Page Contents

Last Updated on 14 November 2019

How Do You Choose a Private Health Fund?

Private health insurance provides convenient access to healthcare. Medical and health services which would have otherwise been very pricey can be readily taken at a fraction of the usual costs through one’s fund. Given their crucial role, it’s then prudent to compare health funds prior to signing up for a policy so that you truly get to maximise the benefits. Below are some points to consider when comparing.

Compare Health Insurance Policies Now!

Photo by

Coverage Type and Level

Your coverage type and level dictate which medical and health services you can access and how often you can use them.

  • Private hospital cover pays for accommodation costs when you get admitted as a private patient in a private or public hospital. Fees associated with the pathological tests performed and use of the hospital’s surgical theatre may be paid for by this coverage as well. A portion of the attending doctor’s fees may be covered too.
  • Extras or general treatment cover pays for dental, podiatry, and optometry services. This coverage may provide for alternative treatments such as chiropractic, acupuncture, and physiotherapy as well.
  • Combined policies provide cover for both hospital and general treatments.
  • Ambulance cover is an add-on which ensures access to round-the-clock and Australia-wide ambulance services.
  • Pharmaceutical cover is another add-on. This gives cheaper access to medicines that are not listed under the Federal Government’s Pharmaceutical Benefits Scheme (PBS).

Health insurance is normally offered in three coverage level packages. You can choose from premium, medium, and basic levels. The higher the coverage level, the lesser the restrictions and/or exclusions will be. For instance, if you choose the premium hospital package, you may be covered for costly procedures such as joint replacement surgeries.

Government Surcharges

Starting 1 July 2012, the Medicare Levy Surcharge (MLS) will increase for large income earners who don’t have private hospital covers with deductibles of $1,000 (for families) and $500 (for singles). It would be worthwhile especially for affected Australians to review whether obtaining the appropriate coverage will be more beneficial given the reforms to the MLS scheme.

Particular Health Services

Every individual will have unique medical and health needs. Going for insurers that allow for tailor-fitting one’s coverage may then prove advantageous. This is particularly true if you must access specific treatments periodically. Being able to modify your coverage prior to inking the policy will ensure you’ll have ready and convenient access to services you most frequently require.

Reasonable Rates

If you’ve ever tried to obtain quotes from multiple insurers, then perhaps you’ve noticed how their rates vary. This is because factors such as coverage types and levels are taken into account when calculating your premiums. But there are a handful of ways to help lower your premiums.

  • Age of entry into a fund is one. Under the Lifetime Health Cover (LHC), one will need to pay an additional 2% annual loading on top of the usual premiums for every year one did not have private health insurance after the age of 30. Avoiding the LHC is possible by signing up for a private hospital cover from an insurer certified by the Private Health Insurance Administration Council (PHIAC) on or before 1 July immediately after one’s 31st birthday.
  • Taking higher excess and/or co-payments is a guaranteed rate-lowering strategy too. Just make sure that the amount you nominate is really something you’ll be able to comfortably pay especially during times of emergency.
  • Special discounts may help lower premiums too. Some insurers extend lower rates to single parents. Other providers lift restrictions on their extras cover after one year to encourage policy renewals.

Everyone wants a comprehensive yet reasonably priced policy. Fortunately, finding this is not impossible. A thorough health insurance comparison will help ensure you find the cheapest policy that provides for all the services you will need.

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

Still have questions? Let's talk!

Confused? Not sure if this applies to your situation? Phone us on 1300 163 402 for some free, no obligation advice.

Or want to Compare Health Insurance Policies Now?

Request a callback close

Our experts can provide you with free personal advice. Let us call you.