Health Insurance Comparison - Compare Private Health Cover & Save

Compare Health Insurance Policies and find the right Private Health Cover for you

Health insurance is a very important part of our lives. It can be quite confusing to go through all the details though. By reading this guide, you will be able to find out about all the different options available, which will help you and your family have the best health cover for you.

Table Of Contents: Overview of Health Insurance

This is to provide an overview of all the major topics in this article, feel free to jump to the relevant section for a much more detailed discussion.

• Why obtain private health insurance
• Medicare
• The benefits of private health insurance
• The types of private health insurance
• Money saving tips
• Choosing the right policy
• Why private health insurance is important
• Understanding the different types of cover
• Waiting times
• Lifetime health cover
• Unexpected charges
• Being treated in a private hospital
• How rates vary
• Always check the fine print
• Finding the best policy for you
• Switching funds
• FAQs about private health insurance
• Finding a private health insurer

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Overview of Australian Health Insurance & Private Health Cover

This thorough and comprehensive guide will take you through all the important aspects of comparing and choosing a private health insurer. Health insurance is a critical part of modern life, and if you think you might get by with just Medicare this article might be an eye-opener for you.

Even when you've decided to opt for private health cover, the array of health funds and the various terms at which they offer to insure you or your family can be confusing to say the least. To simplify the evaluation and comparison process we have compiled this guide, so that you can get the most beneficial cover that is applicable to your circumstances without paying too much on premiums.

We hope all your private health insurance queries are satisfied through this very comprehensive coverage of the topic. Now, without further adieu, let's get started.

Why obtain private health insurance?

More and more Australians are opting for private health insurance. As the population increases, wait times are increasing at doctors' and hospitals, and many Australians feel that private health insurance is worthwhile. There are additional tax benefits that can be enjoyed by obtaining private health insurance, due to which some people are choosing a basic private health insurance cover.

By opting for private health insurance, Australians are gaining the right to access the private health system. They are then covered for various different services that their health fund offers.

By obtaining access to private health cover, you are insuring your family against many different medical issues. The various benefits you can enjoy by obtaining private health insurance include:

• The ability to choose between being treated in a public hospital or a private hospital.
• The ability to choose the hospital you will go to
• The ability to choose the doctor who will treat you
• Shorter wait times at hospitals and doctors'
• Cover for a range of different fees including doctors' fees, theatre costs and accommodation costs
• A range of additional services such as chiropractic, dental care, optical care, remedial massage, appliances such as hearing aids, acupuncture and more

As you can see, obtaining private health cover is not just a matter of enjoying tax benefits. Individuals with private health cover can enjoy better service in terms of shorter waiting periods and greater choice of hospitals and doctors. Private health insurance covers a range of additional services as well, including "preventive" therapy and alternative medicine such as acupuncture and massage.

Private health insurance is supported by the Australian Government. All Australians who obtain private health insurance can enjoy a 30% rebate. Older Australians enjoy a higher rebate: Australians aged 65-69 receive 35% rebate and Australians aged 70 and over enjoy a 40% rebate.

There are a number of different ways to claim your rebate:

• You can deduct it from your premium
• You can claim the rebate on your tax return
• You can get the rebate paid in cash from the local Medicare office.

While you might initially think that having Medicare cover is enough, there are many reasons why private health insurance is so important to you and your family.

With health funds, it is possible to choose the kind of private health cover that best suits you, your family and your circumstances. Because of this wide range of cover, you are able to stay insured against any eventuality.

As someone with private health insurance, you get to enjoy greater choice regarding your treatment options. This can be highly beneficial, since you get to choose the option that is right for you. You can choose to be treated in either a public or a private hospital and you can even choose the exact hospital where you would like to be treated. You can also enjoy the benefit of choosing your doctor - if there is a particular doctor who is renowned in the field, or who comes recommended to you, you can opt to be treated by him or her.

If you are a regular public health system patient, you will need to endure rather long waits to be treated, unless your situation is absolutely life-threatening. However, if you have private health insurance, there are minimal to no wait time at all.

Hospital admissions are increasing and wait times are getting progressively longer. There has never been a better time to consider private health insurance for your family and yourself.

Choosing private health insurance is not a decision to be taken lightly. There are a range of options which can suit any budget and lifestyle. You can choose from basic cover to comprehensive cover to anything in between.

The basic private health insurance cover is perfect for people who are on a tight budget. This cover is best for those trying to obtain tax benefits, and who are actually not so enthusiastic about the other benefits of private health cover.

You can obtain comprehensive cover to cover for all eventualities. You can also obtain an excess or co-payments option in order to lower your premium. However, if you do choose either of those two options and get admitted to a hospital, you will be required to pay some extra costs.

Medicare

In Australia, the health care available is both public and private, which means that all Australians are covered. The public health system here, Medicare, makes sure that every single Australian has a variety of care available to them. This includes eye tests, various types of examinations and tests, subsidised or free treatment by practitioners and free treatment to public patients in a public hospital.

But, it is worth noting that Medicare doesn't cover every aspect of health cover; private health care is an important part of the Australian health care system.

About a third of all health care in Australian is funded by the private health system. They provide more than Medicare by offering patients treatment in both public and private hospitals. Medicare also does not offer various ancillary services, such as chiro, physio etc.

Also, there is a Medicare Levy Surcharge that is charged to any individual who is earning more than $70,000 a year; and couples or families who earn more than $140,000 a year combined. If they do not have private health insurance (and hospital cover) then they will have to pay this surcharge, on top of a 1.5% Medicare Levy that almost everyone already pays with their taxes. The Medicare Levy Surcharge is $700 for single people and $1,400 for couples or families.

There is a way to avoid this charge however, by taking out hospital cover that does not have an excess any larger than $500 for an individual or $1000 for couples and families. This may sound like it may turn out to cost a lot more by getting hospital cover instead of just paying the surcharge, but with some policies taking out hospital cover is actually cheaper than paying the Medicare Levy Surcharge.

The benefits of private health insurance

By being insured, Australians are able to have access to the private health system and are then covered for various different services offered by their health fund. By having access to private health cover, you are covering yourself and your family for many different medical issues, including:

• The choice to be treated in either a private of public hospital; you also get to choose the hospital and the doctor that treats you.
• Shorter waiting times to be seen or treated.
• Cover for a number of different hospital fees, including doctor's fees, accommodation and theatre costs.
• A variety of Ancillary services, including dental care, chiropractic, optical, physiotherapy, remedial massage, acupuncture, appliances like hearing aids and much more.

Private health cover is also helped by the Australian Government - all Australians receive a rebate of at least 30% if they have private health cover. Older Australians get an even bigger rebate, with people aged 65-69 receiving 35% and anyone over the age of 70 getting 40%.

There are 3 different ways that you can claim your rebate; you can deduct it from your premium by sending off a form supplied by your health fund, you can claim the rebate on your tax return or you can head in to your local Medicare office and get your rebate paid to you in cash.

The types of private health insurance

With most cover, you can choose between two different options; these are hospital cover and ancillary cover. You can choose to have either one or both.

The hospital cover pays an accommodation benefit, some treatment costs in certain hospitals and some of the doctors' fees. Extras such as television sets and phone calls may not be included in your cover.

Ancillary (or extras) health insurance will cover any treatment costs that aren't covered by Medicare, such as physiotherapy, acupuncture and dental care. Products such as glasses and contact lenses are also usually covered by this.

Of course, the benefits which are offered vary from fund to fund. It is also worth noting that the payout will most probably not cover the entire cost of your treatment.

All Australians, under Medicare, have access to free treatment at a public hospital even if they do not have insurance. However, Australians who do have private health insurance have many benefits as mentioned earlier.

Money saving tips

There are a few different ways you can save money by being aware of the different options and offers available.

• If you earn more than $73,000 (or $146,000 if you're a couple/family) then you'll need to pay 1% surcharge to Medicare as well as the 1.5% Medicare levy that almost everyone has to pay. However, you can avoid this charge by taking out hospital insurance.
• The older you get, the more expensive lifetime health cover is going to cost you. The older you are, the higher the premiums are going to be. The normal age now that policy premiums start to go up is 31 - before that you can secure much lower premiums - but we'll have more on that later.
• You can save a fair amount of money by having an excess on your policy, meaning you have to pay a certain amount of money for staying in a hospital before your private health fund pays anything.
• By only being covered as a private patient in a public hospital, you can find a cheaper policy. Although, this is one of the poorer options as treatment is limited to only some conditions.
• Another way to save on your policy is by paying a co-payment if and when you go into hospital. Every time you receive a service, you pay an agreed amount, which is usually a set amount per day for a certain number of days whilst you are in hospital.
• By choosing a policy that does not cover treatment for certain conditions (but which are nevertheless covered by public health insurance), you can save money too. However, if you ever did need treatment for one of the conditions that is not offered, you will find yourself having to use the public health system. Such treatments that are not covered normally include bone marrow transplants, cataract eye surgery, cosmetic and plastic surgery, psychiatric care, all birth-related care and more.

Out of all the tips above, the two that will most probably reduce your premium the most are the excess and co-payment options. An excess is a certain amount of money, that is agreed at the time of taking the private health insurance policy out, that would be paid towards any hospital treatment costs. Depending on the policy, you may have to pay the excess fee on only your first admission to hospital or you may have to pay an excess every time you are admitted to hospital. The good thing about this option is that you only pay the excess when you are admitted. This means that if you had an excess of $250 and you were in hospital for 8 nights, you'd only pay the $250 on the first night that you are admitted and then your insurance would cover the rest of your stay.

If you are looking to avoid the Medicare Levy Surcharge by taking out private health insurance cover, it is worth noting that if your excess is over $500 for a single person or $1000 for couples and families then you will not be exempt from this charge; it is a good idea to check with the fund if you will be able to avoid the Medicare Levy Surcharge before you buy their private health insurance.

The co-payment option is a little different; whilst you still agree on an amount of money to pay, with this option you would pay that amount every day that you spend in hospital for an agreed amount of days. For example, if you have a co-payment of $100 for 3 days, you'd pay $100 for the first 3 days that you are in hospital and then after this time, you will be covered for the rest of your stay by your health insurance.

All excess and co-payment options are different depending on the policy you are taking out, so it is always important to check through all the fine print and details before you decide on your cover. For example, with some health funds, if you have an excess agreement with your policy, you may only need to pay your excess once a year, whilst with other funds you may need to pay an excess multiple times for every time you are admitted to hospital or treated.

It is worth nothing that some funds will not charge excesses or co-payments for any children who are on a family or single-parent policy.

However, although you may end up having to pay out some extra money if you are ever admitted to hospital, having an excess or co-payment option is probably the best idea instead of opting to have some treatments excluded from your cover as a way to save money. This way, you will be covered for various treatments for different conditions should you ever need them.

Another thing to keep in mind is that if you spend more than $1500 on your medical costs, you can claim a 20% tax rebate.

Choosing the right health insurance policy

When looking into buying a policy, it is very important to see how much you will get back for a particular treatment. You will also want to find out what the overall limit is that you can claim in a year.

Some policies will combine the maximum limits. For example, they may tell you that you can have $500 worth of physiotherapy and chiropractic in a year - that's $500 shared between the two different treatments, not $500 each. Also, it is worth looking into the details of family limits and single limits. Some policies may limit the amount of times that a family can claim for some services and treatment.

There are lots of extras and benefits offered by funds that vary from ambulance cover and treatment at their own dental or optical clinics - these extras are sometimes deal breakers for some people, so it's always a good idea to check whether the policy is best suited to your needs.

The main thing to look at when trying to find the right health cover for you is your budget and lifestyle; the policy you take out must relate to this as it can affect the price of your policy dramatically. For example, if you are a young person with a low income, it would not be in your best interest to take out a comprehensive policy that has cover for hip replacement - you need to make sure that the cover you pick fits you perfectly.

Why private health insurance is important

Whilst you might think that having public health care in Medicare is enough for you, there are many reasons why private health insurance is so important to both you and your family. With health funds, you are able to choose the type of cover that best suits you and your situation. This way you can be covered for almost every eventuality.

As someone with private health insurance, you are able to choose to be treated either in a private or public hospital with the doctor of your choice. As a private patient, you will also be able to take advantage of much shorter waiting times to be seen or treated; whereas if you are a regular public health system patient you will be treated by a doctor who is chosen by the hospital. This means that you will only be treated when the doctor is available to treat you (unless the situation is life-threatening, of course).

With hospital admissions on the rise and waiting times getting longer, there has never been a better time to look into getting private health insurance for you and your family. There are private health funds available to suit every budget and lifestyle, starting with basic cover through to comprehensive cover.

The basic cover is perfect for anyone who is on a tight budget and just wants to avoid paying the Medicare Levy Surcharge whilst the comprehensive cover is perfect if you want to be fully covered for almost all eventualities.

There is also the option of an excess or co-payments which can reduce your premium. Although, if you take one of these options and you are ever admitted to hospital, you will have to pay some extra costs.

While you may not be able to predict a freak accident happening, you do know that you'll need dental care, possibly glasses and eye contacts or maybe even pregnancy services. For this reason, it is very wise to have some form of private health insurance; people with comprehensive cover will most likely be covered for all of the above and much more.

Understanding the different types of health cover

There are various different types of cover available on the market. One type of cover is hospital cover; this helps with all costs associated with the hospital, such as the cost of treatment, doctors' fees, accommodation and theatre fees.

If you choose to be fully covered and have all accommodation and treatment costs taken care of (when you are admitted to a hospital), you will of course attract higher premiums. You can reduce the premiums by either agreeing to not being covered for certain conditions; or by using the excess or co-payment options that were mentioned above. This basically means you will cover some of the costs if you ever need to be treated instead of the insurance covering all the costs (applicable when you're on a comprehensive plan).

Certain treatments are sometimes not covered anyway by your hospital, despite the type of cover you take out. These treatments normally include:

• Cataract eye surgery
• Bone marrow transplants
• Dialysis
• Rehabilitation
• Plastic surgery
• Cosmetic surgery
• IVF treatment (assisted reproduction)
• All birth-related care
• Coronary bypass and major heart surgery

If you are looking to be covered for any of the above, it is a good idea to look for a health fund and hospital that can offer you these treatments. Some other policies may offer some of the above treatments, but you will be expected to pay some of the costs towards your treatment instead of having your private health insurance cover any and all costs.

However, you may not be 100% covered in all hospitals - not all of the hospital costs are covered with your hospital insurance. If you agree to pay an excess or any co-payments when you take out your policy to reduce the amount of your premium, you could find yourself paying out extra money during your stay in hospital.

You may not also be guaranteed a private room by hospital cover and the cost of pharmaceuticals may also not be covered. It is worth checking with your potential health fund whether these different exclusions may apply to you if you end up being admitted to hospital. The main reason people like to take out hospital cover is to be fully covered when they are admitted and then treated in hospital, but if you are not in the know there could be some unexpected charges coming your way.

The other type of cover is ancillary cover, which is basically all the extras that a hospital does not offer, such as dental and eye care. It's a good idea to take out insurance for all the different features that you know you'll be needing, such as optical care if you are someone who has poor eyesight and needs to see an optician regularly. This type of cover will sometimes also come with complementary services and treatment, such as massages.

You may have limits on your ancillary cover, meaning that you can have $500 a year worth of physiotherapy and chiropractic treatment instead of $500 for each. Also, if you are on a family plan you may only be able to claim certain services a certain amount of times. This is why it is very important to check whether you have separate limits or an overall limit for your ancillary cover, as this can really change the value of your cover if you are limited to what services you can use and how many times you can use them per year.

If you live in a rural area, you should check with your health fund how far you would have to travel to take advantage of any ancillary cover treatments that you may want to use.

It is also worth considering whether you really need the ancillary cover; while for some people, the lack of extra benefits such as massages may be a deal breaker, for others they are an unnecessary add-on that might just be bumping up the price of your premium. If you don't think you'll need ancillary cover, you will want to look around for a fund that doesn't include it as part of your cover as this should reduce the price you have to pay for your private health insurance.

However, one of the most popular private health insurance options is to combine both of these types of cover together. By giving yourself both hospital and ancillary cover together in one policy, you are getting yourself (and your family) a very varied type of cover.

Waiting times

There is a certain amount of time after signing up for your cover that you have to wait before your health insurance cover comes into effect. The waiting period varies from policy to policy. However, if you have an accident after you take out the policy, you will normally be covered and your insurance should be able to cover you for any hospital stay and/or treatment that you receive.

Another key point is that if you are changing your policy from one health fund to another, you will not have to endure any waiting time as you would've already done so when you signed up for your original policy.

There are maximum waiting times that have been brought in by the Australian government to stop health funds from bringing in extra long waiting times for new policy holders. The maximum time that you would have to wait is 12 months if you have any pre-existing medical problems (the same waiting time applies for obstetric cases).

If you are looking to be covered for psychiatric care, palliative care or rehabilitation, you will have to wait 2 months for your policy to be active, even if these are pre-existing conditions; this is the same waiting time for all other new policy holders too.

Whilst there are government regulations for hospital cover, there are no regulations in place for ancillary cover. This could mean that you have to wait quite a long time before any of the benefits from this type of cover are available to you.

However, for extras such as hearing aids you may have to wait up to 3 years until you will be able to use your cover to get them.

It is therefore always very important to make sure you know how long you'll have to wait before your cover becomes active. Any of your circumstances can delay your private health insurance being available to you - always ask your fund questions that are specific to you and your needs. For example, if you did want to get hearing aids on your cover, you should ask your fund how this would work, how long you'd have to wait and if you'd have to pay anything towards them.

Lifetime health cover

Lifetime health cover is an idea brought in by the Australian government. It encourages young people to take out private health insurance cover at a young age and then keep that cover running for their entire life. By staying a holder of lifetime health cover, you are entitled to savings towards your insurance policy.

If you wish to switch to a different health fund at any point in time, it will not affect the entitlements that you have acquired by being a lifetime health cover holder. Although to be eligible for continued benefits your new policy does have to include hospital cover.

If you are aged 31 or over and you have not yet signed up for any health insurance, you will have to pay higher premiums than someone who is younger than you. After you have been with a private health insurer for 10 years, your premiums will be adjusted down to that normal levels i.e. the premium paid by someone in your position but who signed up for health insurance before their 31st birthday.

If you are a young person who is healthy and you just want health insurance that covers you for some kind of accident or emergency, you should be able to sign up for health cover and not have to go on any kind of waiting list. If you are signing up for private health insurance whilst you have an existing ailment however, you will most likely have to go on a public hospital waiting list.

You can however take out ancillary cover at any time in your life without being penalised by higher premiums because of your age, which is great for older people as later in life you will most probably need to have more visits to the dentist and optician, for example. Of course, there are also other "extras" that come with this type of cover. Therefore it might be worth looking into the ancillary cover regardless of your age.

If you are aged 31 and you are looking to get private health insurance but you think that now you'll be hit with higher premiums, you might be in luck if you act immediately; the first time that 1 July comes round after your birthday is when the cut-off point comes into play. If for example you turned 31 in February, you should still have a chance to apply for private health insurance before 1 July and avoid any surcharges and higher premiums.

If you can't take advantage of the lower premiums, you'll find that a 2% surcharge is applied every year up to a maximum of 70% - for example, if you sign up at 45 you will pay 30% more than someone who joined up at the age of 30.

But, after you have paid the surcharge annually for 10 years, your premiums will change to the same rate as people who signed up for private health insurance before their 31st birthday. Therefore, in the long term it will pay off for you to still get cover even if you are aged over 31.

Unexpected charges

As a private patient, in some cases your treatment will not be completely covered by your health insurance and you may end up having to pay a certain amount of money towards your health care bills. This will also be on top of any excess or co-payments that you may have already paid whilst being admitted to hospital and being treated there too.

These extra charges, or gaps, are often charged mainly to doctors' fees, although some of it will go to the hospital too. However, there are quite a few hospitals that have an agreement with private health insurers which states that you will not be charged a gap for any hospital fees.

There are also some private health insurers who have an agreement with doctors too, which means you will either have to pay nothing towards the doctors' fees or a certain stated amount. It is up to the doctor to decide whether they will bring this agreement into play when they treat you.

It is worth checking to see if your hospital has an arrangement with the fund you are going to sign up with, as this could be a very good way to save some money should you ever be presented with these gap fees.

If you already have a fund, you will want to look into switching to a fund that has an arrangement straight away, especially if you are about to have an operation. There should be no problem with switching your fund before treatment as long as you switch to the same type of cover that you had before - there shouldn't be any waiting periods to have your new insurance activated either, so this is a good option to look into. You can even suggest it to friends and family who have private health insurance.

If you are someone who is going to hospital soon for treatment, it is always a good idea to check over your policy to make sure it is exactly what you need and you're covered for the treatments you require. If you think you're going to be in hospital for a while, it may be worth looking into upgrading your policy to one without excess. Before doing so, however, you would need to check with your fund whether this would require a 12 month waiting time for your new level of insurance to become active.

It is also important to communicate with your doctor if you are going to be treated in the near future; find out if they have any gap cover arrangements with your current fund and see if they think there will be any extra charges. Also ask them if you will be charged by any other doctors that may treat you, including any assistants.

You will also want to check with your hospital to see if they have an arrangement with your fund. It is worth contacting your fund after you have talked with your doctor and hospital so they can confirm that everything you have been told is correct. Even if they do have an agreement, it is always a good idea to keep checking every now and then whether your fund still has an agreement with your hospital as the arrangements can change over time and you may not be notified by either your private health insurers or your hospital.

You will also want to check how far you'd have to travel to your nearest hospital that has an agreement with your fund, especially if you live in a rural area. It really is a bonus if your fund has an agreement with your doctor or hospital as it is going to bring down your medical bills immensely and you will then also not be shocked by any surprise charges both during and after your treatment.

When you have any hospital treatment as a private patient, Medicare will pay 75% of a fee set by the government for every medical service. This is known as the MBS fee. Your private health insurer will pay the other 25%, meaning you'll have less of a gap fee, if any, to pay off.

Your insurer may also make a no gap scheme or known gap scheme available to you. This basically means that you will either have to pay no gap fee at all or any gap fee you will have to pay will be made known to you, so there won't be any nasty surprises after your treatment with unexpected payments to be made.

Once again, always check with your doctor and hospital whether they are in an agreement with your fund. This is especially important with your doctor, because this can change on a case-by-case basis.

You could find you'll have to pay a gap for doctors' fees if you are charged an amount that is above the MBS fee. The main reason that it is important to make sure your doctor has an agreement with your fund is because your fund will be able to help.

Being treated in a private hospital

Whilst private hospitals may have luxuries and advantages that a regular public hospital might not have - such as a room just for yourself, television sets and your own private bathroom - there is no real evidence out there that shows you will get better health care in the private system. You will, however, most probably find your stay in the hospital more enjoyable and you have a much better choice and flexibility when it comes to choosing when you want to be admitted into hospital.

All Australians are entitled to free treatment under Medicare in a public hospital, even if they do not have any insurance of their own. One of the common problems that people have with private health insurance is the bill that can add up if they are in hospital for an extended period of time. If you cannot afford to pay your bill after being in hospital for a long time, you may need to be moved from private care to a public hospital during your treatment, which could cause some extra stress to you and your family.

How rates vary

In the past, health insurance used to be available as either single or family cover. Single cover used to cost half as much as a family policy would. However, now there are five categories:

• Family
• Families with adult children
• Single-parent families
• Single
• Couples

Now, single insurance is still normally half the cost of a family rate insurance, with couples being given the same rate as families - for this reason, it is always worth considering signing up for family cover if it is the same cost as cover for couples; that way if they ever do start a family, they will be covered at no extra cost.

Single parents are also able to receive discounts now on their policy; the discount is not a set amount however and it can vary from fund to fund, so it's a good idea to look around and make sure you get the best deal available to you.

Always check the fine print

It is vital to make sure that you fully understand all of the ins and outs of any policy that you are getting into. You will want to ask your fund a few things before you decide whether you are going to sign up with them for their private health insurance cover.

The first thing you will want to find out, if you are taking out a family policy, is who counts as a family member and is therefore covered by your insurance. Family cover will almost always include your partner and any children who are under a certain age. The maximum age can vary from anything from 16 to 23 depending on the policy. Also, if your child is a full-time student and is under 25, they may be eligible to be covered on the family policy. You will want to ask the fund if there are any extra charges for including more family members on your cover.

Ask the fund if there are any discounts or advantages available - some private health insurers may offer you advantages if you are with them for a long period of time. The advantages can include more benefits or a lower excess. The longer you have been signed up with them the greater the advantages to be expected from private insurers.

You will also want to ask the fund whether there could be any extra charges if you want to specify which private hospital you are treated at, and/or if you want to choose the doctor who treats you.

Also, ask them if there are any waiting times that will apply to your policy after you sign up; this is an important question to ask as you could have to wait up to 12 months for your cover to come into effect meaning your private health insurance may not be active for some time after you buy your policy. You will also want to ask your potential fund about your hospital, ancillary and ambulance cover. Here are some of the questions you might want to consider asking them:

Hospital cover

• Are any of the treatments only available at public hospitals, are any of the treatments excluded and could you end up being a private patient in a public hospital?
• Does your local hospital - or the hospital you want to be treated at - and your doctor have an arrangement with the fund?
• With excess, do you have to pay the excess once or multiple times if you are admitted to hospital?
• With co-payments, how many payments would need to be made and how much would these payments be?
• Even if you are "100% covered" are you going to need to pay any extra costs during your stay in hospital?
• Are there any treatments not fully covered or limited in scope?

Ancillary cover

• If you are going to receive any extra benefits, what are the extra costs that you will be charged every year and is the cost per membership or per person?
• Be sure to find out whether the extra benefits cost a percentage of any fee that is charged or if it is a percentage of a "reasonable fee" set by the private health insurers - this can sometimes be a trap, as your extras can end up costing a lot more than they should if you are paying a percentage of a fee set by your fund.
• Ask your fund if any of the providers of the extra services need to be either registered with the appropriate state board or if they need to actually be registered with your fund. If you are looking to receive a particular benefit, such as massage therapy, and you have a certain practitioner in mind, you will want to check with your fund whether you will be able to be treated by them on your ancillary cover. Otherwise, you could end up getting ancillary cover that you can't use and is totally useless to you.

Ambulance cover is another type of cover that is normally offered with hospital cover and sometimes even with ancillary cover. However, this type of cover can be very different depending on the fund.

For example, on some occasions ambulance cover will only cover you to be picked up by an ambulance after an accident and taken to the hospital. Any extra transportation after that, such as being transferred to another hospital, would not be covered on some policies whilst on other policies, ambulance cover can cover you for all ambulance transport that is needed. Therefore, ask your fund for the ambulance cover situation to be explained clearly to you. Doing all of this may seem like a lot of trouble at the time but it will pay off in the long run as you will understand your policy fully and then hopefully you won't be met by any surprise charges.

Finding the best policy for you

It is important to find the best policy out there for you as there are so many different policies available.

When it comes to hospital cover, you can choose the level of cover that you would like to pay for. In general, there are 3 basic levels of cover available. The top level basically means you will be covered for treatment in both a public and private hospital as a private patient. By being fully covered and a private patient, you are able to eliminate public hospital waiting lists.

By signing up for the middle level of cover, you are basically not covering yourself for all the treatments available in a private hospital. However, you will probably be able to get the treatment in a public hospital with the doctor of your choice. This does mean though that you'll have to be put back on the public hospital waiting list.

Lastly, you may opt for the cheapest cover available to you - the lowest level of cover. Obviously, these kinds of policies will most likely have many different restrictions and exclusions. They normally will also have a fairly high excess too. However, you should be able to avoid the Medicare Levy Surcharge if you find the right deal. As you are most likely to be excluded from a number of different treatments, you'll need to go in to a public hospital to receive a certain treatment just like you would if you did not have any private health insurance.

Again, as with the hospital cover, ancillary cover generally has 3 different levels of cover that you can choose from.

With a top level policy, you'll be covered for all kinds of extra services and treatments such as all dental and eye treatments - you should also have access to cataracts and glasses, amongst other complementary services such as massage therapy.

The next level down is middle level cover option, which will still give you some dental care and other services, but not as much as with the top level cover policy. The same goes for the lowest level cover; dental care is still available, but orthodontic treatment is not available. If you think that you'll be needing a lot of dental treatment that will cost a fair amount of money, this is probably not the best option for you and you'd be better off going for a higher level policy.

Finally, there is of course the option to combine both the hospital cover and ancillary cover together to give yourself greater protection and all-around cover. The top level will offer you cover for all treatments and you will not have to pay any excess or extra fees when you are admitted to hospital and then treated there (in most situations).

The next level down will offer you cover in a private hospital with medium level extras. You will have to pay an excess for this type of policy but it is still good for families who are on a middle level budget.

The lowest level is probably best for young people who are healthy and single; you will be on a restricted combined policy, but you'll avoid taxes and surcharges and have basic hospital cover and ancillary cover.

You must decide whether you need one or the other (hospital cover or ancillary cover) or even both if you want to cover all the bases.

With the more comprehensive plans you will have much more choice and reduced out-of-pocket expenses which can turn out to be surprise expenses after treatment is complete, however, with this type of plan there are minimal (if any) extra charges.

On the other hand, the lower end of the plans will give you less choice and fewer services will be available to you. You will most probably be like every other Australian who doesn't have any private health insurance and is treated by the public health care system, except you will have some benefits and extras.

You'll then want to consider what features and extras are best suited to you and your lifestyle. For example, if you are expecting to have children in the future, you'll want to get a plan that is suitable for all birth-related care and is suitable for families. If you are someone who needs glasses or contact lenses, you'll want to choose a plan that has optical cover.

It is important to look at your lifestyle when deciding what type of plan you are going to go for; in many cases, along with the price, it should be the deciding factor for which fund you choose to sign up with.

If you want to reduce your premium, you can either agree to pay an excess or use co-payments, as mentioned earlier. This is a good option to choose if you feel like you won't be going in to hospital anytime soon. If you did end up getting admitted to hospital and getting treated there, then you'd pay out an excess or co-payments for a certain amount of time that you are staying there.

Therefore, this is a great way to reduce your premium and still have private health insurance active in case of any accident or emergencies. You can also avoid the Medicare Levy Surcharge with certain cover plans.

When you do actually get round to looking for a private health insurer, it's a good idea to use a comparison website to see which deal is the best for you and your family. You can literally compare multiple insurers within minutes and decide which fund is the best to suit your needs.

Switching health insurance funds

You may decide that you want to switch your health fund to a different fund to either save money or get a deal that is of greater value to you. Problems sometimes occur when people try to switch between funds and on some occasions, if the new fund does not receive your paperwork in time, you may be charged with extra costs.

On top of that, you may even have no private health insurance for a certain period of time, meaning that if something happened to you during this time you would have to be treated as normal by the Australian public health service. You may also have to pay the Medicare Levy Surcharge if you don't have any private health insurance active while you are switching between funds.

Private health insurers may offer you some kind of incentive to switch to them, such as getting free cover for a certain amount of time. Even if you are not aware of any current special offers, it's always a good idea to ask the fund you want to switch to if they have any active special offers that you can take advantage of. If you see an offer that you like with another fund, you could tell the fund (you are currently with) about it and they may offer to match it to get your business.

If with your old fund you were receiving some kind of discount or benefits for being a long-term member, tell the fund you want to switch to as they may be able to carry over these discounts and benefits to your new fund.

Following are a few quick steps which should organize the switching process for you and make it slightly easier to understand:

1. If you are going to go ahead with switching funds, you'll want to get a detailed quote from the fund you want to switch to and check that everything is what you need - make sure you check the applicable government rebate and any discounts that you can take advantage of, such as signing up for lifetime cover.
2. Next, you will want to apply for cover with the new fund that you want to switch to.
3. Tell your new fund that you would like your new cover to start as soon as your old cover is cancelled.
4. You will also want to request a clearance certificate which shows your membership level and your lifetime cover status. Also, you'll want a statement from your old fund which has a list of any claims that you have made and keep a copy of these before you send them off to your new fund.
5. Then, arrange a cancellation of your old cover by contacting your old fund.
6. You will then need to check your bank statement to ensure that your new fund has started and that your old fund has ended.
7. Finally, if you pay via direct debit, you'll need to cancel it with the old fund and also let your bank know that you want to cancel it.

If you are having problems switching your fund and you can't resolve the problem with the fund, you can try contacting the Private Health Insurance Ombudsman on 1800 640 695 or you can check out their website www.phio.org.au.

FAQs about private health insurance

Do I have to wait for my private health insurance to become active?

You may have a waiting period after you sign up for your private health insurance to become active. On some occasions, certain features of your cover may be active whilst others have certain waiting times. The reason that this system is in place is so people don't abuse the insurance by signing up and (for instance) using their cover for an operation and then ending their insurance after their treatment is over.

If you are switching between funds, you shouldn't have to serve a waiting period again as you would have already had a waiting time when you originally signed up for your private health insurance cover.

Can I receive the Federal Government Rebate?

If you are someone who has a blue or green Medicare card, then you should be able to get a minimum 30% rebate on the cost of your private health insurance from the Federal Government as long as your insurer is registered. If you are aged between 65-69 you will receive a rebate of 35% whilst people over 70 with receive a 40% rebate.

If I have a pre-existing ailment, will it affect my waiting period?

If you are someone who has a pre-existing condition (which basically means that you have a condition or illness six months before you take out any insurance) and someone who has a pre-existing ailment but doesn't know yet as it hasn't been diagnosed, you could find yourself waiting 12 months for your private health insurance to become active.

What is an excess and co-payment and should I use one of these options with on policy?

Excess and co-payments are options that can bring down your private health insurance premium quite a lot. An excess is the amount of money that you will pay towards the hospital and your treatment. It could either be applied every time you are admitted to hospital or once in a year (or any other period of time), depending on the policy.

A co-payment is the amount of money that you would pay if you are admitted to hospital and then treated. For example, you may have a co-payment arrangement of $50x5 meaning that you would pay $50 for only the first 5 days that you are in hospital and then after that, your private health insurance would cover the rest of your stay.

If you're someone who wants to get one of the cheapest plans available, an excess or co-payment arrangement is probably the best option for you. It is also a good choice if you are someone who is young and healthy. If you are confident that are in very good shape and you won't be heading in to a hospital that often, this is a good choice for you. Under the co-payment system you will still be covered if you ever need the treatment, but you will need to pay some of the bills and costs when/if you are treated, and your insurance will pay for the rest. Contrast this with a plan with no excess or co-payment option: your premiums will be larger but you will also be fully covered, i.e., you won't have to pay any of the treatment charges when/if you're hospitalised.

What is lifetime health cover?

If you are someone who signed up for your private health insurance before 1 July 2000 or before 1 July after your 31st birthday (and you have had hospital cover ever since then) you will have a lifetime health cover for the rest of your life. Under this arrangement - known as the lifetime health cover of the age of 30 - you are covered for private health insurance, which means you will have the lowest premium possible for you. If you are someone who signed up for your cover after 1 July following your 31st birthday, you will have a 2% surcharge added to your premium each year. However, after 10 years of having hospital cover with your private health insurance, you will be able to have a lifetime health cover of the age of 30, meaning you'll be on a great premium for the rest of your life.

Finding a private health insurer

The following table gives you an overview of some of the private insurance companies in Australia. Of course, there are other smaller companies who do provide private health insurance as well, but you can get a good idea from the following data:

Title	Type	States
ANZ Health Insurance - Bupa Australia Health Pty Ltd	Open	ACT, NSW, QLD, SA, TAS, VIC, WA, NT.
Australian Unity Health Limited	Open	ACT, NSW, QLD, SA, TAS, VIC, WA, NT.
Central West Health Cover	Open	ACT, NSW, QLD, SA, TAS, VIC, WA, NT.
CUA Health Limited	Open	ACT, NSW, QLD, SA, TAS, VIC, WA, NT.
Defence Health Limited	Restricted	ACT, NSW, QLD, SA, TAS, VIC, WA, NT.
GMF Health	Open	ACT, NSW, QLD, SA, TAS, VIC, WA, NT.
HBA - Bupa Australia Health Pty Ltd	Open	ACT, NSW, QLD, TAS, VIC, WA.
HBF Health Limited	Open	WA.
Health Insurance Fund of W.A. Limited	Open	ACT, NSW, QLD, SA, TAS, VIC, WA, NT.
Latrobe Health Services	Open	ACT, NSW, QLD, SA, TAS, VIC, WA, NT.
Manchester Unity Australia Ltd	Open	ACT, NSW, QLD, SA, TAS, VIC, WA, NT.
MBF - Bupa Australia Pty Ltd	Open	ACT, NSW, QLD, SA, TAS, VIC, WA, NT.
Medibank Private Limited	Open	ACT, NSW, QLD, SA, TAS, VIC, WA, NT.
Mutual Community - Bupa Australia Health Pty Ltd	Open	SA, NT.
National Health Benefits Australia Pty Ltd (onemedifund)	Open	ACT, NSW, QLD, SA, TAS, VIC, WA, NT.
Navy Health Ltd	Restricted	ACT, NSW, QLD, SA, TAS, VIC, WA, NT.
NIB Health Funds Ltd.	Open	ACT, NSW, QLD, SA, TAS, VIC, WA, NT.
NRMA Health Insurance - MBF Alliances Pty Ltd	Open	ACT, NSW, QLD, TAS, VIC.
Peoplecare Health Insurance	Open	ACT, NSW, QLD, SA, TAS, VIC, WA, NT.
Phoenix Health Fund Limited	Restricted	ACT, NSW, QLD, SA, TAS, VIC, WA, NT.
Police Health	Restricted	QLD, SA, TAS, WA, NT.
Queensland Country Health Fund Ltd	Open	QLD.
SGIC Health Insurance - MBF Alliances Pty Ltd	Open	SA, NT.
SGIO Health Insurance - MBF Alliances Pty Ltd	Open	WA.
St.Lukes Health	Open	ACT, NSW, QLD, SA, TAS, VIC, WA, NT.
Westfund Ltd	Open	ACT, NSW, QLD, WA.

Source:http://www.privatehealth.gov.au/dynamic/searchbyinsurer.aspx

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