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Comparing Health Insurance

aldwin sab August 31st, 2011 0 comments

Comparing private health insurance policies can seem a bit overwhelming at first, with a number of coverage options. There are 2 main forms of private insurance: hospital cover and ancillary, or general, cover. Combined coverage is also available. The more extensive the coverage, the higher the premium, making it important to compare health insurance to choose private coverage that suits your needs and budget.

Image by Harald Hoyer

The best way to compare health insurance is to first decide whether you need hospital, ancillary or combined cover. Next, determine the most appropriate level of cover and check individual policies to determine which provides the highest benefit limits.

Why Compare Private Health Insurance?

There are many benefits to good private health insurance coverage. Patients covered by private insurance are given their choice of doctor and surgeon, as well as choice of hospital. Those with private insurance also benefit from shorter waits at hospitals. Full ambulance coverage is available in some states, along with broader programs to treat chronic disease. General treatment cover, or ancillary cover, also includes a range of services, such as chiropractors and dentists. The government incentives like the health insurance rebate and Lifetime Health Cover offered for purchasing private health cover also make it a worthwhile option for many.

What is Hospital Cover Insurance?

Hospital insurance is designed to cover costs associated with in-hospital treatments. This form of insurance includes hospital accommodation as well as doctor’s fees and applies for treatment in public, private or day hospital facilities. Medical services that are usually covered by hospital insurance include most items listed under the Medicare Benefits Schedule (MBS). Other services, such as laser eye surgery, are usually only covered in part by private hospital insurance, or not at all.

The Levels of Hospital Cover

There are 4 classifications of hospital cover that determine coverage as well.

  1. The top level covers all medical services that Medicare pays a benefit for.
  2. The medium level restricts coverage on at least one of the following: pregnancy and birth, cataract and eye lenses operations and procedures, reproductive assistance, joint replacements, dialysis and sterilisation. However, it includes all services from the basic classification.
  3. The basic level of hospital cover excludes one or more services from this list: cardiac-related services and procedures, non-cosmetic plastic surgery, rehab services, psychiatric services and palliative care.
  4. The last level of hospital cover is public, which provides default benefits for treatments that take place in a public hospital.

It’s important to remember that hospital cover classifications don’t consider surgery by podiatrists or hospital treatments that Medicare does not pay a benefit for.

What is Ancillary Cover Insurance?

Ancillary cover, also referred to as general treatment cover, is designed to help with services like optical treatments, dental services and physiotherapy. The main benefit of this form of insurance is it provides coverage for health services not covered by Medicare, including optical, dental, naturopathy and physiotherapy treatments.

The Levels of Ancillary Cover

There are 3 classifications of general treatment cover that provide different levels of coverage to meet very different needs.

  1. Comprehensive ancillary cover includes coverage for general dental as well as major dental treatments, with average or better benefit limits. Comprehensive policies also cover endodontic, optical, non-PBS pharmaceuticals, podiatry, psychology, physiotherapy and orthodontic treatments.
  2. Medium level ancillary cover provides coverage for general and major dental and endodontic procedures. It also includes any five of the following treatments: orthodontic, non-PBS pharmaceuticals, optical, physiotherapy, podiatry, chiropractic, psychology and hearing aids.
  3. Basic ancillary coverage provides a more limited range of covered treatments for a lower price.

Do I Need Combination Health Insurance?

Many individuals find that combined health insurance is the best option for them. Many health funds offer this option, which provides coverage for both hospital and ancillary treatment. While some funds offer pre-packaged policies, many allow you to mix and match, creating a policy that works best for you. These mix and match policies combine hospital and general treatment options, allowing you to select medium hospital cover and a comprehensive ancillary policy, for example. This is the best way for many to create a policy that fits their budget and the needs of their family.

What is the Excess?

It’s necessary to also compare the excess on any private health insurance you’re considering. Excess is used to reduce your premium, allowing you to pay an agreed amount towards the costs of treatment in exchange for a reduced premium. This amount of money may be payable every time you get treatment at the hospital, or even only once, depending on your policy terms. It’s common for many health funds to not require an excess payment for day surgery. The amount of the excess is set when the insurance is purchased and will vary.

Private health insurance comparison might seem like a lot of work, but if you cover the main points above you’ll find a deal that suits your needs.

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