ambulance services work across Australia.

Extras cover

From dental, to optical, to chiro and more, extras insurance helps cover the bills for routine treatments that aren't covered by Medicare.

While we've summarised the key points of each plan below, it's always worth digging a little deeper into any gap fees, how much you can claim back, and whether your preferred healthcare provider, such as your local dentist, is recognised by the health fund.

Take the time to work‌ ‌out‌ ‌what‌ ‌you‌ ‌need‌‌ and what you're prepared to pay. If this feels a bit overwhelming, you can speak to one of our experts.

With the health.com.au extras plan, you have the freedom to choose your own provider and still receive the same benefit.

Health.com.au currently has one open extras plan, which we've detailed below, and the Pulse 50, Pulse 60 and Active 60 extras plans.

At the time of writing, these are all closed to new customers.

Extras 50

Health.com.au's Extras 50 cover will cover you for a wide range of treatments, including dental, orthodontics, optical, non-PBS pharmacy, dietetics and psychology.

Podiatry, hearing aids and blood glucose monitors are not included.

Customers get up to 50% back on all treatments.

They also offer 100% back on single vision and multi focal lenses and frames, up to a $200 limit per policy.

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Waiting periods

Waiting periods are there to stop people from signing up, claiming and then cancelling their cover.

It means once you take out a new plan, you may have to wait a certain amount of time before receiving your benefit.

When you switch to health.com.au from another provider, you won't have to re-serve your waiting periods, unless you have upgraded to a higher level of cover.

Hospital Waiting Periods

  • 1 day -- For treatment in hospital as a result of an accident
  • 2 months -- For treatment in hospital as the result of a new condition
  • 12 months -- For treatment in hospital as a result of a pre-existing condition and for pregnancy related services

Extras Waiting Periods

  • 1 day -- For Ambulance Cover
  • 2 months -- For General Extras
  • 12 months -- For Major Dental and Orthodontics
  • 12 months -- For Health Appliances

How to claim

Hospital

Simply tell the hospital you are a member of a health.com.au policy.

Your hospital account will be sent directly to health.com.au for them to assess on your behalf.

However, health.com.au members might be sent invoices for any specialist services such as anaesthetists or assisting surgeons.

These services have a separate claims process.

Extras

You can swipe your membership card to claim directly on the spot with your provider's HICAPS or iSOFT terminal.

You can also receive a copy of the invoice and claim online through your member portal.

Usually, you can do this without having to take a photo or scan your invoice.

Hospital agreements

Health.com.au has agreements with most hospital and day surgery providers across Australia.

When comparing policies, it's worth checking if your preferred local hospitals and clinics are covered.

Our specialists at Compare Club can do this for you.

Customer service

According to privatehealth.gov.au, this fund had 1.8% of complaints from a 0.6% market share, suggesting that health.com.au's customer service may be below average.

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FAQs

Is Health.com.au a not-for-profit fund?

No, health.com.au is a for-profit fund.

However, their parent company GMHBA is not-for-profit.

Who can apply? Are there any restrictions?

Health.com.au is an open fund, so anyone aged 16 or over can apply.

Is it easy to switch to Health.com.au?

Health.com.au is not on our panel of insurers, so you’ll need to contact them directly to switch.

If you’re still interested in exploring your options, it’s free to compare a range of funds with Compare Club and we’re confident we can get you a great deal.

Do I need to re-serve waiting periods?

You can switch to an equivalent or lower level of cover without re-serving waiting periods.

You will only be required to serve waiting periods if you have upgraded to a higher level of cover and/or higher benefits.

Can I change my level of cover?

Yes, you can modify your cover with Health.com.au directly.

If you move to a higher level of cover, you will usually need to serve waiting periods on the extra services and/or higher benefits.

Do I get the government rebate?

For every dollar of private health insurance premiums, the Australian Government provides eligible Australians with a rebate of up to 33.4% (depending on your age and income).

The easiest way to claim the rebate is to ask health.com.au to provide you with a premium reduction.

You could also claim the rebate at tax time.

Do I have to pay the Lifetime Health Cover loading?

Perhaps – but you can avoid the LHC if you take out eligible private health insurance hospital cover before your 31st birthday.

Who underwrites the policies?

Health.com.au which is owned by GMHBA.

What age are children covered up to?

Dependent children are covered until 21 years of age – or between the ages of 21 and 25 if the dependent is studying full time.

How do I get in contact with Health.com.au?

You can get in touch with health.com.au any time through the live chat function on their website.

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This guide is opinion only and should not be taken as medical or financial advice. Check with a financial professional before making any decisions.