The Ultimate Guide to Comparing Private Health Insurance in Australia

Choosing the Right Private Health Insurance Plan for Your Family in Australia

compare private health insurance in Australia

Learn more about Private Health Insurance

Save time and effort by comparing a range of Australia's health funds.

To compare family health insurance policies, follow these steps:

  1. Determine your coverage needs: Consider factors such as the number of family members to be covered, pre-existing conditions, type of care required, etc.
  2. Gather information from different insurance providers: Look for providers that offer family health insurance policies and get information on coverage, premium costs, and other details.
  3. Compare premium costs: Premiums can vary widely, so compare the monthly or yearly costs of each policy.
  4. Compare deductibles and copayments: Deductibles are the amount you pay before insurance kicks in, while copayments are the amount you pay when you receive care. Consider how these costs compare between policies.
  5. Look at the provider network: Consider whether the insurance company's network of healthcare providers is adequate for your needs and accessible in your area.
  6. Check for additional benefits: Look for policies that offer additional benefits, such as preventive care, wellness programs, or telemedicine services.
  7. Read the policy details carefully: It is important to understand the terms, conditions, and limitations of each policy before making a decision.
By considering these factors, you can compare family health insurance policies and choose the one that best fits your needs and budget.

What is private health insurance?

Private health insurance provides financial cover for all or part of the cost of various health-related treatments and services. Depending on the policy, it can provide cover for treatment as a private patient in a public or private hospital, allowing you to choose both your doctor and hospital, at a time that suits you. Additionally, it can provide cover for health services not covered by Medicare (such as physiotherapy, optical, and dental). It functions similarly to other types of insurance, such as home and contents or car insurance, although rather than being risk-based, it’s community-based. This means that everyone is eligible to receive the same base price for the same policy from any single provider, rather than being rated on their individual health concerns. There are two main types of policies you can take out: Hospital Cover and Extras Cover. These can be purchased separately or combined into a single policy with your health provider. One of the biggest benefits of health insurance is choice and flexibility. For example, as a private patient, you’re given the choice of doctor, the choice of agreement hospital or clinic, and you have flexibility over the time of your appointments. In comparison, when you’re treated as a patient in the public system, the appointment times, doctors, and hospitals are typically inflexible, determined by your location and your health concern. Health insurance can also help you avoid long waiting lists for treatments (provided you’ve served the necessary waiting periods) which exist in the public system.

Why should I get private health insurance?

The Australian Government health system is called Medicare and covers most basic medical expenses - but it doesn’t cover everything. Using this public system, you may need to wait a long time for certain surgeries and you may also be limited in your choices when it comes to where and who you are treated. 

This is where private health insurance helps. 

Private health insurance is designed to help cover costs associated with doctor and hospital expenses when being admitted to a hospital and treated as a private patient. Other benefits of private health insurance are:

  • Greater choice of specialized medical professionals.
  • Access to a wider range of hospitals.
  • Can help you avoid paying the Medicare Levy Surcharge.
  • Shorter potential wait times for planned surgery.
  • Cover for a private room for services included on your cover (subject to clinical eligibility and availability).
Regular trips to the dentist and physio can add up - but Extras cover can help. Depending on the type of Extras cover you choose, after you serve your waiting periods you may be able to claim money back for a range of health services that may not be covered by Medicare, like dental, physio, optical & chiro, up to yearly limits.

What are health insurance waiting periods?

A health insurance waiting period is the period of time at the start of your membership before you can claim some benefits and services of your policy1. The period of time you will wait will depend on the procedure, type of cover (like extras cover or hospital cover), and your health fund.

Let’s say you’re looking to start getting regular dental checkups. You might take out extra cover to help pay for these checkups. But before you can start to claim these benefits, you’ll likely need to wait an average of two months. Now let’s imagine you need a more complicated dental procedure, like braces or a crown. The waiting period for a service like this can usually be at least 12 months.

Why do insurers have waiting periods?

In Australia, it’s illegal for insurers to charge you a higher premium because you’re more likely to need a procedure2. But if everyone only signed up for private health care when they required a serious treatment, health insurance premiums would go through the roof. To keep costs low for everyone, providers use waiting periods to encourage consumers to purchase private insurance before they actually need it.

When do waiting periods apply?

Generally, signing up for new coverage or increasing your level of cover will trigger the start of the waiting period for the additional items covered.

How long is the waiting period?

The answer will depend on your insurance provider, as well as the type of cover. For hospital cover, the government has set maximum waiting periods that health insurers are allowed to apply to your plan. Let’s take a look at those maximum waiting periods.

Waiting periods for hospital cover:

These are the maximum waiting periods insurers can ask you to wait before receiving different types of hospital cover.

12 months for pre-existing conditions: defined as conditions, illnesses, and ailments that you’d had signs or symptoms of for the 6 months before your policy started.
12 months for pregnancy cover (obstetrics): to be covered, you must be admitted to the hospital after the 12 months waiting period.
2 months for psychiatric care, rehabilitation, and palliative care, even for a pre-existing condition.
2 months for new conditions and accidents.
Waiting periods for extras cover:
For care that falls under extra covers, like dental care or visits to the physio, waiting periods are decided by health insurance providers. These are some typical waiting periods for extra cover2:

2 months for general dental benefits and physiotherapy
6 months for optical items, like glasses or contact lenses
12 months for major dental procedures, like crowns or bridges
Up to 3 years for some high-cost procedures such as braces and other orthodontics
Some providers will even have no waiting periods for certain treatments, which means you can start using your benefits straight away. For example, some insurers won’t make you wait for treatments like a dental checkup.

How can family health insurance help my family?

In Australia, we’re lucky to have access to the public healthcare system. Medicare helps cover part or sometimes even all of the cost of certain medical health care services, but there are some services that aren’t included.

If you want your family covered for many common procedures and consultations, then Family Health insurance is worth considering. It’s a great way to protect your family and if you make the most of the benefits, you might even save some money.

What types of treatments not covered by Medicare could be covered by Family Health Insurance?

Medicare only covers certain medical procedures. The good news is family health insurance could cover a lot more, including things like dental and orthodontic treatments, physiotherapy, speech therapy, contacts, and glasses. See a list of what could be included here and make sure you check what’s included in your policy before you sign up.

What types of family health insurance policies are available?

There are generally three types of family health insurance policies to choose from:

Family Hospital Cover: can help you pay for in-hospital treatments at a private or public hospital, including theatre fees for surgery and accommodation at a hospital. You also typically get to choose your doctor and hospital. When deciding on a policy it’s important to think about what your family needs and will use don’t search for ‘cheap family health insurance. First, consider what tier is suitable for your family: Gold, Silver, Bronze, or Basic. This will determine the premium you pay and what treatments you’re covered for.

Family Extras Cover: can provide you and your family with a level of cover for part (or all) of the costs of some allied health services that Medicare does not usually pay a rebate for, like dental and optical. When choosing an extras cover policy there are usually three levels to choose from: basic, medium, and comprehensive. Remember to check what’s included in your policy before signing up, as not all treatments will necessarily be included.

Family Combination Cover: family extras cover and family hospital policies cover very different things, so a lot of people actually get both. If you take out hospital cover and extras cover for your family you can usually combine them into a single policy You should also be able to combine different levels of cover to suit your needs, for example, you might want a gold hospital cover and a medium extras policy.
Compare our range of different policies and providers to find suitable cover for your family,. which iSelect can help you with! Call 13 19 20 and someone from our team will help to compare our range of policies and providers.

What are some benefits of family health insurance?

Here’s a list of some of the benefits that can come with family health insurance: 

Skip hospital waiting times: one of the big struggles in the public healthcare system is the waiting times. If you have health insurance you can go to a private hospital and generally skip the long waiting times for elective surgeries, such as hip replacements, cataract extraction, and ligament repairs.

Choice of doctor and hospital: family health insurance can also give you and your family more power to choose when it comes to what doctor and hospital you want to have your procedure at.

Save money on the services you use a lot: one of the best things about private health insurance with extra cover is that you might be able to get money back on non-medicare health services, like dental, physiotherapy, and optical. Saving on the smaller things like this can help pay for some of the bigger stuff in life, like schooling, mortgages, and loans.

Private Hospital Rooms: public patients often share a room with several other patients, but with most private health policies, you and anyone under the same cover in your family can request a private room at the hospital (subject to availability).

Manage unexpected costs: health insurance acts a bit like a safety net. So you don’t have to be worried about being caught off guard by any unexpected costs, like dental care, chronic illness, or hospital treatments.

How do I know what family health insurance covers to get?

Well, it depends on the size and shape of your family. When choosing a Family Health insurance policy you should consider the age, lifestyle, and medical history of every member of your family.

Start by asking yourself the following questions:

Are you planning on having another child? If the answer is yes, then you might want to consider getting a hospital policy that includes pregnancy cover. As pregnancy and birth generally have a 12-month waiting period so we suggest you start looking at getting cover about a year before you want to start planning for the new arrival. For pregnancy cover, you may want to look at Gold-tier policies, as this is the only tier that includes obstetrics as a minimum requirement.

Do you have young children? Then you might want to look at a policy that covers a range of services. From little monkey-bar warriors to football superstars, kids are a little more susceptible to accidents and illnesses. Additionally, procedures for grommets and tonsils can often come with long waiting lists in the public sector. But with health insurance, your child may not have to wait nearly as long to be treated.

Do you have older children? Generally, if they’re under the age of 25 they can still be on your family health insurance policy. But you might want to consider whether you’re on an appropriate level of cover. If they need prescription glasses, physiotherapy or orthodontic work, it might be worth moving from basic to comprehensive extras. Alternatively, you might find they’re hardly using any of the benefits and it’d be more worthwhile going down a tier and paying a lower premium.

Does anyone in your family have any specific needs? If you know someone is going to need regular checkups for stuff like dental, speech therapy or podiatry, then it again might be worthwhile looking at a policy that provides benefits for therapies.
What could family health insurance cost?
Like all insurance policies, the cost for family health cover varies depending on the provider you choose to go with, the level of cover, and your family. Compare a range of different policies and providers to find one that suits you and your family. You can do this online here or you can even call iSelect on 13 19 20 and we can help you over the phone.

If I have family health insurance do I have to pay the Medicare Levy Surcharge?
Good news! If you have appropriate private hospital health insurance, you don’t have to pay the Medicare Levy Surcharge. Going off your current income, you can use the table below to work out which rate applies to you and your family1. The MLS rate of 1%, 1.25%, or 1.5% is levied on your taxable income.

If you have two or more dependent children, the family income threshold is also increased by $1,500 for each child after the first.

How long can my kids stay on my family health insurance policy?

Until your kids turn 18, they’re automatically covered under your family health insurance policy as dependents. Once they hit 18, it’s up to your insurer whether or not they still qualify. If they’re a full-time student or financially dependent on you, some insurers will still allow them to stay on your policy or they may ask that you pay a higher premium. Generally, once they hit 25, they’re considered independent and booted off your cover. So they’ll need to weigh up going on their own health insurance plan or relying on Medicare.

How do I compare family health insurance policies?

Choosing a suitable policy for your family might seem daunting, but it’s actually a lot easier than you think. Because we can do it for you! Just call 13 19 20 and someone from our team could help you find a health insurance policy that suits you and your family from our range of policies and providers.