How to Choose the Best Health Insurance?

Choosing the right health insurance in Australia can be confusing, especially with all the different options available.

Whether it’s deciding between public or private cover, understanding what’s included, or figuring out the cost, there’s a lot to consider.

The goal of this guide is to simplify the process for you by breaking down the key things to look for when selecting a health insurance plan.

This article aims to help you understand the basics of health insurance, compare options effectively, and make informed decisions about your health coverage.

What to consider when choosing a health insurance plan

When choosing a health insurance plan in Australia, it’s important to start by identifying your personal needs. For example, think about your current health status, family needs, and any potential risks based on your lifestyle or medical history.

If you’re young and generally healthy, a basic plan with coverage for unexpected hospital visits may be sufficient. But if you have a family or a pre-existing medical condition, you might want a more comprehensive policy.

Next, evaluate the type of cover you need. Health insurance in Australia is generally divided into hospital cover, extras cover, and combined cover:

• Hospital cover helps pay for treatment as a private patient in both private and public hospitals. This can include surgeries, specialist care, and accommodation.
• Extras cover includes things like dental, optical, physiotherapy, and alternative therapies that aren’t covered by Medicare.
• Combined cover offers the benefits of both hospital and extras cover.

Consider what you’d actually use—don’t pay for extras you don’t need.

Public vs. private health insurance – which is better?

In Australia, you have access to both public and private healthcare systems. Public healthcare, through Medicare, is available to all Australian citizens and permanent residents. It covers a wide range of services, from general practitioner (GP) visits to treatment in public hospitals. However, it doesn’t cover everything, such as dental, most elective surgeries, or physiotherapy.

On the other hand, private health insurance provides additional benefits, like quicker access to treatments, choice of doctors, and cover for private hospital rooms. It’s also helpful for certain elective procedures that aren’t available under the public system. Private insurance can also be beneficial if you want coverage for extras like dental or optical.

So, which is better? The choice largely depends on your personal needs, budget, and whether you prioritize accessibility or affordability. Public healthcare ensures basic services for all, but if you want more options and faster treatment, private health insurance might be a better fit.

How to compare health insurance coverage and prices

When comparing health insurance plans, start by looking at what’s included in the coverage. Different insurers offer various benefits, so check what’s covered and what’s not. Pay close attention to details like:

• Type of treatments covered: Some policies may exclude certain medical procedures, so it’s essential to review the inclusions.
• Level of hospital cover: Some plans only offer basic hospital cover, while others include more comprehensive services, such as specialist care and elective surgeries.
• Extras cover: Look at which services are included and the limits for each, such as dental, optical, or physiotherapy.

Next, compare prices. Health insurance premiums can vary significantly, so use tools like the Private Health Insurance Ombudsman’s comparison website to find plans that match your needs. Consider the excess and co-payment you’ll need to pay if you’re admitted to the hospital. Higher excesses usually mean lower premiums, but you’ll pay more out-of-pocket if you need treatment.

What is included in health insurance in Australia?

Health insurance coverage in Australia is divided into basic, bronze, silver, and gold tiers. Each tier offers a different level of coverage:

• Basic cover is the most affordable but offers minimal coverage, mostly for accidents and essential treatments.
• Bronze cover adds a few more treatments, including some procedures that might be planned.
• Silver cover provides a more extensive range of treatments, including things like heart surgery and joint replacements.
• Gold cover offers the highest level of coverage, including maternity services and other complex treatments.

Extras cover typically includes services like dental, optical, chiropractic, and physiotherapy, but the extent of coverage varies by provider. Be sure to understand exactly what is included and the annual limits for each type of service.

Tips for saving on health insurance

Health insurance can be a significant expense, so it’s important to find ways to save while still getting the coverage you need. Here are some practical tips:

• Evaluate your needs regularly. Your health needs may change over time, so it’s worth reassessing your plan each year to ensure you’re not paying for services you don’t use.
• Consider your income. If you’re a high-income earner, private health insurance may help you avoid the Medicare Levy Surcharge (MLS), which is applied to those without private hospital cover.
• Choose a higher excess. Opting for a higher excess can lower your premiums, though you’ll need to pay more if you need hospital treatment.
• Claim eligible tax rebates. The Australian Government offers a Private Health Insurance Rebate to help make premiums more affordable, depending on your income and age.

Understanding waiting periods and coverage limits

All health insurance policies in Australia have waiting periods, which are the timeframes you need to wait before you can claim benefits for certain services. For example:

• 12-month waiting period for pre-existing conditions and pregnancy-related services.
• 2-month waiting period for psychiatric care, rehabilitation, and palliative care.
• General treatments like dental, optical, and physiotherapy may have waiting periods ranging from 2 to 12 months.

Additionally, most plans come with coverage limits, which cap the amount you can claim for certain treatments within a year. Understanding these limits is crucial to avoid unexpected costs, especially for extras like dental or optical.

Detailed information about the public healthcare system in Australia, including what is covered by Medicare and how it works alongside private health insurance.

Conclusion

Choosing the best health insurance in Australia requires a clear understanding of your personal needs, the level of coverage required, and how much you’re willing to spend.

It’s about finding a balance between affordability and adequate protection. Whether you’re considering public or private cover, be sure to compare your options and understand the details of each plan. With the right approach, you can select a policy that offers peace of mind and suits your lifestyle and budget.

FAQ

1. What is the difference between hospital and extras cover?
   Hospital cover helps pay for treatment as a private patient in hospitals, while extras cover includes services like dental, optical, and physiotherapy.
2. Can I switch health insurance providers in Australia?
   Yes, you can switch providers at any time. Your new insurer will typically recognize any waiting periods you’ve already served, provided you maintain the same level of coverage.
3. How does the Medicare Levy Surcharge affect health insurance?
   The Medicare Levy Surcharge (MLS) is an additional tax for high-income earners who don’t have private hospital cover. Taking out private health insurance can help avoid this tax.
4. What are waiting periods in health insurance?
   Waiting periods are specific times you need to wait before making claims on certain treatments. They vary depending on the service and insurer.
5. How can I lower my health insurance premiums?
   You can lower premiums by choosing a higher excess, tailoring your coverage to your needs, or claiming available government rebates based on your income and age.