Private Health Insurance Western Australia

Getting the right health insurance for your lifestyle and needs can be a challenging task, especially if you’ve never taken out private health cover before or have recently moved to a different state. In Western Australia, there’s a variety of health insurers to choose from.

Whatever your situation, it’s really important to take the time to understand how health cover works in WA.

We’ve put together this helpful guide to explain the key considerations so you can find the right policy for your situation.

How do I compare private health insurance in Western Australia?

In order to get quality private health insurance at a price that matches your budget and covers you for all the services you need, it’s important to compare the various health insurers in Western Australia. When comparing policies, consider the:

• Benefits offered with each policy, including coverage for hospital stays, outpatient services and specialist appointments.

• Cost of each policy, including monthly premiums and any deductibles or out-of-pocket expenses.

• Reputation of the insurer and their customer service track record.

• Local coverage: Does the insurer have an agreement with your nearest hospital or dentist? This is especially important if you’re living in regional or remote WA.

Because doing these comparisons manually could take hours, days or even weeks, it’s worth reaching out to an expert service like Compare Club to help you find a provider and policy that best matches your needs and budget.

What are the largest health funds in WA?

Just because one health insurer is larger than another, this doesn’t necessarily mean they offer the most appropriate cover for your needs.

Western Australians tend to lean towards Perth-based funds HBF and HIF, but also choose other large funds like Medibank and Bupa.

These are the 10 largest health funds in WA, as well as their approximate market share. Remember, not all funds have agreements with all hospitals and healthcare providers in WA, especially if you live outside of Perth, so it’s worth checking before you commit.

• HBF – 53.1%

• Medibank – 20.2%

• BUPA – 11.5%

• HIF – 3.7%

• HCF – 3.3%

• NIB – 2.9%

• GMHBA – 0.9%

• CBHS – 0.8%

• Defence Health – 0.7%

• Teachers Health – 0.5%

What are the best-performing health funds in Western Australia?

This depends on a variety of factors, many of which are specific to your individual wants and needs, as well as your location. To decide which are the best-performing health funds in WA, you may want to consider:

• How much each insurer pays back to its members via benefits and payouts.

• What percentage of hospital-related charges are covered by the insurer.

• The number of services with no gap or a known gap.

• Whether there are agreements with your closest hospitals & other health care providers.

A better-performing health fund does include one that offers very high benefits as a percentage of contributions. However, other funds may be preferable because their policies have a higher percentage of services located close to you, and then there are those with no gap or a known gap as well.

What types of cover can I get in WA?

Every health fund in Western Australia provides a selection of policies for you to choose from. Hospital cover, for example, comes in Basic, Bronze, Silver and Gold tiers that are tailored to your individual requirements.

Many West Australians choose to get private hospital cover because it exempts them from having to pay the Medicare levy surcharge at the end of the financial year.

Alternatively, you can take out a combined hospital and extras policy – or extras-only. The former is preferred by many West Australians because it covers them for everyday treatments such as dental, optical and chiropractic, and may end up offering the best value for money.

If you only want to be covered in the event of an emergency, you can simply take out ambulance-only cover to avoid paying a substantial bill.

What’s the best health insurance in Western Australia?

There’s no one-size-fits-all health policy or provider that will suit every single West Australia resident.

It depends a lot on the level of cover you want, how much you can budget for premiums each month, where you live in the state, and the types of procedures or extras you want included in your policy.

Public vs private hospitals in WA:

Public hospitals are owned by the WA State Government and managed by WA Health, whereas private hospitals are owned and managed by private organisations.

Some private hospitals may collaborate with WA Health to offer free public healthcare, with these partnerships typically being where a public hospital is situated in the same location as the private hospital. 

When it comes to your health cover, it’s important to do your due diligence and ensure you’re covered for what you need. For example, checking whether your local hospital or dentist has an agreement with your preferred health fund helps protect you against unexpected gap fees.

How much does West Australian ambulance cover cost?

The total cost of an ambulance transfer depends on the seriousness of the callout. If you have private health insurance or ambulance-only cover, these costs are usually covered by your insurer. However, if you’re uninsured then you will have to foot the bill yourself.

According to the latest figures from St John Ambulance WA, ambulances fees range from:

• Life threatening (Emergency - Priority 1): $1,072

• Urgent (Priority 2): $1,072

• Non-urgent (Priority 3): $576

• Patient Transfer Vehicle (Booked Priority 4 & 5): $511

Are there any health insurance levy and rebates for West Australians?

Yes.

The Federal Government uses the Medicare levy as an incentive for Australians to take out private health cover. If you are a high-income earner in Western Australia and do not have private health insurance, you’re liable for paying a surcharge of 1.5% of your taxable income.

In terms of rebates, the Federal Government contributes varying amounts to help cover the cost of your health insurance premiums. The total amount depends on your income:

Source: Private Health Rebate Incentives *Single parents and couples (including de facto couples) are subject to family tiers. For families with children, the income thresholds are increased by $1,500 for each child after the first.

Waiting periods for Western Australians

The Government sets the maximum waiting periods for hospital services, but waiting periods for extras are determined by individual health insurers, so make sure you read your policy in full to understand any specific waiting periods that apply for you.

As a general rule, here are some of the most common waiting periods for private health insurance in Western Australia:

• Physiotherapy and general dental – 2 months

• Rehabilitation, psychiatric care and palliative care – 2 months

• Optometry – 6 months

• Pre-existing conditions, pregnancy and birth-related services – 12 months

• Major dental – 12 months

Why get private health cover in Western Australia?

Getting private health cover in Western Australia can help you cover the cost of some – or all – of your healthcare bills as a private patient. It also gives you the freedom to choose your preferred doctor or specialist when you’re receiving treatment in a private hospital.

You can also be treated as a private patient in a public hospital if you have private health insurance.

Finding the best-for-you health cover in Western Australia is made so much easier when you use Compare Club. We saved Australians $300 on average when they compared and switched with us in 2022*.

The best way to find a good policy in Western Australia is to compare, so start comparing today:

Sources:

Private Health Insurance Ombudsman, 2020 State of The Health Funds Report.

St. John WA, Metro Ambulance Fees

Australian Institute of Health and Welfare, Elective Surgery Statistics.

Australian Tax Office, Income Thresholds and Rates For The Private Health Insurance Rebate.

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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.

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).