Health.com.au: Private Health Fund Review
Health.com.au is one of the online-only health insurance options for Australian residents. They boast that their platform is “health insurance but not with the traditional frustrations.”
With the online interface of Health.com.au, you don’t have to wait in line or on hold with a service member to clarify any questions you might have. You don’t even need to contact them during business hours. Health.com.au has an online chat platform where representatives are available 24/7.
The team at health.com.au makes understanding your cover easy. They break everything down for you to see, and leave nothing to question when it comes to health insurance.
- 24/7 chat support
- Emergency ambulance transport is free with all plans
- Enhanced customisation of coverage
- $0 extra for kids who need to visit the hospital
- The ability to choose where/when you receive treatment
- ServiceRage National Champion award for Happiest Customer in 2015 and best service in health insurance in 2014.
There are a variety of coverage plans from Health.com.au. They allow their users some of the largest customisation options on the market for extras, hospital, and combined cover.
Hospital Only Cover
- Entry Hospital: Entry Hospital is the most basic plan you can select through Health.com.au. This version of coverage will cover everything Medicare covers, with the addition of ambulance services. Health.com.au covers almost everything else in a limited capacity in this plan.
- Base Hospital: Base Hospital is the step up from Entry Hospital. You can purchase this coverage option with or without a co-payment. The option without a co-payment costs a little more each month. These plans cover common procedures healthy patients need and exclude procedures like cardiothoracic services, pregnancy-related services, cataract and eye lens procedures, etc.
- Core Hospital: The Core Hospital plan is for those who want peace of mind that Health.com.au will cover virtually everything they need. At the same time, you won’t pay for services like pregnancy and reproductive services which you won’t need. If you’re aging and looking for health insurance from Health.com.au, this might be a plan you’d want to consider.
- High Hospital: A full range of cover for those who don’t want to leave anything to chance. This level of hospital coverage includes reproductive and birth services. There are still some restrictions you should consider before making a decision, but this is the highest level of hospital cover health.com.au provides.
- Pulse Extras 50 & 60: These two options give you 50% and 60% back on select extras services. By Health.com.au’s estimation, these extras are enough to get you started. The plans include general dental, remedial massages, chiropractic and osteopathy, natural therapies, health maintenance, and physiotherapy.
- Extras 50: Extras 50 is health.com.au’s comprehensive extras plan. It covers most extras you’d need with a 50% back offer. There are some exemptions in this plan, however. Some of the notable exclusions are podiatry, occupational therapy, speech therapy, eye therapy, health appliances, and health screenings.
Hospital + Extras cover
- Simple Essentials 60: Simple Essentials 60 is best for those who prioritise extras cover over their hospital cover. For example, if you’re healthy and need minimal health maintenance but want to make sure your dentist visits are covered, this would be the plan you’d want to consider. Simple Essentials 60 includes base hospital cover with the most popular extras.
- Base Hospital + Pulse 50 & 60: Covers the basic needs of healthy people plus 50% or 60% back on the Pulse Extras plan.
- Base Hospital + Basic 65 & 75: These plans include the base hospital plan, and are available with or without a co-payment. You can choose the cheaper plan that gives you 65% back on extras or pay a bit more for 75% back. All of these plans include extras that cover a full range of dental procedures.
- Heart Hospital + Basic 65 & 75: Heart hospital includes the coverage of Base Hospital but adds heart and lung coverage. WIth the hybrid plan, you’ll also receive 65% or 75% back on the most common extras.
- Heart Hospital + Middle 65 & 75: You receive the heart hospital package plus the medium range of extras.
- Heart Hospital + High 65 & 75: Heart Hospital plan plus 65% or 75% back on the most comprehensive extras available.
- Core Hospital + Middle 65 & 75: The second-highest level of hospital cover plus the medium package of extras. You’ll receive either 65% or 75% back on extras.
- High Cover: The highest form of cover provides options for all extras, pregnancy and birth, eye procedures, etc. This is the most comprehensive form of coverage Health.com.au offers their members. You can choose plans that give you 65%,75%, and 85% back on your extras claims.
Below is a breakdown of how Health.com.au stacks up against other health insurance providers. We obtained the data from the Private Health Insurance Ombudsman.
- Hospital Related Charges Covered:
Health.com.au is below the industry average
- Medicare Services with No Gaps:
Health.com.au is slightly below the industry average
- Medicare Services No or Known Gap:
Health.com.au is above the industry average
- General Treatment Covered:
Health.com.au is slightly above the industry average
Health.com.au Compared to Industry
Share of Private Health Insurance Ombudsman complaints
Since Health.com.au is an online-only platform, you’ll need to make a claim online as well. If the hospital you visit has a billing agreement with Health.com.au, though, the process is a whole lot easier.
When you visit a hospital that has a partnership with Health.com.au, all you have to do is present your Claims Card. The hospital will get the information they need from there, and send an invoice directly to Health.com.au for processing.
If you receive services that require additional claims or visit a hospital that doesn’t have a billing agreement with Health.com.au, you’ll need to make an online claim. Thankfully, this provider makes claiming simple for you.
You’ll need the following information once you log into the Health.com.au online portal:
- Name of the practitioner
- Practitioner provider number
- Date you received the service
- What the service was
- Fee attached to the service.
You might also need to provide a receipt for your service if you’re claiming an ambulance trip, health maintenance class, or pharmacy purchases.