How to Choose Private Health Insurance Cover
Choosing the right health insurance cover can be overwhelming at the best of times. With so many policies available it's important to do your research to ensure you choose one that meets your needs and circumstances – both at the time and for the future. After all, our needs change along with our life stages, and not having the right cover can be a huge drain on our finances and emotional wellbeing.
What is private health insurance cover?
Private health insurance can help to offset the costs of hospital medical treatments where the public system may only pay a portion of the fee, and it can help reduce the long wait times for a range of services. It can also allow you to choose your doctor or specialist. There are two parts – Hospital and Extras cover. But what do these two types of cover mean?
Hospital cover helps pay for costs associated with in-hospital services such as surgery, anaesthesia, private rooms and theatre fees. Your out-of-pocket costs may vary according to the hospital excess you choose, your health fund, the medical professionals required, and the procedure involved. Extras cover (also known as 'general treatment' or 'ancillary' cover) helps pay for things that are 'extra' to in-hospital services – and often not covered by Medicare. Purchased separately or together with Hospital cover, an Extras policy covers health care services like dental, physiotherapy and optical.
For further guidance, the Australian government provides comprehensive and independent health insurance information.
What's covered by Qantas Health Insurance?
The level of cover you need or want depends on your life stage, individual needs, and circumstances. That's why it's important to think carefully about what you need now and what you may need in the future such as pregnancy, dental work, eye surgery etc. (especially as waiting periods may apply to new benefits – see below for more information). You can select a policy to cover yourself or your family: Single, Couples, Families, Single Parent.
Qantas Health Insurance offers the following products:
Hospital cover – Basic, Bronze, Silver, Silver Plus, Gold
Extras cover – Basic, Family, Lifestyle, Active, Top
Each option offers a staggered cost and inclusions package, starting at Basic and working up from there, with the flexibility to mix and match the standalone Hospital and Extras cover. All of the inclusions can be found on our health insurance product pages.
Speak to an expert: 13 49 60
And don’t forget, if you’re still undecided on choosing your health insurance policy, you can call us to chat through your options. One of our trusted advisors can help you decide which level of cover best suits your needs and circumstances. Call 13 49 60.
What’s not covered by private Hospital insurance?
Hospital covers include a wide range of services, depending on what level of policy you choose, but there are occasions where there is limited or no cover on some hospital services. Limitations to hospital treatment may include:
Exclusions - list of services not covered at all under the cover
Restrictions - list of services where costs are not fully covered so you will have greater out-of-pocket expenses
Surgery or hospital treatments not covered by Medicare such as cosmetic surgery
Out of hospital treatments, such as a GP visit
View our Qantas Health Insurance cover options to see at a high level what types of procedures are covered. For more detail refer to our Policy booklet. If you have any questions about cover for particular items, call us to talk to one of our experts on 13 49 60.
Health insurance waiting periods
You may have heard the term “waiting periods” when it comes to health insurance.
You may not know this but maximum waiting periods for Hospital services are not set by your individual health fund, they’re set by The Federal Government. Waiting periods for Extras cover are set by health funds and most of these are 2, 6, or 12 months. Typically waiting periods are based on: when you initially take out private health insurance, switch cover within a health fund, or switch to a different fund. This means that if you switch funds, to a similar or lower level of cover, the waiting periods you’ve already served on comparable services will be recognised and the time you have waited carries over. But if you’ve switched (either within your current fund or to a new one), to a higher cover with services not on your previous cover, you’ll need to wait before you can claim on any part of the policy that’s new.
Waiting periods are there to prevent individuals from making a large claim shortly after joining, only to cancel their policy shortly after that. This type of behavior results in higher premium increases so the waiting periods help protect all members.
Do I need private health insurance?
Of course, this choice is entirely up to you but generally speaking, if you’re in a good position financially and can afford it, then it could provide the financial safety net should you need to go to private hospital. These include private hospital costs, any type of surgery that is elective and more regular costs like going to a physio, getting your teeth checked or a new pair of glasses.
As private health insurance is not mandatory, there are no immediate penalties for not having it. However, if you don’t have private hospital cover by 1 July following your 31st birthday, you’ll be charged a Lifetime Health Cover (LHC) loading of 2% on top of your Hospital premium for every year you don’t have it. This will be calculated as soon as you do choose to take out private health cover and could eventually increase your premium by up to 70%. Once you have paid LHC loading for 10 years of continuous cover, you will no longer have to pay this loading.
Also if you earn a higher income, you may want to take out private health insurance to avoid the Medicare Levy Surcharge (MLS). MLS is a means-tested tax on top of the Medicare Levy, put in place to encourage those who can afford it to take out Hospital Cover, lessening the burden on the public system. You won’t pay the MLS if:
You have Hospital cover and keep it for the full financial year; or
If your annual taxable income is less than $97,000 or $194,000 for couples, families and single parents
How much is private health insurance?
The cost of private health cover will vary depending on your age, income, and chosen level of cover. The best thing to do is to speak to an expert and work out which cover suits your needs and budget.
The Australian Government's Money Smart website has further information to help you make a decision.
Click here for a Qantas Health Insurance quote today, or to learn more, call one of our experts on 13 49 60.
