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Health Insurance 101
What is Lifetime Health Cover (LHC) loading?
The Lifetime Health Cover loading is a penalty that applies to individuals who take out health insurance after they turn 31. The loading increases your premium by 2% every year that you don’t have insurance over the age of 30. You can avoid the LHC by taking out a hospital policy before you turn 31.
Does my health insurance policy automatically provide ambulance cover?
Medicare does not cover the cost of ambulance transportation (TAS + QLD gov cover some costs for residents). Without ambulance cover, you can pay up to $1,500 or more for ambulance transportation. Ambulance cover falls under most hospital cover, and some extras policies
Do I need to take out hospital and extras cover?
Here are 7 things you need to understand when deciding on a health insurance policy that will help you to avoid wasting money on cover you’re unlikely to use. Understand the difference between Hospital cover and Extras cover. Understand which level of hospital cover you need. Understand the different levels of extras cover. Get to know all the health insurance jargon. Understand what policy waiting periods are. Figure out the level of Government Rebate you’re likely to receive. Understand the Medicare Levy Surcharge. Like anything new, health insurance can seem complicated at first, but once you understand the jargon and the way policies are structured, it all starts to make sense. Now all you need to do is use our online comparison tool to compare health fund policies and find the right one for you. Or you could simply contact our experts and we’ll do it for you!
Which states in Australia have Private Health Cover?
Combined hospital and extras cover is the most popular form of private health insurance in Australia. You can customise your combined hospital and extras based on your needs There’s no hospital cover option without waiting periods (unless you’re switching health funds and have held hospital health insurance for a consecutive period).
How do I access a support service for addiction?
Many private clinics will accept private health insurance for their inpatient programs and many private hospital covers will include (at least partially) medications and procedures necessary during the first crucial phases of the recovery.
Why should I consider getting family health insurance?
A family health insurance policy means you/your partner & children are covered under one policy. Children can stay on your policy for free until they turn 25 – or even older in some cases. Keep updating your family policy as your family grows/your needs change/or as your children get older.
What’s important to know about couples health insurance?
Choose from extras only cover, hospital cover or combined cover. If you have different health needs to your partner (for example one has pre-existing health conditions and needs Gold-tier hospital cover), an individual policy for each person can be cheaper. Waiting limits apply – anywhere from 2 months to 12 months
What kinds of family health insurance are available?
For health insurance choose from hospital only cover, extras cover or combined cover. Life insurance is an important consideration to protect your family’s financial well-being. Travel insurance, income protection insurance and funeral insurance are additional popular family insurance policies.
Why should I consider getting optical health insurance?
Medicare does not cover prescription glasses or contact lenses. There are two types of optical health cover: General and Major. 2 month waiting periods and annual limits apply
Should I get a different health insurance policy at age 55?
If you need a procedure having health insurance and going through private health means shorter wait times. The higher your hospital coverage tier, the more you’re covered for. Annually check your policy to make sure it covers the things you need, and you’re not paying for the things you don’t need.
What do I need to know about pregnancy and private health insurance?
Start researching and comparing pregnancy health insurance policies early – before you’re pregnant if possible. If you are already pregnant without private hospital cover, you are unlikely to get coverage for pregnancy. Even if you’ve found the best pregnancy health cover for your needs, there will still be additional expenses you’ll need to pay out-of-pocket.
What advantages can private health insurance offer single parents?
Choose from single parent hospital cover, extras cover, or both.. If you already have insurance, your premium may slightly increase for the first child, but the rest of your children are covered at no additional cost. Your children receive the same coverage as you without any waiting periods
Do I have to serve waiting periods if I switch health insurance covers?
Every health insurance provider in Australia will make you serve a waiting period if it’s your first time taking out private health. You cannot claim money back from your provider until you’ve served the waiting period (anywhere from 2 months to 12 months). All hospital policies have the same waiting periods but extras vary depending on your health fund.
What is extras cover and can I save on medical expenses?
Extras cover helps cover the costs of non-hospital treatments (and not covered by Medicare) like physio, dental, optical and more. There are three levels of extras cover: Basic, Medium, and Comprehensive. Waiting periods apply (usually 6-12 months)
How do I know if the Medicare Levy Surcharge (MLS) is relevant to me?
The Medicare levy surcharge is a government tax to encourage high earners to get private hospital cover. Your tax may increase by up to 1% if you earn over $97,001 a year as a single, and don’t have private hospital insurance. If you have extras cover only, that does not exempt you from the Medicare Levy surcharge – you must have hospital cover.
What is the difference between a private hospital and public hospital?
The implementation of the Medicare Levy Surcharge (MLS) by the Australian Government means singles earning over $90,000 a year ($180,000 for couples and families) without hospital cover on their private health insurance policy will be charged an additional 1% in tax, on top of the standard Medicare levy. Earn over $105,000 ($210,000 for couples and families) and you’ll be charged 1.25%, and an income of over $140,000 ($280,000 for couples and families) will see you paying an extra 1.5% on tax.
What is the best health insurance for seniors in aged care homes?
Neither Medicare nor private health funds cover aged care homes today. Certain hospital covers offer home nursing, which could be considered by seniors who either prefer home care or a hybrid of home care and residential nursing home. Aged care facilities often have registered nurses or clinicians to oversee the care provided to the senior residents and handle certain day-to-day medical needs. However, they do not (and should not) provide many of the assessments, treatments, or procedures hospitals do.
What do I need to consider when choosing health cover for kids?
There aren’t many (if any) health insurance policies that cover kids only. To get coverage for your child, you’ll need a family policy. Young dependents can typically be added to a family policy at no extra cost.
What do I need to know about dental health insurance?
General dental is the base tier of dental cover, which includes Major Dental, Orthodontics and Endodontics.. Medicare doesn’t cover dental treatments (unless it’s part of a Medicare approved treatment). The waiting period for general dental can be as short as 2 months, and in some cases, waived for treatments like preventive check-ups.
How much does genetic testing cost, and is it worth it?
Genetic testing or DNA testing scans one’s DNA sequence to find patterns that could indicate risk levels for certain conditions such as cancer. Genetic testings could be conducted or requested in various scenarios such as testing newborns to identify genetic disorders for early treatment and diagnostic testing in case physical symptoms indicate you may be suffering from a genetic disorder. This test used to only be available to patients for diagnostic testing as determined by qualifying physicians. However, it became available to the general public in Australia in 2017 to assess and reduce their health risks by changing their lifestyle or behaviours earlier on in life. Some authorised clinics host genetic testing for certain types of cancer which could cost anywhere between $200 to $1000. For more comprehensive genetic testing conducted by Genome One, the cost is about $6000. Genome One’s genetic testing covers 31 cancers, 13 heart conditions, and five other genetic conditions as well as your likely responses to more than 200 medications. The costs of genetic testing are not currently covered by Medicare.
How can I reduce my out of pocket expenses for private healthcare?
Out-of-pocket costs are the additional charges beyond Medicare and health insurance coverage for medical services. Private health insurance doesn't mean healthcare is free; you still need to pay for some of the costs. How much you’ll pay depends on your treatment, your level of private health, Medicare coverage and hospital patient type.
What are the advantages of private physio health insurance?
Physiotherapy is covered under most basic extras cover policies. Without private insurance, you can be paying up to $120 or more for a standard consultation. 2 month waiting period and annual limits apply.
How does the private health insurance tax rebate work?
Taking out private health insurance may entitle you to a tax rebate. Earn a tax rebate if you have a taxable income of under $140,000 (singles) or $280,000 (couples or families). The rebate is applied as a discount on your premiums or can be claimed at tax time.
What should I consider when choosing health insurance for myself?
Choose from hospital only cover, extras only cover or combined cover. If you’re a couple without kids, getting 2 single health insurance policies is often cheaper than a couple’s policy. Make sure you take otu health insurance before you turn 31 to avoid the Lifetime Health Cover Loading.
What is the Australian Government Private Health Insurance Rebate?
To be eligible for the rebate, you need approved health cover, a Medicare card and to meet the income threshold. You can claim your insurance rebate through your health fund, or come tax time. Overseas visitors or students may not be eligible.
What’s the main benefit of having hospital cover?
Combined hospital and extras cover is the most popular form of private health insurance in Australia. You can customise your combined hospital and extras based on your needs There’s no hospital cover option without waiting periods (unless you’re switching health funds and have held hospital health insurance for a consecutive period).
Are all health insurers the same?
It’s no coincidence that at a time when cost of living pressures are high for things like electricity, food and child care, people are becoming more and more savvy with what they spend their money on. When it comes to balancing the household budget, nobody wants to pay for something that doesn’t deliver what it promises. The same is true for private health insurance.
When will my health insurance premium increase?
Health insurance premiums rise every year in Australia. The 2024 average premium percentage rate increase was 3.03%. Make sure you’re getting the most value from your current health fund and research new policies regularly.
What are the benefits of chiropractic health cover?
Chiropratic cover generally falls under mid-tier extras cover. Chiropractic treatment is not covered under the Medicare Benefits Scheme. Get up to 60% back on your chiropractic treatment (depending on your policy and provider). 2 month waiting periods and annual limits apply
What are the pros and cons of private health cover for seniors?
As you enter the golden years of life, having good health becomes a top priority. Your circumstances may have changed, with children having grown up and started their own families, or perhaps you're embracing the freedom of retirement. However, ageing brings with it a greater susceptibility to various health risks, making health insurance a crucial consideration. While you may already have health insurance, the policy you obtained during your earlier years may no longer align with your current needs no longer align with your current needs. That's where health insurance for Australian seniors comes in. These policies are designed to cater specifically to your present and future health requirements, ensuring that you're not paying for unnecessary coverage. Why pay for obstetrics when expanding your family isn’t on the horizon? Instead, focus on treatments and services that are more relevant to your age group, such as cardiac-related procedures, hospital treatment, palliative care, or the option of hospital accommodation in a private room. If you have a chronic condition like arthritis, you may benefit from the expertise of specialists within the private system. The last thing you want is to worry about the financial burden of future medical treatments. You deserve to enjoy your later years with peace of mind, knowing that your health needs will be well taken care of without any added stress. Health insurance for seniors offers the assurance and support you need to navigate this chapter of life confidently.
How much does family health insurance cost?
The cost of family health insurance will depend on the cover option you choose.. Children can stay on your policy for free until they turn 25 – or even older in some cases. Keep updating your family policy as your family grows/your needs change/or as your children get older.
When should we switch from couples cover to families health insurance?
Most singles who enter into a long-term relationship end up bundling up into a combined couples plan. Couples plans do not necessarily offer cheaper premiums than the individual plans but bundling has its benefits. First, combining helps you manage the limits better. Since you may use certain types of benefits more than your partner and vice versa, you’ll have more flexibility in the covers you choose. It’s also administratively easier to manage. Second, the costs could be more manageable if you and your partner earn different levels of income. If you are earning less, you could still access better policy by combining the plan with your partner. You can file a combined claim for the private health insurance rebate. Lastly, for the purposes of the Private Health Insurance Rebate and the Medical Levy Surcharge, you could be considered as a ‘family’ and thus your combined income will be required to meet the threshold for couples/families. Some couples plans also include pregnancy and birth and other maternity services if you are considering starting a family. However, if you are thinking of starting a family, you could benefit significantly from bundling up again to a family cover earlier than later. Family health insurance plans (hospital covers and extras covers) would offer a broader level of coverage for maternity-related needs. If you stay on the couples funds, there may be restrictions on when you can add a dependant to your policy. If you want to have more than one kid, these restrictions and penalties could result in significantly higher premiums. Family plans allow you to add an unlimited number of dependants at no extra cost. Whilst family plans could be more expensive, getting much better benefits for your entire family for higher premiums is more sensible than paying more premiums on the couples plans for no additional benefits. You’d also want to make sure that your newborn baby has immediate access to all the necessary medical services. Since family plans are tailored for parents with children, it’ll be easier for you to find a plan that suits your new expectations for coverage. Keep in mind that the waiting periods for many of the benefits may still apply. So switching to family plans in advance to ensure your baby will have access to all important treatments and services could be a good idea.
Should my health cover change after I turn 65 years old?
Skip the queues – private waiting times are shorter than public waiting times. Get covered for the issues that affect you in your current life stage, from cataracts to heart surgery, joint replacements and more (silver and gold hospital cover). While there are no health insurance policies specifically for over 70’s, you can tailor a combined hospital and extras policy to suit your needs.
How do pre-existing conditions affect private health insurance cover?
A pre-existing condition is an illness you’ve had signs or symptoms of in the six months prior to purchasing private health. You don’t need to be diagnosed beforehand for it to be considered a pre-existing condition. The pre-existing waiting period cannot exceed 12 months.
What health rebates and support measures are available in Australia?
Your rebate depends on your age and your income. Rebates only apply to hospital cover, or combined cover – there is no rebate for just extras cover. You can choose to claim your rebate via a premium reduction, or a tax offset when you file your annual tax return.
Terms and conditions
How easy is this?
Step 1: Send a copy of your renewal notice, which shows a price rise on the policy you purchased through No Worries.
Step 2: We pay you the difference!
The Fine Print
- The policy must be unchanged, not in arrears or cancelled
- Limit of 1 per named policy holder every 5 years
- Does not apply to annual payments made before April 1
- Only relates to policies purchased while our price rise protector offer is in place
