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We do not compare all health funds in the market, or all policies from our partner funds, and at times certain funds or products might be unavailable. Learn more.

Top 5 things to know about health insurance

1

Save at tax time if you’re single and earn over $97K

Avoid the Medicare Levy Surcharge (MLS) if you earn over the relevant threshold by taking out an eligible private hospital insurance policy for the entire tax year.

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2

Get rewarded for taking out hospital insurance before 30

The longer you leave it to take out private hospital insurance for the first time, the more it could cost you.

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3

Choose from two types of cover

There are two types of health insurance to choose from: private hospital cover and extras cover. You can choose the one that suits you best, or both!

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4

Avoid public waiting lists

With private hospital insurance, you could avoid potentially lengthy public waiting lists, and choose your own available hospital and doctors.

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5

Reduce your costs for services Medicare doesn’t cover

Extras cover can help reduce out of pocket costs for healthcare that Medicare doesn’t pay a benefit towards, such as dental, physio and optical.

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A guide to health insurance

Updated December 11, 2023
Written by Joshua Malin
Reviewed by Steven Spicer

Dr Ginni Mansberg explains the benefits of having private health insurance

Ginni Mansberg
Health insurance expert
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Expert tips for finding the right health insurance for you

Our health insurance expert, Steven Spicer, has some helpful tips for finding the right health insurance policy for you.

Steven Spicer
Executive General Manager – Health, Life & Energy

Flexibility is key

Flexibility is one of the key benefits of private health insurance. For example, any waiting periods for treatments like physio or dental check-ups that you have already served will be recognised by your new fund if you switch to the same or lower level of cover.

Buy for your current needs

When selecting your coverage, make sure you’re across the waiting periods and don’t pay for things you don’t need right now or in the near future. In hospital cover, most waiting periods are only 2 months, excluding pregnancy and birth and most pre-existing conditions.

Get the right level of cover

When comparing health insurance, deciding on the right level of cover can be vital. It could mean the difference between being covered or leaving yourself out of pocket. Some choose to take out hospital cover alone, whilst others consider extras only.

What is private health insurance?

Private health insurance gives you more choice in your healthcare. Private hospital insurance covers medically necessary treatment as an in-patient in hospital and lets you avoid public waiting lists, choose your own doctor and have your own private room (on availability). Extras cover pays a contribution towards many out-of-hospital medical treatments like physiotherapy or dental care. For the benefits of both types of cover, you can take out a combined cover policy.

Why should I take out private health insurance?

How does private health insurance work?

What does private health insurance cover that Medicare doesn’t?

The public and private healthcare systems complement each other. When you have hospital cover and are treated in a private hospital, both Medicare and your health fund can contribute to the cost. When you have extras cover, your health fund helps you pay for out-of-hospital services that aren’t covered by Medicare such as dental, optical and physio.

If you’re admitted to a private hospital as a private patient, Medicare will pay 75% of the Medicare Benefits Schedule (MBS) fee for your procedure. Your private health insurance pays the other 25%, as well as covering accommodation costs and theatre fees. There may be a ‘gap’ between the MBS fee and the total cost of your procedure. You may have to pay this gap, or your health fund may cover some or all of it.

Extras cover

Ambulances

Pregnancy

Dental

Optical

Other medical and allied health services

Combined health and extras cover

Which health insurance is the best?

The best fund for you will depend on your unique circumstances. Thanks to our handy private health insurance comparison service, we make it even easier to find health insurance. With our free tool, it takes only minutes to compare policies side-by-side to find great-value cover that suits your family’s needs. Our partner funds are:

We do not compare all health funds in the market, or all policies from our partner funds, and at times certain funds or products might be unavailable. Learn more.

Private health insurers in Australia

Premiums, charges and tax breaks

How much does health insurance cost?

Age based savings and other discounts

What is a health insurance excess?

What does ‘no gap’ mean in health insurance?

Is private health insurance tax deductible?

The cost for Australia’s top surgeries

When you receive an elective surgery listed on your hospital insurance policy as a private inpatient, Medicare will pay 75% of the Medicare benefit schedule (MBS) fee for the cost of your procedure, while your private hospital insurance will pay the remaining 25%.

Because private specialists are allowed to set their own fees, there may be a difference between the MBS fee and the actual cost you end up paying, known as the ‘gap’. Depending on your policy and treating doctors, this gap may be partially or fully paid by your health fund through their gap cover scheme.

There are also various hospital fees associated with private treatment, like accommodation, theatre fees and medical devices. These hospital fees can get quite expensive; luckily, your health insurance can also cover some or all of these fees, although you may have to pay an excess or co-payment.

Below are some of Australia’s most common elective surgeries1 and their typical costs in a private setting with private health coverage in 2021-22.2 Keep in mind that these are averages and your own personal costs will vary.

The cost for Australia’s top surgeries

Why compare health insurance?

With so many health insurance providers and policies available, it can be hard to know which one is right for you. At Compare the Market, we can help you on your journey to find the best health insurance for you. You can compare health insurance through our free comparison service in minutes, or if you prefer a more personal approach, you can talk to someone at our expert run call centre to discuss your options.

Meet our health insurance expert, Steven Spicer

As the Executive General Manager of Health, Life and Energy, Steven Spicer is a strong believer in the benefits of private cover and knows just how valuable the peace of mind that comes with cover can be. He is passionate about demystifying the health insurance industry and advocates for the benefits of comparison when it comes to saving money on your premiums.

Steven has 20 years of experience as a people-first business leader, with a focus on creating services that put customers first.

Steven Spicer, Executive General Manager