Last Updated on 23 October 2020

Guide to Private Health Insurance in Western Australia

Throughout Australia, over 30 health funds offered cover to approximately over 12 million Australians in 2015, which reflected around 56 percent of the population. While some health funds operate country-wide, there may be significant differences among cover and policy costs from one state to another. If you live within Western Australia, it is helpful to understand how your market compares to others and which health funds  provide the majority of service within your area.

Who Are the Biggest Insurers in Western Australia?

In Western Australia, one insurer, HBF, has 53.2 percent of the market share. Medibank has the second highest percentage of the market share, with its fund providing coverage to 20.6 percent of the Western Australian market. BUPA comes in third, with a 10.7 percent market share and HIF provides insurance cover for 4.1 percent of the market.

While the majority of West Australians have chosen the three largest health funds to offer their cover, this does not mean policies offered by these health funds will necessarily be the best ones for you. You should comparison shop carefully among a wide variety of different heath funds to determine which provides the overall best value in terms of cover to you.

How Does the Cost of Health Insurance in Western Australia Compare?

In Western Australia, the average 2015 annual premiums for family hospital cover were $3,991 with obstetrics cover and $3865 without it. This was less expensive than most other states for obstetrics cover but on a par with

These are average premiums, and you or your family may have a different experience in terms of what provides the best value. Be sure to shop around and compare different health funds and different types of cover to find out which provides the best deal with reasonable premiums for cover you require.

How Does Ambulance Cover Vary?

There are substantial differences in how ambulances are paid for depending upon where you live. If you live in rural areas in Western Australia, you will receive your ambulance services from St John Ambulance Australia, which is under contract to the local government. If you live within the Perth metropolitan area, on the other hand, you must secure ambulance coverage from a health fund in order for an ambulance to be paid for when emergency service is required. This affects individuals located in the geographic area stretching from Two Rocks in the North, to Wundowie in the West and Port Kennedy in the South. All Aged Pensioners who reside within Western Australia will be provided with no-cost ambulance services, while other senior citizens aged 65 and over pay only half the normal costs of ambulance service when it is necessary.

How Profitable Are Health Funds in Western Australia?

Within Western Australia, insurers make a gross profit margin of 11 percent for hospital treatment and 22.2 percent for general treatment. The total profit margin for insurers within the territory is 14.6 percent, compared with a national average of 12.4 percent. It is not a bad thing for a for-profit insurer to make money, but the profit margins should not be too high at the expense of consumers.

As you shop for health funds, consider who offers the most expansive cover at the most reasonable premiums. By doing your research and comparison shopping, you can find a policy that will provide a good value for your family and that ensures your health needs will be taken care of.



Disclaimer: The above information is correct and current at the time of publication.


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