How to choose hospital insurance

It's important to remember that, under Medicare, all Australians are entitled to free treatment in a public hospital, regardless of their insurance status.

What’s the benefit of private cover?

• access to a private hospital
• greater choice of doctor
• shorter waiting times for some forms of elective (non-urgent) surgery

Another thing to consider is government incentives on hospital insurance:

• Lifetime health cover penalises people who take out health insurance after age 30 with higher premiums.
• Medicare levy surcharge: Singles earning more than $50,000 and couples/families with incomes over $100,000 (plus $1500 for each child after the first) pay an extra 1% Medicare surcharge if they don’t have hospital insurance.

How to save $$$

You can save money by buying a policy:

• with an excess (an amount of money you have to pay for a hospital stay before the private health fund starts paying). Be sure to check how may times the excess applies per year.
• where you pay a co-payment if you go into hospital (you pay an agreed amount each time a service is provided — usually a set amount per day). Be sure to check how may times the co-payment applies per year.
• that excludes treatment for some conditions. But remember if you need them you’ll only be covered as a public patient in a public hospital – like someone without private health insurance.
• that only covers you as a private patient in a public hospital for some or all conditions.

As a general rule it's better to save money by choosing a product with a high excess/co-payment rather than choosing a product that excludes or limits treatment for some conditions.

Commonly limited and excluded treatments include:

• Assisted reproduction, obstetrics and birth related care
• Bone marrow transplants
• Cataract eye surgery
• Coronary bypass and major heart surgery
• Cosmetic and plastic surgery
• Dialysis
• Hip, knee and other joint replacements
• Psychiatric care
• Rehabilitation

If you specifically want coverage for any of these things, check and double check with your health fund to make sure they aren’t excluded or limited in any way.

Want to know more?

See the full report from Choice. Choice is an independent, non-profit organization for Australian consumers.