14 Things You Didn’t Know You Could Claim on Private Health Insurance


Do you have private health insurance? Are you thinking it only covers you for basics such as hospital services, the odd medication, and perhaps dental and physio? Do the perks end there? In most cases: absolutely not.

In addition to being able to choose your surgeon, hospital, and date of surgery, you may also be covered for services like remedial massage, wellness benefits & IVF, or get rebates for pilates classes, gym memberships, sunglasses and more. The following 14 services may be covered in full or part by your private health fund. Can you benefit from any of these?  

#1 Physical Rehabilitation

Rehabilitation comes in many forms for many different types of needs. Cover includes therapy for disease, injury, and other conditions, to improve skills and abilities which will return a person to a previous level of functionality. If you have had a knee replaced or need thoracic or respiratory therapy after a heart attack, this cover will pay you back for treatment. Some cover even goes as far as to pay for prosthetics and plastic surgery.

#2 Ambulance Coverage

Often, people are held accountable for payment when an ambulance is used, and while you may not think the expense will be significant, it can cost the earth. Not all ambulances travel by road – many people are rescued by helicopters – and that, alone, may give you a better indication of cost. While the expense may not be front of mind in an emergency, the bill will hit later – and the peace of mind is a nice luxury to say the least. Some hospital policies will cover ambulance services but most will not. Shop specifically for ambulance coverage and you’ll be good to go.

#3 Massage

Massages are real nice, right? What makes them even nicer? Knowing that you don’t have to fork out for them. Your fund may pay for remedial massage services – and not only do they feel great, they’ll be great for you and your wallet, too. Remedial massage has been shown to improve mental and physical well-being, back pain, tension, and other physical ailments.

#4 Glasses & Sunglasses

Many of us take our vision for granted. But most of us also end up with glasses or contact lenses at some point in our lives. Just as we endeavour to visit the dentist regularly to keep our pearly whites clean and healthy, visiting an optometrist will ensure our eyes are looked after, too. Better yet, with extras cover, you’ll often get glasses, contacts and even prescription sunglasses covered, at least in part. If you already have contacts or glasses, you’ll know they can be a big out-of-pocket expense – particularly if you enjoy updating your frames every year or two. 

#5 Cataract and Eye Lens Procedures

If you have cloudy vision, chances are you have cataracts, the result of a thin film which has grown over the lens. Removing this film has become a routine procedure and is most often covered by your private health fund. Other procedures may be covered, such as lens replacements. Procedures will often need prior approval, but having this cover will give you peace of mind if you find yourself facing cataract surgery.

#6 Eating Disorders

The most common surgery for obesity is gastric banding (or lap band) but others include gastric sleeves, staples, and bypass. If you’ve been diagnosed or have received any of these treatments in the past, it may be important for you to ensure continued coverage for the future. Post-surgery therapy may also be covered, so verification is wise.

#7 Postnatal Depression

Often, women who have just given birth go through a period (up to 18 months after birth) when they feel they have lost their identity, can’t cope with the responsibility of their newborn, and/or feel their lives have become out of control. This is postnatal depression (the Baby Blues). It is the period when a woman’s body returns to its hormonal levels prior to conception. This period is temporary, but may require therapy or hospitalisation. Note: This condition may be covered outside the hospital also, as a Substitute Hospital Treatment or Clinically Appropriate Alternative, as stated in your cover. Further description of this is stated below.

#8 Gym Membership

With private health cover, there’s really no excuse for skipping the gym. Your workout will become significantly less expensive and therefore, the financial motivation will also be there. Some private health policies will offer gym membership discounts and you could end up paying next to nothing. If the gym isn’t your thing, check to see if any other fitness or wellness benefits are offered by your fund. You may find that rebates for various health & fitness classes are offered. Which takes us to #9…

#9 Pilates & Yoga

Pilates classes can get pricey and yoga isn’t cheap either. Why not take advantage of your private health cover and try a class? Some funds may even offer rebates for personal training, which is great bang for your buck.

#10 In-Hospital Psychiatric Treatment

If you find yourself or a loved one in need of psychiatric counselling or treatment, these services can also be included in your cover. The costs for treatment often have to be pre-approved, as do most, but rest assured, there can be help. When you or a family member needs support and guidance, it is a comfort to know you won’t have to pay for the sessions.

#11 Dietitian Services

Private health insurance is a little different to most other types of insurance. You can claim for services even while you’re healthy and well, rather than getting paid out in the event of something bad happening. It’s preventative, designed to keep you going – so that you can harness your mental and physical well-being. And that’s exactly how it should be. So, for this reason, your fund may offer rebates for diet and lifestyle services. It can really help to speak with a professional, such as a dietitian or nutritionist, to keep yourself in check and on track when it comes to food and lifestyle habits.

#12 Drug/Alcohol Rehabilitation

Rehabilitation services for drugs and alcohol can be costly, especially if diagnosed as needing overnight or extended observation while under doctor supervision. Having these costs covered enables family and friends to focus on supporting their loved one. Recovery is different for each patient and can be short or long term. Having help in these circumstances gives the recuperating patient and their family the comfort of knowing someone has their back in a time of need.

#13 Assisted Reproductive Services

Anyone who has had a friend or relative in need of reproductive assistance knows it can be a very long, emotional, and draining experience. When one procedure doesn’t work, you move on to the next, and then the next. Not only is it a roller coaster for the couple, but it is also a financial drain on any money the hopeful parents may have saved. It’s nice to know private health insurance can pick up the slack on any hospital assisted services when the time comes, allowing money to be used on more practical needs, such as paint for the nursery or a new carriage for the baby!

#14 Sterilisation

On the other side of assisted reproductive services, we have sterilisation services. If having a vasectomy or tubal ligation is in your future, your private health cover may be able to pick up the charges. Counselling for surgery as well as recovery may also be covered, but should be pre-approved by your insurer. Double check the requirements and see if you comply before scheduling your procedures.

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