Health partners private health fund review

Overview

Health Partners was originally established in 1937 to serve the South Australian community.  Today, they are still proudly South Australian and are the largest open membership health fund in the state, with over 90,000 members all across Australia.

A not-for-profit fund, all profits are invested back into the fund to provide greater benefits for members.

Key Points

  • A not-for-profit, community-based fund with over 80 years of history.

  • 100% back on dental check-ups and optical on all extras plans.

  • Emergency ambulance cover included in all policies.

Health Partners isn't on our panel but we're confident we can get you a great deal on your health insurance.

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Hospital cover

Nobody chooses to go to hospital. But when you do, appropriate hospital cover will help you get the treatment you need, where and when you want it. It also helps to pay the bills, as fees for hospital rooms and specialists can add up.

Think about what services you’re likely to need, in line with your budget. If you earn over $90,000 individually or $180,000 as a couple, you could avoid paying the Medicare Levy Surcharge.

Health Partners offers five types of hospital cover, ranging from Basic Hospital Plus for affordable and basic cover, to Gold Hospital for comprehensive cover that covers all bases.

All hospital policies include unlimited emergency ambulance and a choice of excess

Basic Hospital Plus

Basic Hospital Plus is Health Partners’ cheapest cover, designed to protect you from accidents, plus a range of common hospital treatments. This policy is only available to singles and couples, not families.

Key private hospital inclusions:

  • Tonsils, adenoids and grommets

  • Joint reconstructions

  • Dental surgery (conditions apply)

  • Hernia and appendix

Bronze Hospital Plus

A step up from the basics, Bronze Hospital Plus is a popular starter policy that includes a lot of common hospital procedures. Includes no excess for accidents.

Key private hospital inclusions:

  • Chemotherapy, radiotherapy and immunotherapy

  • Ear, nose and throat

  • Gynaecology

  • Male reproductive system

Silver Hospital

Silver Hospital includes more protection, with some key exclusions to keep costs down. It also includes no excess for kids, making it an option for families.

Key private hospital inclusions:

  • Podiatric surgery

  • Heart and vascular system

  • Back, neck and spine

Silver Hospital Plus

A higher cost plan that includes many items usually found in a top tier policy that are suitable for older Australians. Like the Silver Hospital policy, there’s no excess for kids, but pregnancy items aren’t included.

Key inclusions:

  • Joint replacements

  • Cataracts

  • Pain management with device

Gold Hospital

The most comprehensive level of cover with no exclusions. Health Partners’ Gold Hospital policy also comes with loyalty benefits for insulin pumps and hearing devices, as well as access to a newborn support program.

Key inclusions:

  • Pregnancy and birth

  • Assisted reproductive services

  • Weight loss surgery

Ambulance Cover 

All Health Partners policies include emergency ambulance cover.

Extras Cover 

Health Partner's extras reset on January 1 every year. From dental, to optical, to chiro and more, extras insurance helps cover the bills for routine treatments with rebates of up to 100%. 

While we’ve summarised the key points of each plan below, it’s always worth digging a little deeper into any gap fees, how much you can claim back, and whether your preferred healthcare provider, such as your local dentist, is recognised by the health fund.

Take the time to work out what you need and what you’re prepared to pay. If this feels a bit overwhelming, you can speak to one of our experts.

Health Partners offers four types of extras cover, ranging from Base Extras for the absolute basics to their top tier Best Extras policies.

 All extras policies include:

  • 100% back on dental check-ups and optical (annual limits apply)

  • 20% off at Health Partners owned and operated pharmacies

  • 100% back on a physio visit (conditions apply)

  • Emergency ambulance

Base Extras

Health Partners’ Base Extras plan offers affordable cover for everyday health services. It’s only available on singles and couples memberships and doesn’t include major dental.

Key inclusions:

  • 100% back on one dental check-up per year (up to $350 per person).

  • 100% back on optical (annual limit applies)

  • 100% back on one physio visit (conditions apply)

Good Extras

Good Extras goes above the basics, with benefits on services like chiro and podiatry and higher annual limits on dental and optical services. It allows you to claim a 20% discount at Health Partners pharmacies for non script items.

Key inclusions:

  • $900 annual limit on general and major dental

  • Up to 60% back on major dental treatments

  • Remedial massage

  • $350 annual podiatry limit

Better Extras

Better Extras provides a high level of cover than the Base or Good Extras packages, with more generous limits on a wide range of services and allows 100% on some dental, optical and physio services and visits. There’s no annual limit on General Dental

Key inclusions:

  • 100% back on orthodontics with a registered orthodontist (up to the annual limits)

  • Access to healthier living services such as bowel cancer screening and quit smoking program.

  • 100% back on two dental check-ups 100% each year (includes cleaning and x-rays)

Best Extras

Health Partners’ top tier extras gives you comprehensive cover with the highest limits. It’s the most expensive policy but gives you 100% back on two dental check-ups, two physio visits and glasses and contact lenses (up to your annual limit).

Key inclusions:

  • $2,800 lifetime limit on orthodontics.

  • Unlimited 20% off at Health Partners pharmacies for non script items.

  • 90% back on healthier living services, up to the annual limits.

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Waiting Periods

To stop people signing up, claiming, then cancelling their health insurance, all insurers apply waiting periods. Generally, the more expensive the treatment, the longer you’ll wait. But keep an eye out for special deals with waiting periods reduced or waived.

When you switch to Health Partners from another provider, you won’t have to re-serve your waiting periods, unless your new policy covers something you didn’t have before.

Hospital Waiting Periods

  • Accidental injury - 1 day

  • Pregnancy and birth, assisted reproductive services, pre-existing conditions, home nursing, home sleep studies, insulin pumps), implantation of hearing devices - 12 months

  • Insulin pump replacements and replacement implantation of hearing device - up to 36 months

  • All other services - 2 months

Extras Waiting Periods

  • Major Dental, Orthodontics, Aids and Appliances - 12 months

  • All other services - 2 months

Member Benefits

Health Partners own and operate Adelaide’s largest private dental practice and their own optical stores, however members are still free to choose their own provider. 

Their network of health care professionals includes pharmacies and physiotherapists.

Members can also enjoy benefits through Health Partners’ partnerships with South Australian organisations, such as discounts on cooking classes and gym memberships.

How to claim

Hospital

Simply tell the hospital you are a member of a Health Partners policy. Your hospital account will be sent directly to Health Partners for them to assess on your behalf.

Extras

You can swipe your membership card to claim directly on the spot with your provider’s HICAPS terminal.

You can also claim via the Health Partners claiming app, through online member services or fill out the claim form and send it via email or mail.

Hospital agreements

Health Partners has agreements with a large number of hospital and day surgery providers across Australia.

When comparing policies, it’s worth checking if your preferred local hospitals and clinics are covered. Our specialists at Health Insurance Comparison can do this for you.

Customer Service

In 2019, complaints about Health Partners to the Private Health Ombudsman totalled 0.5% of all complaints. Health Partners has a market share of 0.7%, indicating their customer service may be above average. Source: Private Health Ombudsman

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FAQs

1. Is Health Partners a not-for-profit fund?

Yes - all profits are diverted back into the fund, for increased benefits to members.

2. Who can apply? Are there restrictions?

Health Partners is open for all Australians to join.

3. Is it easy to switch to Health Partners?

Health Partners isn’t on our panel but we’re confident we can find you a great deal on your health insurance. You’ll need to contact Health Partners directly if you’re interested in switching to one of their policies.

4. Do I need to re-serve waiting periods?

You can switch to an equivalent or lower level of cover without re-serving waiting periods. You will only be required to serve waiting periods if you have upgraded to a higher level of cover and/or higher benefits.

5. Can I change my level of cover?

Yes, you can modify your cover with Health Partners directly. If you move to a higher level of cover, you will usually need to serve waiting periods on the extra services and/or higher benefits.

6. Do I get the government rebate?

For every dollar of private health insurance premiums, the Australian Government provides eligible Australians with a rebate of up to 33.4% (depending on your age and income). To learn what you’re entitled to, use our rebate calculator.

7. Do I have to pay the Lifetime Health Cover loading?

If you’re 31 or over, you usually need to pay 2% loading for each year you’ve gone without hospital cover since the 1st July following your 31st birthday. You can find out more here.

8. Up to what age are children covered?

Children can remain on your Health Partners policy until they’re 21, or 25 if they’re studying full time or you have Family Focus Cover.

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This guide is opinion only and should not be taken as medical or financial advice. Check with a financial professional before making any decisions.