The Best Private Health Insurance In Australia: Explained

Private health insurance has become popular in Australia as it gives more choices in healthcare, faster treatment, government incentives, and tax rebates.

More than 30 insurers offer around 3,500 health insurance products in Australia. Depending on the circumstances, people can choose from more than 100 health insurance policies.

The various features and coverage benefits make it difficult for beginners to find the best policy that suits their needs. This comprehensive guide presents information and tips on choosing the best private health insurance in Australia.

1. What Is Private Health Insurance?

Private health insurances cover the full or partial cost of health treatments and services. In exchange for the coverage, one must pay policy premiums fortnightly, monthly, or annually to maintain their insurance coverage.

The insurance can provide coverage for health treatments in a public or private hospital, enable the insured to choose their choice of hospital and doctor, and provide coverage for health services not covered by Medicare. 

Private Health insurance helps you avoid long waiting lists for treatments.

2. How Many Private Health Insurance Companies Are in Australia?

There are 37 private health insurance companies In Australia. Not all funds are available to the public, as a few are limited to a group of people. For example, the Doctors Health fund only covers members of the healthcare community and their family members.

Here is a list of restricted and open health insurance providers in Australia:

Open For All:

• HCF Private Health Insurance 

• Bupa HI Pty Ltd

• AHM health insurance

• Latrobe Health Services

• HBF Health 

• Medibank Private Health Insurance 

• Australian Unity Health 

• AIA Health Insurance Pty Limited

• CBHS Corporate Health Pty Limited

• CUA Health 

• GMHBA 

• Nib Health Funds 

• CDH Benefits Fund

• GU Health

• Health Care Insurance 

• Health Insurance Fund of Australia 

• health.com.au

• St.Lukes Health

• Mildura Health Fund

• National Health Benefits Australia Pty Ltd

• Peoplecare Health Insurance

• Queensland Country Health Fund Ltd

• Health Partners

• Transport Health Pty Ltd

• Westfund Limited

• Phoenix Health Fund 

Restricted Health Insurance Funds:

• Teachers Health

• ACA Health Benefits Fund

• Defence Health Limited

• Reserve Bank Health Society Ltd

• Doctors' Health Fund

• CBHS Health Fund Limited

• Police Health

• Nurses & Midwives Health

• Railway and Transport Health Fund Limited

• Navy Health Ltd

• TUH Health Fund

3. What Are The Types Of Private Health Insurance In Australia?

There are two health insurance policies: Hospital Cover and Extras Cover. Where Hospital Cover pays for the treatment expenses you incur as an in-patient, Extras Cover pays for out-patient services such as ocular, dental, physiotherapy, and remedial massages.

You can buy them separately or as a combined product with your health provider and enjoy more coverage.

In some states, health insurers also provide a third type of policy called "Ambulance cover". It offers monetary compensation for ambulance services during an emergency or non-emergency case. Some covers include it in extras or under the hospital cover.

4. What Is A Waiting Period In A Health Insurance Policy?

A waiting period is a pre-determined time that covers you only for an illness or treatment after a specific period has passed. Check your policy document to find the exact waiting period.

You don't have to wait a second time if you have served the waiting period without terminating the policy cover.

5. What Are The Benefits Of Buying Health Insurance?

There are numerous benefits of having a health insurance policy. Some of these are:

• Protect from financial loss due to health emergencies

• Covered for both in-patient and out-patient expenses

• Lessen out-of-pocket expenses

• Convenient access to medical treatments 

• Free yearly medical checks ups to track your health 

• It covers individuals (children, teens, adults, and old) and families

6. What Are Health Insurance Extras?

"Extras cover" offers financial cover for out-of-hospital medical care that includes the following:

• Dental Insurance: It covers the expense of minor or major dental work.

• Physiotherapy Cover: It includes physiotherapy consultations and treatment to help recover from an injury.

• Ambulance Cover: It covers the cost of using an ambulance for transportation and other emergency services.

• Lifestyle Program Benefits: Under this feature, you get financial compensation for the expenses incurred on health services that include nutritionist consultations, gym memberships, screenings for skin cancer, and more.

• Optical Cover: You can get insured for contact lenses, prescription-based glasses, laser eye surgery, and other eye-related treatments.

• Pregnancy Cover: This is ideal for would-be mothers planning to deliver a child as a private patient.

• Chiropractic: The expenses incurred in treating musculoskeletal issues are covered with this extra.

7. What Is The Best Private Health Insurance For Families In Australia?

Private health insurers present a range of health policies to match the needs of families at different stages. 

It is vital to pay attention to the following key features that might benefit you and your family:

• Pre-Pregnancy: Are you planning to start a family? It is worth buying a gold-level policy with a money-back feature for fertility treatments and pre-and post-natal care. However, there is a minimum 12-month waiting period between policy inception and claim date if you want private hospital care for your newborn.

• Children: Many health insurers offer policies for children. Look for child health insurance covering your child at a small additional cost, offers "no-gap" dental benefits, and waives off the hospital excess in case of hospital admission.

• Teenagers: Many private health insurances cover dependent children up to 18 years. You can even go for a health fund if you want extended coverage up to age 25 if they are students and unmarried.

Based on your budget and life stage, find a suitable family health insurance policy to get financial protection and mental peace against any unexpected situation.

8. What Is The Cheapest Health Insurance In Australia?

The insurer and product level determine the health insurance premium. The best way to find a cheap health insurance policy is to compare premium quotes from different providers based on your coverage requirements.

Ensure that you get the necessary hospital/extras covered in the policy. Also, read the inclusions and exclusions for every insurance policy.

Most cheap health insurance options offer a Basic level hospital policy. It gives you less coverage than other health plans such as bronze, silver, or gold. Checking the cover limits and excess of the insurance policy is vital when making a decision.

Here are our top five picks for the cheapest health insurance policies in Australia:

9. What Are The Best Health Insurances In Australia?

It is vital to compare health insurance in Australia on various parameters. These include market share, types of policies offered, features, sum guaranteed, premiums, and customer satisfaction ratings.

According to the best private health insurance reviews, the top five companies for market share are HCF, Bupa, Medibank, Nib, and HBF. The premiums for a Basic Hospital policy covering a single adult range between $101.35 and $129.94 monthly, depending on the insurer you choose.

Below is a comparison of top health insurance companies in Australia to make it easier to find the best one:

Medibank Health Insurance

• 26.9% market share

• The best private health insurance in NSW, Nine Hospital, plans an estimated starting premium of $101.80 per month.

• 21 Extras policies with an estimated starting premium of approx. $26.50 

• Waiting periods: 0 days to 36 months based on the type of illness

• Type of products: Medibank Silver Plus Assured, Medibank Healthy Start Extras, and Medibank Bronze Plus Progress + Essential Extras

Bupa Private Health Insurance

• 25.4% market share

• Trusted by over 4 million customers in Australia

• The best private health insurance in Western Australia 

• Six different Hospital Cover plans with premiums starting from $101.35 monthly and 21 Extras policies with starting premiums at $26.70 per month.

• Two months to three years waiting period depending on the type and condition of your coverage 

HCF Health Insurance

• 11.7% market share

• The best private health insurance near Sydney NSW 

• The largest not-for-profit private health insurance provider in Australia 

• 100% back on dental services

• According to APRA statistics, it consistently reimburses more benefits than the industry average. 

• Bronze plus policy covers 26 treatments, and Silver plus covers 30 treatments.

• Seven Hospital policies with starting monthly premiums of $102.30 and 5 Extras cover options with premiums starting at $12.70 per month. 

• Between 2 to 12 months waiting period

• Types of Health Insurance Products offered: HCF Starter Extras starting from $12.70 per month, HCF Mid Extras starting from $32.00 per month, and HCF Hospital Standard Silver Plus starting from $116.15 per month.

Nib Private Health Insurer

• 9.2% market share

• Five Hospital policies with premiums starting from $107.55 monthly and 4 Extras options available at a monthly premium of $43.97 

• Offers Rewards programme that gives discounts at leading retail stores and access to exclusive programs for those who live healthy lifestyles 

• One day to 12 months waiting period

HBF Private Health Insurance

• 7.3% market share

• One of the most significant not-for-profit funds in Australia

• The Commonwealth Ombudsman's State of the Health Funds Report 2020 recorded the lowest number of complaints in comparison to the market share of any significant health fund.

• Seven different Hospital policies with starting premiums of $102.45 each month and 13 various Extras cover with premiums starting at $22.95 per month.

• Seven days to 12 months Waiting periods

• Great value hospital policies: HBF Basic Hospital Plus: From $76.52 per month, HBF Bronze Hospital Plus: From $90.13 per month, and HBF Gold Hospital: From $176.57 per month

10. How To Choose The Best Private Health Insurance In Australia?

Finding the right private health insurance may be a complicated and challenging process. With some research and planning, you can choose a cover that works for you. 

Here are the four essential steps to finding the right insurance:

Step 1: Understand The Type Of Plan

There are plenty of private health insurance funds competing for your business. Before buying any health funds, you must be clear about how much coverage you need and what you can afford.

Pay attention to important factors. These include an existing health condition, being prone to a genetic health condition, planning to extend your family, or nearing an age where you need more health assistance.

Once you have evaluated your needs, understand the type of plans available in the market:

• Hospital Cover: It covers all or a certain percentage of hospital treatment costs. Each bronze, gold, and silver tier offers different benefits and features.

• Extras Cover: It covers the costs of services and treatments received outside of a hospital. Available in basic, comprehensive, or mid-extras.

• Combined Cover: Includes hospital and extras cover to help you provide extensive coverage under several circumstances.

Step 2: Find The Right Product Tier

Find insurance that offers services that are of use to you. You may find services offered in the basic or bronze hospital cover and don't necessarily need expensive higher-tiered products. 

Gold and Silver products are comprehensively designed and meet almost all health requirements. Also, a combined policy that includes extra and hospital cover can be a good option for those seeking peace of mind.

Take time to evaluate Extras covers to find the ones you need, such as physiotherapy and dental check-ups. It will prevent you from wasting money on cash services you would not need. Consult a doctor to find the essential services you should look for in an insurance plan.

Here are some of the top-rated plans under different categories:

Best Gold Health Insurance

• Bupa Gold Hospital's $500 excess

• HCF Gold Hospital $500 excess

• Phoenix Health Fund Gold Complete $500 excess

Best Silver health insurance

• Bupa Mid Hospital $500 Excess – Silver Plus

• CUA Standard Hospital Silver Plus $500 Excess

• NIB Silver Hospital $500 excess

Best Bronze health Insurance

• Health.com.au Base Hospital (Bronze +) $500 excess

• HBF Health Limited Bronze Hospital Plus $500 excess

• HCF Hospital Bronze Pus $500 Excess

Step 3: Learn About Discounts And Rebates

The Federal Government provides several incentives to attract people to buy private medical coverage. Some of these include:

• They provide a private health insurance rebate for hospital cover, extras cover, or a combined policy. The rebate gets deducted from the premium or offered as a tax offset when lodging the tax return.

• Aussies between 18 and 29 can receive discounts on hospital policy premiums to encourage them to take out private health insurance policies.

Step 4: Don't Buy And Forget

Evaluate your insurance needs from time to time. Consider choosing an additional cover or feature if you need it. 

Suppose your existing policy is expensive or offers fewer benefits than other competitive plans in the market. In that case, you can even consider switching to a better insurance provider.

Insurance terms and conditions can change with time. Assess the policy documents to stay updated with benefits and service changes in the existing policy, such as exclusions and restrictions, waiting periods, gaps, and other charges when accessing benefits.

11. Conclusion

There is no single health insurance that is appropriate for everyone. As health requirements, family size, and budget of everyone are different, policy cover varies. The best private health insurance is the one you can afford and offers the required coverage.

We hope the above information has helped you learn how to compare private health insurance on many factors and find the best plan that meets your needs.

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