What you need to know about Extras – your complete health cover comparison

When it comes to extras cover on your private health cover many of us ask the question is it really worth it?  Do the benefits outweigh the cost?  Extras cover is worth it if you use non-Medicare services on a regular basis.  The value for money comes with the usage of your extras cover. For instance if you require glasses or contact lenses – optical extras cover is beneficial or if you play a sport you may require ongoing physiotherapy treatment.  If you have children that require braces or dental work, having extras on your private health cover is worth considering. 

Why should you take out extras cover?

This type of cover is useful if you require out of hospital medical services to maintain your health and wellbeing and improve your overall quality of life. You will find it covers physiotherapy and chiropractic services, prescription glasses and contact lenses, hearing aids, ambulance cover (depending on your state of residence) and some non-PBS pharmaceuticals depending on your level of extras cover and state you live in. 

Need help choosing the correct level of extras cover?

There are a few factors that will come into play when choosing what extras cover you require such as budget and your specific health needs. Higher levels of cover are generally more expensive but offer a wider range of covered services. Depending where you are in your life stage, you may opt for this higher option or if you are younger and only require the basic services, basic extras may suit you. 

Below are the areas of treatments that are covered when it comes to extras policies:

Each private health policy varies from provider to provider, so it’s best to compare private health cover to find the best extras policy for your needs.

General Dental & Major DentalGeneral Dental Care: This includes routine check-ups, fillings, examinations, X-rays, and those refreshing scale and clean sessions.
Major Dental Work: When things get serious, like needing crowns, surgical tooth extractions, bridges, dentures, wisdom teeth removal and veneers.
Orthodontic Treatments: From the subtle alignment of Invisalign to the traditional braces and retainers, including their fitting and adjustments.
Endodontic Services: This covers gum treatment and root canal therapy to keep those teeth and gums healthy and pain-free.
Optical (Glasses & contact lenses)Optical Needs: Whether it’s prescription sunglasses, eyeglasses, or contact lenses, ensuring you see clearly is a priority.
PhysiotherapyPhysiotherapy Sessions: Post-operative care and tailored exercises to keep your muscles in top form, whether for recovery or sports-related therapy.
Hydrotherapy: Using specialist exercises that take place in a warm water pool to heal injuries and aid in rehabilitation.
Chiropractic/ osteopathy Remedial Massages: Soothing deep tissue massages or targeted treatments for sports injuries, helping you bounce back faster.
Massage/ natural therapiesChiropractic Care: From consultations and X-rays to gentle spinal adjustments, addressing musculoskeletal issues with a holistic approach.
Chinese Medicine: This is a holistic approach to disease and focuses as much on the prevention of illness as the treatment of it.
Acupuncture: You will be covered for acupuncture treatments working to restore health and wellbeing.
PodiatryPodiatry Services: Taking care of your feet and lower limbs, addressing everything from ingrown nails to bunions, crucial for athletes and those with mobility challenges.
Orthotics Support: Customised shoe inserts to enhance natural foot function and alleviate discomfort.
LifestyleExercise Physiology: Utilising specialised exercises to aid in injury recovery, manage chronic conditions, and improve overall wellness.
Psychological Support: Guidance from psychologists to tackle both mental and physical health concerns, with a focus on holistic well-being.
Non-PBS Pharmaceuticals Coverage: Assisting with the cost of prescription medications not covered by the government’s Pharmaceuticals Benefits Scheme (PBS).
Lifestyle Programs: Supporting approved courses aimed at enhancing your well-being, whether it’s quitting smoking, joining fitness classes, or managing weight effectively.
Hearing Aid Services: Covering the purchase, repair, or replacement of devices to address hearing impairments.
Dietician Consultations: Professional guidance on diet, nutrition, weight management, and disease control from recognised dieticians.
Travel Vaccinations:  Selected travel vaccinations administered by a doctor or at a vaccine clinic if you have a pharmacy receipt, doctor’s account or vaccine clinic account.
AmbulanceAmbulance Cover: Depending on where you live, considering ambulance cover is essential. Some health insurance extras policies include ambulance cover, but the extent of coverage can vary, so it’s worth exploring.

Extras Cover Levels Explained

There are basically three levels of extras cover that you can include on your private health policy in addition to your chosen hospital cover. Some providers also offer levels in between these three core levels for example – basic plus extras, medium plus extras etc. 

Basic Extras Cover

This is basically your lowest level of extras cover that will cover:

  • General dental
  • Physiotherapy
  • Optical

Medium Extras Cover

This level of cover usually provides good value for money. The medium level of extras cover generally include so or all of the following:

  • General dental 
  • Major dental 
  • Endodontics
  • Orthodontics
  • Optical
  • Physiotherapy
  • Chiropractic/osteopathy
  • Ambulance

Top Extras Cover

By choosing this level of extras cover you can have the peace of mind that you are covered for most health issues that may arise, such as:

  • General dental 
  • Major dental 
  • Endodontics
  • Orthodontics
  • Optical
  • Non-PBS pharmaceuticals
  • Physiotherapy
  • Hydrotherapy
  • Chiropractic/osteopathy
  • Podiatry
  • Psychology
  • Hearing aids
  • Acupuncture 
  • Chinese Medicine 
  • Travel Vaccinations 
  • Ambulance

Extras Waiting Periods Explained

Each private health fund varies but some waive extras waiting periods if you move over to them, if you’re looking to move its best to do a private health cover comparison and see who can offer you the best value for money to suit your life stage. 

When it comes to extras cover insurers can apply any waiting period they like. Some examples of extras waiting periods may be: 

General dental2 months
Physiotherapy 2 months
Chiropractic/osteopathy2 months
Natural Therapies2 months
Optical6 months
Healthy lifestyle6 months
Dental special (periodontics, removal wisdom teeth, oral surgery, root canal, orthodontics, dentures)12 months
Orthotics12 months
Hearing aids36 months
Ambulance servicesImmediately or 1-2 days

Although for hospital services, private health funds must follow the Government guidelines for waiting periods and these waiting periods must be no more than:

  • 12 months for pre-existing conditions
  • 12 months for pregnancy and birth-related services
  • 2 months for psychiatric care, rehabilitation or palliative care (even if it’s for a pre-existing condition)
  • 2 months for all other services*

* Source: Health.gov.au 

Remember to check your Extras Limits

Depending on your private health fund provider, each extras cover service will have a benefit limit per calendar year.  Generally you can claim a certain percentage of the cost of that service up to a maximum limit set out by your private health fund. 

Percentage Limits

Your private health fund may offer a percentage of the total cost of a service as a rebate. For example – your policy may cover 70% of your dental costs and you are responsible to pay the other 30% owing. This is called a gap payment. Alternatively, your policy may cover 100% of your new pair of reading glasses if the cost comes in under or equivalent to the annual claim limit. 

Dollar Amount Limit  

Some private health extras allow you to claim each service up to a particular dollar limit per service. 

To conclude, navigating the large number of extras cover options can be overwhelming, but understanding your specific needs and comparing private health policies can ensure you find the best fit for your health and financial circumstances. Whether it’s routine dental care, physiotherapy sessions, or even lifestyle programs, extras cover can provide invaluable support in maintaining your well-being. 

Remember, the key is to strike a balance between coverage and cost, ensuring you’re adequately protected without overpaying for services you may not need. By doing your research, considering your life stage, and consulting with experts, you can confidently choose an extras cover that complements your private health policy and gives you peace of mind. 

If you need assistance navigating through the extras options or have questions about what’s best for you, don’t hesitate to reach out to our dedicated team to compare private health cover. 

Call us today at 1300 861 413 or email hello@healthmarketing

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Compare dental health insurance – which funds offer the best cover

If you’re in need of some dental work, minor or major, there are many options on the market with various private health providers that may offer the ideal rebate and solution for your oral care plan. Most of us put off a visit to the dentist for fear of the need of fillings or other work.  Using your private health extras policy to claim each year on regular dental check ups may save you money in the long run. If you keep on top of dental checks and cleans, you may not need that filling. 

Dental health insurance pricing can vary greatly from provider to provider, spend time researching and weighing up which extras policy that includes dental will be the best value for you and your family.  If you are a single person maybe you only need basic dental cover, or if you have a family with 2 or more kids you would be better off with a more comprehensive plan to make sure everyone is covered.

Compare dental health insurance providers:

ProviderDetails
Bupa offers a range of dental extras to keep your teeth and gums healthy. With different levels to suit different dental needs, Bupa covers you from check-up and clean to major dental work such as crowns. Read more
Providing high-quality affordable treatment for a range of dental services, HCF will cover your child’s first visit to caring for your teeth when you’re older. HCF boasts a dental provider network of over 10,000 practitioners.  Read more
NIB offer ‘First Choice Dental’ with their extras policies which allow you to access a range of treatments with their dental practitioner network. These practitioners offer treatments at agreed rates so you are not out-of-pocket. Read more


AAMI’s dental insurance offers various levels depending on if you require minor or major dental work. For instance if you require root canal work or removing wisdom teeth, this would be considered major dental work. Read more

HBF offers a 100% rebate on your first scale and clean each year, resulting in more money in your pocket. They offer cover for preventative dental, restorative and major dental and orthodontics. Read more

FAQ

Are there waiting periods with dental insurance? 

Waiting periods vary from private health fund to health fund, generally when you sign up for an Extras policy there will be a waiting period. A few other factors that can come into play are if you are a new customer to the provider. They may offer reduced waiting periods as part of a sign up promotion or depending on what dental treatments you require there could be extended waiting periods. It pays to shop around and compare dental health insurance plans.

How much can I claim on dental services with my private health cover?

By taking out Extras cover with your private health provider, some of the health funds have arrangements with dental health care providers to offer services to the members at a higher benefit rate than others. This is known as preferred providers and health funds recommend these dental providers to their members.  This may result in ‘no out-of-pocket expenses’ or ‘reduced out-of-pocket expenses’.

Are dental treatments covered by Medicare?

If your family currently receives government benefits, you will find that your children can get bulk-billed for most dental services – these include:

  • dental check-ups
  • x-rays
  • cleaning
  • sealing cracked teeth
  • dental fillings
  • root canal treatment
  • tooth extractions

Otherwise generally dental health care is not covered by Medicare, taking out an Extras policy with dental with your  private health fund will help cover the costs.

What types of dental health care coverage comes with private health insurance?

Once you have taken out Extras cover with dental coverage, generally the following services are fully or partially covered:

  • General check-up appointments
  • Scaling and cleaning
  • Basic fillings
  • Extractions
  • Flouride treatments
  • X-rays
  • Root canal therapy 
  • Crown and bridgework
  • Orthodontics

If you are in need of major dental work like root canal therapy, crowns, bridges and orthodontics you will need to compare private insurance providers and check what level of cover offers the best rebates for these types of major dental services as this will vary from provider to provider. It’s also important to note that these major dental services may have longer waiting periods.

Are braces or Invisalign included with my dental cover?

Certain private health funds cover up to 80% for specialised orthodontic costs, speak to your health fund and compare extras policy and cover. Here are some health funds that offer this cover:

What is the average cost of each dental health care service?*

* Source: PrivateHealthcareAustralia.org.au

When it comes to dental health insurance, finding the right provider and policy can significantly impact your oral health care and financial impact. Whether you’re an individual or a family, assessing your dental needs, present and future by comparing different dental health plans is essential to ensure adequate coverage. Each private health provider offers various levels of coverage, from basic check-ups to major dental procedures, with varying rebates and waiting periods. It’s crucial to consider these factors such as preferred providers and out-of-pocket expenses to make your final decision. Remember, prioritising regular dental check-ups and cleanings can potentially prevent the need for costly treatments down the track. So, take the time to research and compare dental insurance plans that best fits your needs and budget, ultimately safeguarding your overall oral health.

Compare dental health insurance today and speak to one of our friendly team members about your options. Call 1300 861 413 or email hello@health.compare

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What do I get with my level of Hospital Cover?

Hospital cover will vary from state to state and from private health fund to health fund. In 2019 the Government made reforms and introduced a system that saw private health hospital cover be brought under four tiers – gold, silver, bronze and basic. This allowed Australians to easily compare private health cover like for like and work out what cover best suited their stage in life. 

In addition the Government set requirements that each tier of hospital cover has a minimum list of treatment categories that they must include. If a health fund may choose to add the word ‘plus’ to their tier of hospital cover, this means they are offering more than the minimum treatment categories. For example:  One private health fund may cover three more categories than the minimum requirement for that tier, therefore they are allowed to add the word ‘plus’ to their hospital cover tier name. 

What treatment categories do the tiers of hospital cover offer?

Gold 

With Gold Hospital being the highest level of cover,  the Government set requirements that it must include cover for all 38 categories of treatment and services. It’s designed for people who are looking for the most comprehensive cover. If you are planning on having a baby, Gold Hospital is the only tier of cover where the pregnancy treatment category is included. All private health funds have pregnancy in their Gold Hospital coverage. 

Silver

Silver hospital cover includes 29 categories and is the second highest tier of cover. There are some restrictions on this level of cover for hospitals such as rehabilitation, palliative care and psychiatric services. If you’re looking for more cover than Bronze hospital but don’t need all the treatment categories of Gold Hospital cover and price tag – Silver is a great middle of the road option.

Bronze

Bronze Hospital cover must include at least 18 treatment categories plus three restricted cover options for palliative care,  psychiatric services and rehabilitation. The upside to Bronze cover you will be covered for hospital services such as ear, nose and throat, brain and nervous system and joint reconstructions. 

Basic 

Basic Hospital is the minimum coverage tier a health fund can offer. With basic hospital cover you will only receive very minimal benefits as set out by the Government. It is best to check what you are covered for before entering hospital as you may have a large amount of out-of-pocket expenses.  

Product tiers and minimum clinical categories set out by the Government:

Source: Health.gov.au

Will I have to pay the Medicare Levy? 

You will only have to pay the Medicare Levy if you do not have private hospital cover. The surcharge is in place to encourage individuals to take out private health cover. 

The surcharge covers you and your dependents.  Your dependents include: 

  • your spouse; 
  • any of your children who are under 21 years of age; or 
  • any of your full-time student children who are under 25 years of age.

The Medicare Levy Surcharge (MLS) is determined based on a percentage ranging from 1% to 1.5% of your income. This surcharge is an additional cost imposed in conjunction with the standard 2% Medicare Levy, applicable to the majority of Australian taxpayers. To work out your yearly income for MLS and Rebate calculations, you may utilise the Private Health Insurance Rebate Calculator provided by the Australian Taxation Office (ATO) or reach out to the ATO directly for assistance.

Compare Policies 

Remember to review your private health insurance requirements depending on your stage of life. Your policy may no longer be suited to you and the treatments you require. A few things to keep in mind when choosing a level of hospital cover is who will be covered, the medical care you need, the services or categories you require and if you are willing to keep your premium costs down by paying an excess.

Be sure to compare private health policies taking into account excesses, benefit limits and co-payments that all influence the total cost of treatments.  You may find the cheapest policy is not the best policy for you and your needs.Talk to us today to compare private health cover and discover what level of hospital coverage you require – call us  on 1300 861 413 or email hello@health.compare

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A Guide to Building Healthy Habits for 2024

As we move  into 2024, setting health goals is important to ensure a successful year of well-being. Here’s some practical routines that will elevate your overall health, alongside these personal care recommendations we’ll explore the advantages of private health coverage extras that will help kick start your goals.

Prioritise Sleep for Optimal Well-being:

Sleep is the foundation of good health, like recharging your body’s battery each day. To enhance your sleep quality, disconnect from technology at least an hour before bedtime. The Sleep Foundation provides great insights into how electronics and technology affect sleep and why it’s a good idea to disconnect at least one hour before bed.

Regular Exercise to Boost Physical and Mental Well-being:

Exercising daily is a great way to boost both physical and mental well-being. Incorporating daily workouts into your routine will set you up to achieving your overall wellness goals. Variation is the key when it comes to workout routines, mix it up – you’ll not only target different muscle groups but also keep things interesting and challenging making it more likely that you’ll stick to your routine over the long term. 

Mindfulness for a Focus:  

When you feel overwhelmed or distracted in day to day life, practicing mindfulness each day can be beneficial to your overall health.  Kick off the day and spend a few minutes meditating, practice some deep breathing, or simply enjoy your morning coffee without distractions. Putting these easy steps into place each day will give you the focus to start your day. 

Foster Connections with Loved Ones:

We as humans thrive on social connection. This connection can be as simple as a phone call to a friend or loved one or a sharing of a movie.  These small actions can significantly contribute to your overall happiness. By investing in the relationships that matter most in your life, you will enrich your mental and emotional well-being.

Hydration is the key to a Healthy Body:  

Water is essential for our bodies, not only does it aid in the removal of waste from our body, it also hydrates and supports kidney function.  Water can assist in flushing toxins from our bodies and promoting a healthier you.  Did you know water also acts as a natural lubricant for our joints?  

Cultivate Gratitude:

There are many benefits from practicing gratitude each day. It not only helps us disconnect from the busyness of our daily lives, it works wonders for your mental well-being.  It’s as simple as thinking of three things you are grateful for each day – this could be people, loved ones, nature, your home or community. Commit to writing these things down and it’s more to notice good things as they happen in your life. Gratitude also may be in the form of returning a favour to a loved one or paying it forward in a simple act of kindness.

Stress Management:

Everyday life can cause pressure, demands and stress. Learning how to manage stress is vital for your mental health and your general overall wellness. Try to balance work and play, achieving work goals but at the same time making time for spending time with friends, working out or walking your dog. Another crucial part to managing stress is getting enough sleep. Start a bedtime routine which includes winding down from technology at least one hour before bedtime.

Embrace Reading:

By incorporating reading into your daily routine and immersing yourself in a good novel it allows the brain to disconnect from stress from daily life. Did you know reading enhances creativity and assists with critical thinking skills? Not only does reading increase your vocabulary, enhance your knowledge but it also helps strengthen your writing abilities. 

Adopt a Balanced Diet:

There are many benefits to a healthy, balanced diet – a diet of fruits, vegetables, whole grains and protein help you lower cholesterol and blood pressure, lose weight and lower the risk of other diseases. The food you eat supplies important nutrients your body needs to maintain your blood circulation, nerves, muscle,  brain, bone, nerves, skin and immune system.

Limit Alcohol Consumption:

By significantly reducing or cutting out alcohol altogether, you will significantly reduce many things that have an impact on your mental health. These included reducing blood pressure, weight loss, improved energy and better sleep. Alcohol also impacts the rate that the body absorbs nutrients.

More Outdoor Time:

Spending time outdoors can have an immediate impact on your health and wellbeing. Not only does it improve your mood, it relieves stress, improves your physical health and helps you connect with your locaL community. Whether it’s a leisurely stroll or a hike in the mountains – spending time in nature allows your body to unwind.

Quit Smoking for a Healthier Future:

We all know the risks associated with smoking, quitting is difficult and most people will experience side effects for around 2-4 weeks. Speak to your GP about a plan and how they can support you during your process to quit smoking. Your longer-term risks of cancer, lung disease, heart disease and stroke will be significantly reduced.

Unplug from Technology:

Make a conscious decision to disconnect from screens and social media. By doing this you will experience improved sleep, a more settled mind and strain on your eyes. Replace screen time with reading a book, walk the dog or take up a hobby.  This break from digital life will work wonders for your wellbeing.  

Listen to Music:

Music has proven health benefits, including anxiety reduction, lower blood pressure, and improved sleep quality as researched by John Hopkins. Incorporate music into your daily routine for a positive impact on your well-being.

How your Private Health Extras can help out

Check your private health insurance extras cover, there are many well-being services that could be covered with your policy, such as:

  • remedial massage
  • chiropractic 
  • physiotherapy
  • optical 
  • gym memberships

Embark on the journey to better health in 2024 by adopting some or all of these routines. As you prioritise your well-being, consider comparing private health insurance options to ensure you have the best health coverage tailored to your needs. Investing in your health is an invaluable commitment that pays dividends throughout the year.

Talk to us today to compare private health cover that’s best for you on your health journey for 2024 – call us  on 1300 861 413 or email hello@health.compare 

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Why skin checks are so important – A Comprehensive Guide on How Private Health Cover Can Assist

In our sun-drenched country, where UV radiation levels are intense, skin checks have become an indispensable aspect of healthcare. Detecting potential issues early on can be a game-changer, especially in a country with the highest global incidence of skin cancer. In this blog, we delve into why skin checks are crucial, how they contribute to overall skin health, and, importantly, how private health cover plays a pivotal role in supporting this proactive approach.

The Australian Skin Cancer Dilemma:

Australia holds the unfortunate record of having the highest rate of skin cancer worldwide. Shockingly, more than two in three Australians are diagnosed with skin cancer by the age of 70. The prevalent types include melanoma, basal cell carcinoma, and squamous cell carcinoma, all exacerbated by our country’s relentless exposure to ultraviolet (UV) radiation.

Early Detection: A Lifesaver:

The cornerstone of successfully combating skin cancer lies in early detection. Early identification significantly improves the chances of successful treatment, reducing the need for invasive interventions. Routine skin checks empower individuals to identify suspicious moles or lesions promptly, leading to timely medical intervention and, ultimately, saving lives.

Preventive Measures for Skin Health:

Beyond the critical aspect of cancer detection, routine skin checks also contribute to overall skin health. They identify non-cancerous conditions, enabling early intervention and preventing complications. By prioritising skin health, individuals can proactively safeguard themselves from various skin-related issues.

Sunscreen Application and Safety:

Consistent use of sunscreen has demonstrated effectiveness in minimizing the likelihood of skin cancer, particularly the most severe type, melanoma. Sunscreen constitutes one of the five crucial sun protection practices known as slip, slop, slap, seek, and slide. According to Cancer Council guidelines, it is advisable to opt for a broad-spectrum sunscreen with a sun protection factor (SPF) of at least 30, coupled with water-resistant properties.

This informational document offers guidance on selecting an appropriate sunscreen, ensuring proper application, addressing sunscreen safety concerns, and providing insights into the use of sunscreen on infants.

Understanding Skin Cancer:

Skin cancer results from the damage to skin cells, primarily due to overexposure to UV radiation. The most common types are basal cell carcinoma, squamous cell carcinoma, and the more dangerous melanoma. However, the positive note is that 90% of detected and treated melanomas in their early stages are curable.

The Importance of Professional Skin Checks:

While self-monitoring is crucial, professional skin checks are equally imperative. Healthcare professionals utilise tools and techniques that go beyond what the naked eye can discern. Experts recommend regular professional checks, with annual appointments being a prudent approach.

Where to Get Your Skin Checked:

Several avenues are available for professional skin checks, including your general practitioner (GP), skin cancer clinics operated by GPs, and dermatologists for higher-risk cases or a second opinion. Regular check-ups, combined with self-monitoring, create a comprehensive strategy for skin health.

At-Home Skin Checks:

Between professional appointments, it is vital to keep an eye on your skin at home. Using the ABCDE guide (Asymmetry, Border, Colour, Diameter, Evolving), individuals can monitor existing spots for any changes. Any new spot or alteration in size, shape, color, itching, or bleeding should prompt an additional professional skin check.

Protecting Your Skin:

Prevention is as crucial as detection. Wearing broad-spectrum sunscreen, covering up with protective clothing, and seeking shade when the UV index is 3 or above are essential measures to protect your skin from UV damage.

Private Health Cover for Skin Checks:

Contrary to common misconceptions, private health insurance can play a crucial role in supporting skin health. Many policies in Australia offer coverage for skin cancer screenings, including consultations with dermatologists and diagnostic procedures. This coverage helps alleviate out-of-pocket expenses for preventive skin checks.

Access to Specialist Care:

Private health cover provides access to a network of specialists, including dermatologists specialising in skin health. Timely consultations with these specialists are instrumental in ensuring thorough skin examinations and receiving expert advice on preventive measures.

Financial Assistance for Skin Cancer Treatment:

In the unfortunate event of a skin cancer diagnosis, private health cover can offer financial assistance for various treatments, surgeries, and follow-up care. This support eases the financial burden on individuals and families during a challenging time.

Medicare Limitations:

It’s essential to note that Medicare in Australia does not provide rebates for mole mapping, and the rebates for skin checks may not cover the full cost of comprehensive skin examinations. Additionally, most major private health insurers in the country do not offer rebates for skin checks or mole mapping.

Prioritising skin health through regular checks is wise, in our climate. Private health cover not only supports individuals in maintaining their skin health but also provides a safety net in case of skin cancer diagnoses. When considering private health policies, a careful evaluation of their coverage for skin checks, dermatologist consultations, and related treatments is essential. By making informed choices, you can actively contribute to your overall well-being and protect yourself from the sun’s harsh realities. Remember, your skin is your body’s first line of defense – give it the care and attention it deserves.

If you’re considering private health cover, talk to us today to compare plans that best suit your needs. Call us on 1300 861 413 or email hello@health.compare  

Your skin’s well-being is our priority!

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Colonoscopy and health cover, how does it work?

Planning a colonoscopy and concerned about whether your private health insurance will cover the procedure? In this blog, we’ll explore information around colonoscopies, the reasons why they are needed, and how private health insurance plans can be beneficial in managing the costs effectively. We’ll also provide all the information around the waiting periods associated with private health cover for colonoscopies.

Understanding Colonoscopies:

A colonoscopy is a medical procedure where a doctor examines the large intestine using a colonoscope, a flexible tube with a light and video chip. This procedure serves various purposes, including screening for conditions without symptoms, diagnosing issues related to blood loss or changes in bowel habits, investigating abnormalities from other tests, and providing therapeutic measures like removing polyps. Given its importance in preventive healthcare, it’s essential to understand how private health insurance plans can assist in covering the costs of colonoscopies.

Tips to Reduce Colonoscopy Costs:

No-Gap Schemes:

Explore private health funds that offer no-gap payments for hospital and specialist fees at specific hospital locations. This can significantly reduce out-of-pocket expenses.

Contact Your Private Health Fund:

Before making a claim, contact your health fund to get a list of doctors and specialists aligned with their gap cover agreements. This step can help you minimise gaps or potentially eliminate costs associated with various healthcare providers.

Shop Around for the Best Policy:

Prices for private health insurance plans vary from one provider to another. By researching and comparing policies, you can find the best private health coverage that suits your needs. Don’t hesitate to seek assistance from experts in the field.

Estimating Costs for Private Health Patients:

Go to the Government website Medical Cost Finder for an estimate of typical costs for private health patients. Understanding these costs will be helpful, before making an informed decision and whether your private health insurance covers the colonoscopy procedure. 

Source: Medical Cost Finder 

Public vs. Private System:

For public patients, Medicare will cover the entire cost of a colonoscopy but be aware the waiting times can be considerable. Whereas private health insurance provides an alternative with shorter waiting times and additional benefits. However, it’s also important to be aware of waiting periods associated with your private health cover. Both could be vastly different.

Private Health Insurance Coverage for Colonoscopies:

Private health insurance plans categorise coverage into tiers (Basic, Bronze, Silver, and Gold). Colonoscopies fall under the treatment category ‘gastrointestinal endoscopy,’ starting from the Bronze tier. Private health insurance typically encompasses a wide range of expenses, including fees for services by a proctologist and anesthetist, as well as the expenses associated with the use of the operating theatre and hospital stay. It also takes care of consumables, in-patient consultations, and any prescribed medications, as long as you’ve already served the necessary waiting periods.

Waiting Periods for Colonoscopy Claims:

Most private health insurance policies require a two-month waiting period, or 12 months if deemed pre-existing, for a colonoscopy treatment. Also switching private health funds while maintaining the same cover generally doesn’t require re-serving waiting periods. However, switching policies or funds before completing a waiting period may mean picking up where you left off.

Being well-informed about your private health insurance options for colonoscopies is crucial for managing costs and ensuring timely access to healthcare services. By simply understanding waiting periods, considering the tips provided here, estimating potential costs you can make an informed decision to find the best private health coverage for your needs. If you have any specific questions or need assistance, our team is here to help. Feel free to call us at 1300 861 413 or email us at hello@health.compare

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What’s the average waiting time in the public system?

Our country boasts a world-class public health system, with some of the best doctors and specialists but the extensive wait times for treatments, particularly non-emergency surgeries, can be a significant drawback for many patients. 

To navigate these delays and ensure you receive the medical attention when you need it, many individuals turn to private health insurance. If you do not have or can afford private health insurance, Australia still has a very stable public hospital and health system that can be accessed. For some treatments there will be waiting times. By understanding the average waiting times in the public system and comparing private health insurance options, you can proactively address your healthcare needs and the timing around what’s most important.

Public hospitals will prioritise surgical procedures based on urgency. Although elective surgeries, recommended by doctors for non-emergency conditions like joint replacements, cataracts, or lump removals, often lead to patients being placed on waiting lists. The duration of these waits varies depending on factors such as the required treatment, specialist availability within the public system, and proximity to the hospital. In some cases, individuals may find themselves waiting nearly a year or more for the care they need.

The impact of the COVID-19 pandemic on the healthcare system cannot be ignored. In March 2020, elective surgeries were temporarily halted, resulting in a 9.2% reduction in admissions for such surgeries compared to 2019. Despite this, the number of people waiting for surgery increased by 2.1% in the preceding year.*

These wait times for specific treatments highlighted the challenges faced by those relying solely on the public healthcare system. Septoplasty, a surgery to correct a deviated nasal septum, had the longest wait time in 2021, reaching up to 315 days. Other treatments, like total knee replacement  and cataract extractions, also had significant wait times, causing pain and potential deterioration of health for those in need.#

The average wait time on public hospital waiting lists currently stands at 43 days, but this figure masks the reality for those awaiting common treatments that can extend to almost a year. Additionally, the average wait time doesn’t account for the time between seeing a general practitioner and consulting with a specialist, which can be months in itself. ^

Taking all of this into consideration private health insurance becomes a viable solution, allowing individuals to receive prompt and cost-effective treatment in private hospitals, where waiting lists are generally shorter.

While private health insurance covers formal admissions to private hospitals, emergency care in private hospital emergency departments may not be covered until a patient is formally admitted. It is crucial to be aware of these nuances and carefully consider your insurance options to ensure comprehensive coverage.

To make an informed decision about private health insurance, it is advisable to compare various plans. You can reach out to us today at 1300 861 413 or via email at hello@health.compare to discuss and compare your private health cover options

Taking this step can empower you to proactively manage your healthcare and avoid the uncertainties of lengthy public hospital waiting lists.

Reference: 

Australian Institute of Health & Welfare

# AIHW – Elective Surgery

^ AIHW – Waiting times

Australia’s public health system is world-class, but wait times for public hospitals can be long and inconvenient. Finding private health insurance that works around the public system could help you avoid long waits for the treatments you need.

There are many benefits to Medicare but one of the major drawbacks is the long wait times for non-emergency surgery. This can often lead to prolonged periods of pain or discomfort while you wait to be treated.

This guide covers current average wait times for elective surgery and emergency care, what the longest wait times are for certain treatments, and how choosing the right private health insurance can help you avoid the back end of a long waiting list.

What are surgery waiting lists at public hospitals?

Australia’s public hospitals are busy, so all surgical procedures are prioritised in order of urgency.

If your doctor has recommended any procedure that isn’t an emergency, this is known as elective surgery and you’ll likely be placed on a waiting list.

Examples of elective surgery include joint replacements, cataracts, and removing a lump from your breast.

Wait times vary depending on the treatment your require, the availability of the specialist medical professionals, and the public hospital nearest to you. Some people will be waiting almost a year.

In March 2020, most elective surgeries were put on hold due to the COVID-19 pandemic.

That meant there were 9.2% fewer Australians being admitted for elective surgery in a public hospital than in 2019, despite the number of people waiting for surgery rising by 2.1% the year before**.

Which treatments have the longest waitlists?

Of the 25 most common surgeries in 2021 in Australia, the longest wait time was for septoplasty (surgery to fix a deviated nasal septum), with a wait time of up to 315 days.

Other treatments with significant wait times include:

  • Total knee replacement – up to 293 days
  • Myringoplasty/tympanoplasty (to repair a hole in the ear drum) – up to 259 days
  • Cataract extractions – up to 158 days

These treatments aren’t considered emergencies but they can still be painful and debilitating to live with. Your condition may also deteriorate the longer you have to wait.

This is why elective surgery waiting lists are a problem for many Australians without health insurance.

What is the average wait time on a public hospital waiting list?

Across all treatments in Australia, the average wait time on public hospital waiting lists is 43 days at the time of writing.

However, some of the most common treatments have wait times of almost a year.

The average wait time also doesn’t include time between seeing a GP and a specialist, which can often be months.

Can wait times be waived if you’re a public patient?

Sadly not. The only way your wait time can be waived as a public patient is if your condition worsens significantly and is considered an emergency.

Are there waiting lists for private patients in a public hospital?

Yes, but as your private insurance is covering you, and you are being treated by your own doctor or surgeon, you may not have to wait as long.

As public hospitals are usually busy, appropriate private insurance can allow you to be treated cost effectively at a private hospital instead.

Does private health insurance cover private emergency care?

Your insurance will only cover you when you’re formally admitted to a private hospital as an inpatient.

This means a doctor has determined that you need hospital care and you have been assigned a bed.

If you arrive at a private hospital emergency department and are not formally admitted to hospital, you are considered an outpatient.

Some health funds won’t cover you in this situation.Talk to us today to compare your private health cover on 1300 861 413 or email us at hello@health.compare

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Psychology and health insurance, how do I claim?

Ensuring that your private health insurance adequately covers psychology treatments and therapies for mental well-being is a common concern for many individuals. Let’s delve  into the intricacies of coverage for these services with your private health insurance. In this blog we will explore the ways it can assist in managing your mental health, and how you can navigate the process of claiming these benefits.

When it comes to private health insurance, it’s not just about coverage for medical treatments but also about taking care of your mental health. One essential aspect is having extras, which may include benefits for psychology and counseling services. These policies typically involve your health fund covering a predetermined amount or a percentage of the service cost, leaving you responsible for the remaining balance.

Understanding the scope of coverage is crucial, as not all private health insurance plans include the same mental health services. Some common services that may be covered include counseling, provided by professionals such as psychologists, nurses, social workers, or occupational therapists. Psychologists can offer various therapies for conditions like depression, anxiety, grief, and stress. Additionally, private health insurance may extend to hospital psychiatric services, involving the expertise of psychiatrists who can prescribe medications and admit patients to hospitals.

For those dealing with stress-related conditions, some policies may cover stress management services and courses provided by recognised providers. Hypnotherapy, a therapeutic technique involving a trance-like state, may also be included in certain plans. Furthermore, individuals with hospital or package cover often have access to a 24/7 Mental Health Support Line, providing support whenever it’s needed.

Understanding the fine print is crucial, as waiting periods and annual limits may apply to these mental health services. Providers must be recognised by your private health fund before they can contribute to the bill. Some plans even offer a mental health waiver, allowing access to hospital psychiatric services after a 2-month waiting period for restricted psychiatric services, without reserving the waiting period.

A critical component of accessing mental health services is having a Mental Health Care Plan, officially known as a Mental Health Treatment Plan. This plan is a brief document created by your General Practitioner (GP), Psychiatrist, or Paediatrician after assessing your current mental health status. It serves as a gateway to receiving rebated sessions with a registered psychologist, with up to 10 Medicare-rebated sessions available each calendar year.

While you may wonder why you need to see a doctor to see a psychologist, the rationale is that your GP serves as your primary health professional. They have a comprehensive understanding of your medical and personal history, making them well-placed to oversee your general health. In addition, GPs can prescribe medication, a capability psychologists lack. Although it may mean answering similar questions during assessments, the GP’s focus is on establishing a diagnosis for a Mental Health Care Plan, while the psychologist’s aim is to create a therapy-focused map of your current situation.

In summary, navigating mental health coverage involves visiting your doctor to obtain a Mental Health Care Plan, taking it to a psychologist for up to 6 rebated sessions, returning to your doctor for a Mental Health Care Review, and potentially having up to 4 more rebated sessions with a psychologist. It’s a structured process that aims to provide comprehensive mental health support.

For more information on private health insurance coverage for mental well-being, our team is here to assist you. Feel free to reach out to us at 1300 861 413 or email us at hello@health.compare

Your mental well-being is a priority, and we’re here to help you navigate the complexities of private health insurance to ensure you receive the support you need.

One of the most asked questions is does my private health insurance cover psychology and treatments for the well-being of my mental health?

General treatment (extras) insurance for psychology and counselling. Some general treatment or extras policies you can purchase will also provide benefits towards psychology services and counselling. Your health fund will pay a set benefit or percentage of the cost of the service, and you pay the rest.

Here’s a list of mental health services and treatments some private health funds can help with the bill for, but they aren’t all included in every type of cover. Waiting periods and annual limits apply, and all extras providers must be recognised by ahm before we can help with the bill.

Counseling

Talking therapy that can be offered by a psychologist, nurse, social worker or occupational therapist.

Psychology 

Hospital psychiatric services 

Stress management 

Services and courses provided by a recognised provider to manage and prevent health conditions associated with high levels of stress. 

Hypnotherapy 

Therapy that involves putting people into a trance-like state, intended to promote focus and receptiveness to suggestions in an individual. 

24/7 support Members who have hospital or package cover have access to a 24/7 Mental Health Support Line.

Mental health waiver After a 2 month waiting period for restricted psychiatric services you can access a waiver to upgrade to cover with included hospital psychiatric services (without re-serving the waiting period). Terms and conditions apply.

What is A Mental Health Care Plan?

A Mental Health Care Plan (or a Mental Health Treatment Plan as it’s officially called) is a brief document created by your General Practitioner (GP), Psychiatrist, or Paediatrician that reviews your current mental health.

To obtain a Mental Health Care Plan you’ll need to sit down with your Doctor and complete an assessment. During this time they’ll check in on your current coping, take a short history and may ask you to complete a questionnaire.

Once this is completed your Doctor will create your plan which makes you eligible to receive 6 rebated sessions with any registered Psychologist courtesy of Medicare. After your 6 sessions you can return to your Doctor to get a “review” of your Mental Health Care Plan which may land you another 4 sessions

So each calendar year you’re entitled to receive up to 10 Medicare rebated sessions with a Psychologist.

Why Do I Have To See A Doctor To See a Psychologist?

There are a few different ideas on this, but the main view is that you GP is your main health professional. Ideally they know your medical and personal history so they are best placed to act as the overseer of your general health. They are also able to prescribe medication which a Psychologist can not do, so it’s generally helpful to have them in the loop.

Unfortunately, it does tend to mean that you’ll be asked the same questions by your Psychologist and your GP as they both have to do assessments. However, the assessments tend to have distinct aims. Whereas the GP is trying to establish a diagnosis for a Mental Health Care Plan, the Psychologist’s assessment aims to create a map of your current situation to determine the best course of therapy.

Of course, if you don’t want to involve your GP in the process of seeing a Psychologist you can still book and attend sessions. You just want be able to claim anything back through Medicare.

How Do Mental Health Care Plans Work?

Okay so let’s summarise:

  1. Visit your Doctor to get a Mental Health Care Plan
  2. Take your completed Mental Health Care Plan to a Psychologist and attend up to 6 rebated sessions
  3. Back to the Doctor to get a Mental Health Care Review done
  4. Have up to 4 more rebated sessions with a Psychologist

Our team is here to assist you with information surrounding cover for the well-being of your mental health. Feel free to call us at 1300 861 413 or email us at hello@health.compare

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Navigating the Path to Wellness: 21 Sustainable New Year’s Resolutions for a Healthier You
  • A new year often serves as a catalyst for personal transformation, prompting you to set health goals that extend beyond mere resolutions. In the pursuit of optimal health, it is crucial to choose resolutions that not only enhance your overall health but are also sustainable for the long haul. In this month’s Blog we’ve given you 21 New Year’s resolutions that not only contribute to overall well-being but can be seamlessly incorporated into daily life. Some of these recommendations can be put into place with the assistance of your private health cover.

1. Prioritise Whole Foods:

  • Whole foods, including vegetables, fruits, nuts, seeds, whole grains, and fish, provide essential nutrients crucial for optimal body function.
  • Research supports that a whole-foods-based diet significantly reduces heart disease risk factors, body weight, and blood sugar levels.
  • Begin by gradually incorporating more whole foods into your diet, making it a sustainable lifestyle change.

2. Embrace Active Living:

  • Combat the adverse effects of prolonged sitting by resolving to move more throughout the day.
  • Tailor this resolution to your lifestyle, such as incorporating short walks during work breaks or committing to regular physical activity that aligns with your interests and time.

3. Reduce Sweetened Beverage Intake:

  • Acknowledge the health risks associated with sugary drinks, including obesity, fatty liver, and heart disease.
  • Gradually minimise the intake of sugary drinks to break the habit, promoting sustained improvements in overall health.

4. Prioritise Quality Sleep:

  • Recognise the vital role of sleep in overall health, with insufficient sleep linked to weight gain, heart disease, and depression. It’s crucial to get at least 7-8 hours of uninterrupted sleep per night. 
  • Focus on lifestyle adjustments, such as reducing screen time before bed and establishing a consistent sleep schedule.

5. Find Physical Activities of Interest:

  • Instead of succumbing to the allure of pricey gym memberships, choose physical activities based on personal enjoyment and convenience. If you take a vested interest in the activity – you are more likely to stick to it.
  • Set realistic goals to ensure new exercise routines become lasting habits, enhancing the likelihood of success. Look into what benefits you can claim through your private health cover, often you can claim back gym membership and more. 

6. Prioritise ‘Me Time’ and Self-Care:

  • Acknowledge the importance of self-care for optimal health, especially if your lifestyle is busy.
  • Make deliberate plans for self-care activities, even if they are simple, to foster a healthier work-life balance.

7. Cook More Meals at Home:

  • Embrace the benefits of home-cooked meals, which are associated with better diet quality and lower body fat.
  • Gradually increase the frequency of home-cooked meals to make a lasting impact on your overall health.

8. Spend More Time Outdoors:

  • Leverage the positive effects of outdoor activities on stress relief, mood elevation, and blood pressure reduction.
  • Incorporate nature into your routine through activities like walking, hiking, or simply enjoying your local park.

9. Limit Screen Time:

  • Acknowledge the potential negative impacts of excessive screen time, particularly on mental health.
  • Set a resolution to reduce time spent on electronic devices, fostering improved mood and increased productivity.

10. Embrace Meditation:

  • Recognise the evidence-based benefits of meditation for mental well-being, particularly for anxiety and depression.
  • Explore various meditation practices through books, podcasts, or apps, making it an achievable and sustainable resolution.

11. Reduce Reliance on Convenience Foods:

  • Acknowledge the adverse health effects of frequent consumption of convenience foods.
  • Commit to preparing more meals at home using nutritious ingredients, gradually shifting away from processed options.

12. Reconsider Dieting Approaches:

  • Understand the detrimental effects of chronic dieting on physical and mental health.
  • Shift focus to a sustainable approach, emphasising increased physical activity and healthier food choices over restrictive fad diets.

13. Regular Grocery Shopping:

  • Make a resolution to visit the supermarket regularly, ensuring a well-stocked pantry with nutritious ingredients. Check out your extras policy with your private health cover, you may have cover to visit a nutritionist to start you on your new year’s health goals. 
  • Designate a specific day each week for grocery shopping to prioritize a diet centered around wholesome foods.

14. Increase Fresh Food Consumption:

  • Incorporate more fruits and vegetables into your diet, benefiting overall health and protecting against various illnesses.
  • Explore diverse cooking methods to make produce a flavorful and integral part of your meals.

15. Moderate Alcohol Consumption:

  • Acknowledge the impact of excessive alcohol consumption on health and wellness goals.
  • Set achievable limits, such as drinking only on weekends or adhering to a weekly drink limit, fostering a healthier relationship with alcohol.

16. Practice Mindfulness:

  • Recognise the positive impact of being present on life satisfaction and psychological health.
  • Incorporate simple mindfulness practices, such as reducing phone usage and actively engaging with your surroundings, into your daily routine.

17.  Prioritise Holiday Time:

  • Acknowledge the immediate positive effects of vacations on stress levels and overall well-being.
  • Make a resolution to take regular breaks, whether short getaways or staycations, fostering a healthier work-life balance.

18. Explore New Hobbies:

  • Rediscover the joy of hobbies, as research indicates their positive impact on longevity and overall health.
  • Commit to trying out a new hobby or reviving an old one to add joy and fulfillment to your life.

19. Promote Positive Body Image:

  • Recognise the detrimental effects of negative body talk on self-esteem and body satisfaction.
  • Resolve to engage in positive self-talk regularly, fostering a healthier relationship with your body and encouraging a positive environment for others.

20. Regular Health Check-ups:

  • Prioritise regular visits to your GP for check-ups, screenings, and necessary blood work.
  • Tailor the frequency based on your age, medical history, and the type of medical care you require.

21. Maintain Oral Health:

  • Sustain oral health by committing to regular brushing, flossing, and dental check-ups. If you have an extras policy with your private health cover, you will be entitled to a yearly dental check-up.
  • Recognise the potential associations between gum disease and serious health conditions like Alzheimer’s and heart disease.

While New Year’s resolutions often wane with time, these 20 resolutions are designed to create lasting improvements in both physical and emotional health. By fostering a healthier relationship with food, prioritising self-care, and incorporating sustainable habits into daily life, this year and the years to come can be the healthiest and happiest possible. Look into the benefits you can claim through your private health cover to help you on your health journey. 


Talk to us today to compare private health cover that’s best for you – call on 1300 861 413 or email hello@health.compare

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What are the biggest health funds in Australia?

In the vast and competitive realm of private health insurance, choosing the best health coverage can be a daunting task. With over 40 insurers in the market, it’s surprising that only a handful are widely recognised. Dominating the landscape are major players such as Medibank Private, ahm, Bupa, HCF (including RT Health), NIB Health, and HBF Health. Understanding the nuances of each provider is crucial for making an informed decision about your private health insurance. In this detailed exploration, we’ll delve into the pros and cons of some of the leading private health insurance plans, shedding light on key aspects like complaints ratings, out-of-pocket costs, and unique offerings.

Medibank Private: Balancing Act

Medibank Private, boasting a 27.4% market share, is a significant player in the Australian private health insurance scene. Let’s weigh the pros and cons of choosing Medibank as your health coverage provider.

Pros:

  1. Complaints Rating: Medium, indicating a reasonable level of customer satisfaction.
  2. Out-of-pocket Rating: Average in various regions, ensuring a fair balance between coverage and costs.
  3. Special Benefits: No excess for children on hospital and combined policies, providing financial relief for families.
  4. Student-Friendly: Free cover for full-time students under 31 on family policies, catering to the younger demographic.
  5. Extended Family Policies: Families with adult children under 31 can benefit from extended coverage.
  6. Discounts: Attractive discounts for individuals joining under the age of 30.

Cons:

  1. Discount Limitations: Lack of direct debit or prepayment discounts may be a drawback for some customers.
  2. Regional Variations: Out-of-pocket ratings vary, with below-average scores in South Australia, Queensland, and well below average in Western Australia.

Bupa: A Comprehensive Coverage Choice

With a substantial 24.7% market share, Bupa is another major player in the Australian health insurance market. Let’s explore the pros and cons of choosing Bupa for your health coverage.

Pros:

  1. Complaints Rating: Medium, indicating a reasonable level of customer satisfaction.
  2. Out-of-pocket Rating: Varied, with above-average scores in some regions and average scores in others.
  3. Excess Waiver: No excess for children on most hospital and combined policies, making it family-friendly.
  4. Student Benefits: Free cover for full-time students under 32 on family policies, catering to the educational demographic.
  5. Extended Family Coverage: Families with adult children under 32 can benefit from extended coverage.
  6. Discounts: Attractive discounts for individuals joining under the age of 30.

Cons:

  • Discount Limitations: Similar to Medibank, Bupa lacks direct debit or prepayment discounts.

HCF: The Nonprofit Choice

As a nonprofit health fund, HCF holds a 12.4% market share. Let’s examine the pros and cons of choosing HCF for your health insurance needs.

Pros:

  1. Nonprofit Status: HCF operates as a nonprofit, potentially aligning with customers seeking socially responsible options.
  2. Complaints Rating: Medium, reflecting a reasonable level of customer satisfaction.
  3. Out-of-pocket Rating: Average in most regions, ensuring a balanced approach to coverage and costs.
  4. Excess Waiver: No excess for children on most hospital and combined policies, providing family-friendly benefits.
  5. Student Benefits: Free cover for full-time students under 31 on family policies, catering to the educational demographic.
  6. Extended Family Coverage: Families with adult children under 31 can benefit from extended coverage.
  7. Premium Lock-In Option: The ability to prepay and lock in premiums for 18 months, offering stability in costs.

Cons:

  1. Discount Limitations: Similar to the previous insurers, HCF lacks direct debit or prepayment discounts.
  2. Age-Related Discounts: No discounts for individuals joining under the age of 30.

NIB: Balanced Coverage with Discounts

NIB Health, capturing a 9.4% market share, is known for its balanced coverage options. Let’s delve into the pros and cons of choosing NIB for your health coverage.

Pros:

  1. Out-of-pocket Rating: Average in various regions, ensuring a fair balance between coverage and costs.
  2. Excess Waiver: No excess for children on hospital and combined policies, providing family-friendly benefits.
  3. Student Benefits: Free cover for full-time students under 31 on family policies, catering to the educational demographic.
  4. Extended Family Coverage: Families with adult children under 31 can benefit from extended coverage.
  5. Discounts: Attractive discounts for individuals joining under the age of 30.
  6. Direct Debit Discounts: Additional discounts for customers opting for direct debit payments.

Cons:

  • Regional Variations: Out-of-pocket ratings vary, with below-average scores in some regions.
  • Discount Limitations: Similar to other insurers, NIB lacks prepayment discounts.

HBF Health: Nonprofit Stability

HBF Health, with a 7.3% market share, stands out as a nonprofit health fund. Let’s assess the pros and cons of choosing HBF for your health insurance needs.

Pros:

  1. Nonprofit Status: As a nonprofit, HBF may appeal to customers seeking socially responsible options.
  2. Complaints Rating: Medium, indicating a reasonable level of customer satisfaction.
  3. Out-of-pocket Rating: Varied, with above-average scores in Western Australia and average scores elsewhere.
  4. Excess Waiver: No excess for children on hospital and combined policies, providing family-friendly benefits.
  5. Student Benefits: Adult children under 25 are covered on family policies for free if they’re full-time students or earning up to $24,500 per year.
  6. Discounts: Direct debit and prepayment discounts available.
  7. Premium Lock-In Option: The ability to prepay and lock in premiums for 18 months, offering stability in costs.

Cons:

  1. Discount Limitations: HBF does not offer discounts for individuals joining under the age of 30.
  2. Extended Family Coverage: Unlike some competitors, HBF does not provide extended family policies.

Best Funds for Low Out-of-Pocket Costs

For those prioritising low out-of-pocket costs, two standout options are Bupa and HBF. These insurers offer at least average gap protection in all states and above-average protection in one or more states. The gap rating, reflecting the likelihood of incurring out-of-pocket costs, plays a crucial role in assessing the overall value of health insurance plans.

Gap (Out-of-Pocket Costs) Ratings:

  • Bupa:
    • Above average in Queensland, South Australia, and Victoria.
    • Average everywhere else.
  • HBF:
    • Above average in Western Australia.
    • Average everywhere else.
  • HCF:
    • Average in the ACT, NSW, Queensland, the Northern Territory, Victoria, and Tasmania.
    • Below average in South Australia and Western Australia.
  • Medibank:
    • Average in NSW, Victoria, the Northern Territory, Tasmania, and the ACT.
    • Below average in South Australia and Queensland.
    • Well below average in Western Australia.
  • NIB:
    • Average in NSW, South Australia, Tasmania, and Western Australia.
    • Below average in the ACT, the Northern Territory, Queensland, and Victoria.

These gap ratings are essential indicators, representing the percentage of procedures in hospitals where members of the fund paid out-of-pocket costs (the gap payment). Choosing a plan with a lower gap rating can significantly reduce the likelihood of unexpected expenses.

Navigating the landscape of private health insurance in Australia requires a careful consideration of various factors. The choice between Medibank, Bupa, HCF, NIB, and HBF depends on individual preferences, budget constraints, and specific coverage needs. 

Understanding what’s on offer for each provider will empower you to make an informed decision about your private health coverage. Our team is here to assist you with your enquiry about private health cover.  Feel free to call us at 1300 861 413 or email us at hello@health.compare

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