What is the best private health insurance in Australia?

(5 Minute Read)

Looking for the best private health insurance in Australia? You’re not alone! Every month thousands of people search the internet looking for the best private health insurance in Australia. Picking a policy can be difficult, especially when there are 45 different health funds to choose from.  Lucky for you dear reader, Health Deal has the answer, and that answer is…..it depends.

Unfortunately, it’s not quite as simple as saying nib or hif have the best private health insurance in Australia. The truth is, it depends on a whole range of factors. If you’ve got 5 minutes spare, we’ll go through some of the things you need to consider when choosing a health insurance policy.

What is the best private health insurance in Australia?

Hospital Cover

If you’re looking for the best hospital cover in Australia, you might end up searching all year. The best thing you can do, is look at it through the prism of “what is the best hospital cover for the next 3 years?”. This is because when selecting a hospital plan, there are essentially 4 things you need to consider when picking a plan:

  1. What procedures do I need coverage for in the next three years?
  2. What is my health funds gap cover rating?
  3. Is the hospital I usually go to a participating private hospital?
  4. What is the price of the health insurance policy?

What procedures do I need coverage for?

Since April 2019, there are now 7 tiers of hospital coverage:

  • Basic Hospital
  • Basic Plus Hospital
  • Bronze Hospital
  • Bronze Plus Hospital
  • Silver Hospital
  • Silver Plus Hospital and
  • Gold Hospital

Depending on where you are in your life, you may not need Gold hospital. For example, a couple in their 60s may not require Gold Hospital to cover things like pregnancy & weight loss surgery, but they may need a Silver Plus Hospital cover to get coverage for joint replacements and cataracts.

A single person earning above the Medicare Levy Surcharge Threshold may not even be concerned about having any sort of comprehensive hospital cover at all, and instead would just need a health insurance policy for tax purposes.

We recommend you look at your hospital policy in 3-year blocks. This is because to add a surgery onto your policy you will have to serve a wait period of either 2 months, if it is a new condition or 12 months if it is pre-existing. If you don’t see yourself needing some of the higher ticket items like pregnancy, IVF treatment, joint replacements or cataract eye surgery over the next 3 years, then it may be best to remove it from your plan and add it back at a later date. Remember, when switching hospital policies, you will never re-serve any waiting periods for anything you’re already covered for; you’ll only serve a waiting period on the new stuff you’re adding to the policy.

What is the best private health insurance in Australia?

What is my health fund’s gap cover rating?

The great thing about the private health insurance ombudsman is that they list all the previous year’s statistics for every health fund. This includes how well the health fund performed at covering customers’ gaps when going into hospital. Health fund performance varies from state to state and these ratings change every year.

This means that even if a health fund has a high rating in New South Wales or Victoria, it doesn’t necessarily mean they will have a high rating in Northern Territory or Western Australia or vice versa.

The final thing you need to be aware of when using a health fund’s gap cover rating to choose a new health fund is that it can only be used as a rough barometer of your chances of having no gap. Your surgeon is under no legal obligation to participate in a health fund’s gap cover scheme, meaning that every surgery he or she does will be looked at on a case by case basis.

Is the hospital  I usually go to a participating private hospital?

Let’s say you’ve found a health insurance policy which covers you for all the things you want to be covered for, and that the health fund performs well at covering gaps in your state. Sound good so far? Well, the next thing you need to make sure is that your chosen health fund actually has agreement hospitals in your area. For example, if your local hospital is a Cabrini or Epworth, then you need to be with a health fund which has an agreement with your hospital of choice.

If you go to a private hospital which your health fund does not have an agreement with, then you can be looking at significant out of pocket expenses, which defeats the purpose of paying for health insurance in the first place. If you’re comparing with a Health Deal consultant, they will be able to tell you all the local agreement hospitals within your area.

What is the price of the health insurance policy?

What is the price of the health insurance policy?

As anyone who has paid for health insurance knows, the price of private health insurance has risen significantly over the past 10 years. Some health funds have risen by over 50%, whilst the industry average is 42%. With this in mind, the difference between two health funds covering customers for the same things can be very different. For example, a couple in their 50s living in Victoria, earning below $180,000 per year and paying by direct debit each month would pay $337.88 per month for Bupa’s Top Hospital No Pregnancy – Silver Plus $500 excess, whereas the same couple would pay $315.80 on nib’s Silver Advantage Plus $500 excess. This would result in a saving of $21.88 per month or $262.60 per year!* If you’re looking for “the best private health insurance in Australia”, then you absolutely need to take price into consideration. If you’re going into hospital on a regular basis, then it will probably be one of the least important factors in your decision. However, if you’re like most people who don’t actually go into hospital all that often, then you don’t want to be paying hundreds of dollars more a year for a policy you don’t often use.

Extras Cover 

If you’re looking for the best extras cover in Australia, then many of the same rules from above apply. There are hundreds and hundreds of different extras plans on the market, all offering different yearly limits and rebates. Picking the right one can seem overwhelming at first, but just by following this simple rule, you can rest easy knowing you’ve made a good choice.

The Golden Rule

When selecting extras cover, you always want to follow this golden rule. That is, you want to claim more money back in rebates each year, than it costs you in monthly premiums.

For example, HCF Mid Extras, for a 35-year-old, living in Western Australia earning below $90,000 costs $256.29 per year. On this plan you can receive a dental check-up with no gap, and pick up a pair of $200 glasses at Specsavers with no-gap too. The combined claim just on these two items alone would be somewhere in the region of $350, meaning you’re already up $93.71 for the year.

It’s all well and good having an extras policy which covers 80% of the physio bill, but if you’re not claiming back more each year than you’re paying in premiums, then when all’s said and done your bank balance would have been better off with you choosing a policy which paid out less, but also cost significantly less too.

best extras cover in Australia

Picking your extras coverage

When choosing a extras policy, you need to weigh up what you need coverage for. At Health Deal, we recommend customers never take risks with their hospital policy, and suggest if you’re on the fence about whether to cover a surgery or not, then to play it safe at get it covered. The same can not be said for extras though. With extras, we recommend focusing on the services that you claim on regularly, and not be too worried about the services you don’t ever use.

Let’s say for example you never claim on chiro or remedial massage, but you just like the thought of it being on the plan. You could end up paying way more in premiums over the lifetime of your policy than you would ever claim back in rebates.

The other thing to consider for these “nice to have” extras, is that many of them only have 2 month waiting periods. For example, services like chiro, remedial massage, podiatry and acupuncture only have two month wait periods attached. Meaning that if you took them off your plan, and changed your mind in the future, you wouldn’t have to wait that long before you could start claiming on them again.

However, with that being said, make sure you don’t take services like major dental, orthodontics, hearing aids or medical appliances off your plan without being certain. The reason being that these services have much longer waiting periods to add back on (12 months for major dental and 36 months for hearing aids) if you change your mind.

best private health insurance in Australia

How to pick a private health insurance policy

The great thing about using a health insurance comparator like Health Deal, is that we will take all this information into consideration. We will conduct a thorough “needs analysis”, where our consultants will really delve deep into what you need coverage for and what you don’t. We’ll take into consideration things like:

  • How can we improve your benefits?
  • How can we lower your price?
  • Which hospital have agreements in your area?
  • Are you better off switching to a new dentist?
  • Which health funds pay more on the services you use?
  • Is it better for you to cut some extras off or leave them on?
  • Are you better off switching, or remaining on your current policy?

Finally, we understand that if you’re looking for the very best private health insurance in Australia, then realistically we might not be able to find it for you as we don’t represent every health fund in the country. However, if you’re looking for an honest assessment of your current health insurance policy with a view to saving money off your monthly premium and improving your extras benefits, then we’re the comparator for you. We’re exceptionally proud of our 9.7/10 rating on Trust Pilot*, so you can trust that you’re in safe hands with us.

(*These prices are correct as of August 2019 – Hospital psychiatric services is fully covered on the Bupa plan, whereas it is restricted on the nib plan)


(*Trust Pilot rating correct as of August 2019) 

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3 Tips For Rural Aussie Families to Save Money This Christmas

3 Tips For Rural Families to Save Money This Christmas

By Chris Quinn


Christmas for most Aussie families is an expensive time of year. Kids these days are hoping Santa brings them more expensive gifts with each passing year.

christmas health insurance

If you live outside of a major metro area and you already know January is going to be a tight month, then continue reading because we’ve got some cracking Christmas tips on how to save money on your health insurance to give you some price relief over this expensive time of year.

Tip 1 Ring Your Health Fund

Yes, we’re a health insurance broker, but if you don’t fancy talking to us directly, then you should still ring your health fund and still see if there is a better option with your current health fund. A perfect example of this, is families who have finished having children.

As a general rule, to have pregnancy covered requires top cover which can be quite expensive. If you’ve finished having kids, then you might not require top cover still if you’re in your 30’s or 40’s. So ask if you can take it off your plan, and save yourself some money in the meantime.

Remember if you take a procedure off your plan, you’ll only have to wait 2 months to add it back on if it’s a new condition, or 12 months if it’s pre-existing.  

Tip 2 Maximise Your Dental

If you’re with one of the big brand name health funds, then chances are you were probably attracted to them with the offer of no-gap dental on check-ups. 

Having this option with a family can be an absolute life saver, as you don’t need me to tell you how expensive dental can be in Australia. But what if you don’t live near a preferred provider?

If there are no preferred providers near you to offer you no-gap check-ups, then you should seriously consider shopping around. Did you know for example, there are some funds which will give you back $191.50 for your yearly check-up (012), clean (114), and fluoride (121), that equates to a massive $766 in claims for a family of four going just once for an annual check-up.

There are also some health funds that will give you back 60% across all dental, no matter where you go! 

Meaning you can continue going to the same family dentist you’ve always gone to, but with added security of knowing you’ll be getting 60% off the bill each time.

save money on health insurance

Health insurance isn’t as complicated as people like to make it out to be, but comparing with Health Deal makes it doubly easy. Enter your details below and a Health Deal consultant will get in contact with you to discuss your options. 

The process is simple, we’ll see what policy you’re on, well conduct a needs analysis to assess what you actually need coverage for, and compare it to our panel of health funds.

It’s always our aim to not only lower your monthly premium, but crucially to improve your benefits on the items that you use most often. 

Anyone can slash your benefits to save you money, we want to give you value for money, that’s why we’re rated 9.6/10 via Trust Pilot.

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Single Parent Health Insurance

single parent health cover

Single Parent Health Cover: Health Insurance Tips For Finding A Better Policy

(6 Minute Read)

Paying for single parent health cover is probably one of the biggest expenses you pay for each month besides your mortgage/rent. The cost of health cover has risen dramatically over the past 8 years, by a whopping 42% on average! On top of rising prices, you also have a significant amount of miss-information spreading throughout the internet surrounding heath cover as well, making single parents more weary about finding a better deal.

We've written this article to give you some basic advice surrounding single parent health cover, and to put your mind at ease in regards to finding you & your kids a better deal.

Topics discussed:

  • Staying on your ex-partners cover
  • Leaving your ex-partners cover
  • Best single parent health cover
  • Hospital cover & wait periods
  • Extras cover
  • Where should I compare?

Staying On Your Ex-Partners Health Cover

Can I stay on my ex-partners health insurance plan? Is one of the most commonly asked questions when thinking about health cover after a separation or divorce. The short answer to this is, it depends.

Bupa for example are quite explicit in their fund rules and state "If you are insured under a couples or family policy and you and your partner become divorced or separated, you will no longer be eligible to remain insured under a policy together and it is your responsibility to ensure that each person takes out their own policy."

However, some health funds which will let you all still stay on the same policy. This is because there is no legislation surrounding this specific issue, so it comes down to a health fund by health fund basis.

So our advice would be to ring up your existing health fund and check. You don't want to be in a situation where your health fund refuses to pay out on a hospital claim due to your new marital status. However, staying on the old family policy will more often than not, work out cheaper for you, so it's worth asking the question.

Leaving Your Ex-Partners Health Cover

If you & your ex-partner split cover, you need to make sure you take up a new policy within 30 days generally. Most health funds will allow a 30 day gap in coverage before making you re-serve wait periods. There are some health funds, like nib, who will extend this to 59 days. However the majority of the health funds restrict this to 30.

So, if you're going to continue having health cover after you split, make sure you take up a new policy within 30 days if you leave your ex's plan. We've heard enough stories first-hand about ex-partners removing people from their plans without them knowing and then having to re-serve all their wait periods.

If you & your ex-partner both take out new policies. Be aware that your children do not have to be covered by both of you, one adult can take out a single policy and the other a single parent policy.

single parent health

Best Single Parent Health Cover

If you only take away one idea about private health insurance away from this article, then it should be this. There is no such thing as the "best single parent health cover", nor does "the best health fund" exist.

Just because your friend, co-worker or even an online reviewer such as Choice or Canstar recommends a health  policy, the chances are that it will not be best suited to you. Why? Because your identity is not a "single parent", you are a unique individual with unique children, who all have a different set of needs and requirements from the next family.

Below we'll discuss what you should be looking out for when choosing health cover policy.

Wait Periods

The first thing you need to know about hospital cover is how wait periods work. If you switch cover to a new health fund, or change cover with your current health fund, you will not, I repeat, will not, re-serve any wait period which you have already served; even if it is a pre-existing condition.

Hospital wait periods will only apply to you if you fall under either of these two categories.

1) You're new to cover

2) You are upgrading a service you previously were not covered for

For example, say you have a basic level of cover now, and you upgrade to a policy which now covers you for heart surgery. You would gain access to all the thousands of procedures you used to be covered for from day 1, you would just have to serve a wait period of the services you were not covered for, ie heart surgery.

The wait periods on hospital cover are:

  • 2 Months New Conditions
  • 12 Months Pre-Existing Conditions
  • 2 Months in-hospital rehabilitation, palliative care & in-hospital psychiatry
  • 12 Months Pregnancy & IVF

Hospital Cover & Wait Periods

Knowing the standard waiting periods are useful as it allows you plan out your health policy in 3 year blocks. What we suggest is to have a think about the types of surgeries your family could plausibly have over a 3 year period and remove items from your plan which you think have an exceptionally low chance of occurring.

For example, if you're done with having children, you may wish to remove pregnancy & IVF from your policy. Similarly, if you think that the likely hood of anyone in the family needing a full knee replacement would be slim to none within the next 3 years, you could remove that.

Remember, most basic hospital covers will cover you & your family for all procedures with a medicare item number, except for a small list of exclusions. However, if you're ever on the fence about a procedure being covered or not, we reckon it's better to be safe than sorry.

single parent braces

Extras Cover

Extras cover can be a great way to really gain benefit from your heath fund. Firstly, let's assess whether all of you actually need it. Did you know you can take out a hospital policy for you & your children, and then an extras policy just for you? You can even do this with different health funds!

Now if you have teenagers or tweens going to the dentist each year then we would recommend you all stay on the same extras plan. But, if your eldest child is below the age of 3 and regular visits to the dentist are not a thing right now, it might work out financially beneficial to you to just cover yourself for extras. (Note if you do this, double check your hospital policy covers you for emergency ambulance)

Now if your kids are at the age where they will use extras you really want to maximise your benefits and make sure you get the best return for your dollar. Things you should consider when picking an extras policy:

  • Can I get gap-free dental check-ups for myself & my children?
  • Do I need to have braces covered at this stage?
  • Do we actually use other services like chiro or massage?
  • How often do we use these services?

Maximise Your Extras

With children who need regular visits to services like speech therapy or psychology, an extras plan can pay for itself and then some. For example, HIF's Premium Options allows up to $1,000 per year on psychology claims and $1,200 per on speech therapy. Having massive limits are great for families with recurring visits.

However, having large limits are not great for families who only use extras services a few times a year, in that case you want to look for a plan which gives you a higher rebate (a higher claim each time). The best advice we can give you on how to choose an extras plan is to think of it like this, you are paying a certain amount of money each year to have a specific extras plan, you need to make sure that you're confident you will earn more in claims, than you would paying insurance premiums.

If you're not claiming more money than it costs you to have the plan, then you would financially be better off having no extras plan at all. We speak to so many people who have top extras, paying an extraordinary amount of money each year, but they only claim on the dentist once or twice a year and occasionally a little bit of physio. These people can often save a fortune when they switch to a plan which is more tailored to their needs.

compare single parent health cover

Where Should I Compare Health Cover?

There are lots of places you can compare your single parent health cover, if you want to use a broker, you have options like Health Deal, Iselect, Compare The Market & a few more. If you want to see every single health fund, the health insurance ombudsman has a useful website called privatehealth.gov.au which you can use to look at policies. Using a broker can be advantageous though, as even though no broker represents every single health fund, they still do offer a range of health funds.

Speaking to a consultant at Health Deal for example, can be brilliant because we go through what we call a "needs analysis" to really delve into how you use your policy and assess whether you're actually getting value from your health cover or not.

If you're better off staying with your current fund we'll tell you to stay put, but we always try to not only lower your premium, but to also increase your benefits on the things you use as well.

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Invisalign and Health Insurance

Invisalign health insurance

Invisalign & Health Insurance: What You Need To Know 

(5 Minute Read)

You’re probably reading this because you’re thinking about getting Invisalign but are unsure about how it all works. That’s why Health Deal has compiled this article to give you all the information you need to make an informed decision.

We’ll explain how Invisalign works, what sort of cost you can be looking at for Invisalign treatment, as well as important information around how it all works with private health insurance and what you can expect to claim back.

What is Invisalign?

Firstly, Invisalign is not actually a dental procedure but is, in fact, a company. Invisalign has become synonymous with clear aligners because they are by far the biggest player in the clear aligner industry (like saying Google instead of saying search engine or Hoover instead of vacuum cleaner).

Invisalign is a convenient alternative to traditional braces. They are clear aligners that fit over your teeth, which over time will straighten your teeth, leaving you with that smile you always wanted. They are brilliant for people who want to have their teeth re-aligned but don’t want the metal train track look from braces. Unlike traditional braces, you can also take them off whenever you want!

How does Invisalign work?

The Invisalign process all starts off in the dentist chair. Your dental practitioner will take a physical impression or a digital scan of your teeth. This scan will be used to help create a digital 3D impression of your mouth, which will be used to create an individual treatment plan for you. Once you’re happy with the plan, your 3D impressions will be sent across to Invisalign to begin the process of making your aligners!

The number of aligners you need will be dependant on the length of your treatment plan. The length of your treatment plan will vary on the amount of work you need doing. Invisalign themselves say that the average length is around 12 months – 18 months for an adult, but again it really is dependant on your individual work, so don’t be alarmed if your treatment plan is up to 2 years.

Once you have your aligners, you’ll need to wear them for around 22 hours a day to receive maximum benefit. You should take them out only to eat, drink & brush your teeth. You will also need to replace your aligners every 2 weeks. When you leave your orthodontists, you’ll be given a series of aligners to wear, it is the gradual replacement of these aligners that slowly alter the arrangement of your teeth. It is recommended that you visit your orthodontist every 6 -8 weeks, to make sure your Invisalign treatment is working correctly.


Invisalign Cost

The cost of Invisalign treatment will be dependant on a few different factors such as:

  •    How long your treatment plan lasts?
  •    How many aligners do you need?
  •    Do you need to have mid-treatment adjustments?

Australian Dentists Clinic estimate the average cost of Invisalign to be anywhere from $3,500 – $7,000. Some dental practices even put the estimates up as high as between $4,500 – $9,000. What is certain though, is that Invisalign is not cheap by any stretch. This is why most people have private health insurance to help them pay for a portion.

Invisalign & Private Health Insurance

You can claim a benefit on Invisalign through your private health insurance. Invisalign is orthodontic work, and as such, any claims you make for Invisalign will come off your orthodontic limit.

If don’t currently have coverage for orthodontics on your current extras plan, or you don’t have an extras policy at all, then you’ll need to wait 12 months before you’ll be eligible to make a claim for your Invisalign treatment. So, if its something you’re considering getting & you currently have no cover, it might be worth investing in an extras policy.

If you do have private health insurance which covers orthodontics, you should shop around and see which health fund will give you the best rebate for your price range. If you switch over to another policy that covers orthodontics, you will not need to re-serve your wait period.

Be aware though, if you switch to a plan which increases your orthodontic limit, you will need to wait 12 months before you can claim any of the additional benefit. For example, if you currently have an orthodontic limit of $1,000 and you switch to a plan with $1,500 for orthodontic treatment, you will gain access to the $1,000 straight away, but you will wait 12 months before you can claim the extra $500.

Listed below are some health funds which will cover you for Invisalign. We’ve also listed the individual policy names and important fund information you’ll need to be aware of if you decide to switch.

HIF Invisalign

HIF can offer fantastic limits on orthodontic & Invisalign treatment. However, they have a few fund rules which are different to the majority of other health funds, which you need to be aware of. Firstly, to quote HIF’s policy booklet “Orthodontic benefits are not payable by HIF if the treatment or service has commenced prior to joining HIF”. This means if you have already started orthodontic treatment, HIF will not pay out a single dollar on orthodontic treatment if you switch to them.

Secondly, your orthodontic lifetime limit will depend on how long you have been with HIF when you make your first claim. HIF’s orthodontic lifetime limits increase each year you stay on the plan, however, the year you claim is the year that your lifetime limit will come into effect. So for example, if you had Super Options for 3 years and you made an orthodontic claim, your orthodontic lifetime limit would be $1,700 (see table below).

HIF invisalign

nib Invisalign

If you want to claim a benefit on Invisalign through nib, you currently have two policy options; Top Extras & the Family Extras bolt on.

With Top Extras, the yearly limit starts at $800 per year, however, it does increase by $100 each year you remain on the policy until you reach $2,600. For example, if you switched to Top Extras, but you didn’t claim on Invisalign for 2 years, nib would actually pay $1,000 yearly instead of $800 yearly. This policy can be good if you have young children who won’t be claiming on orthodontic treatment for a number of years.

Family Extras is a bolt-on package with nib. Family Extras cannot be purchased as a stand-alone product. This means you must at least also purchase either Core Extras or Core Extras plus, alongside Family Extras.

nib invisalign

ahm Invisalign

ahm currently have 3 stand-alone extras policies which will cover a benefit for Invisalign; Lifestyle Extras, Family Extras, and Super Extras. The two things you need to know about ahm policies in relation to orthodontic/Invisalign claims are; ahm are a financial year fund & that your yearly limit increases with loyalty.

ahm run on a financial year, unlike most other health funds. This means that all your yearly limits re-set on July 1, as opposed to January 1 like most other health funds, for example, Bupa, Medibank, HIF, HCF etc. With this in mind, it means that you could claim for your upper teeth in June & your lower teeth in July, granting you the highest amount of claims in the shortest amount of time.

Like HIF, ahm will also reward you for your loyalty, by increasing your yearly limits on orthodontic treatment over time. The table below will show you how much they increase by.

ahm invisalign

HCF Invisalign

HCF currently have 2 extras policies which will cover you for Invisalign; Gold Extras and Platinum Extras. Unlike the previous health funds discussed in this article, there are no loyalty benefits over time with HCF when it comes to orthodontics.

Something you need to be aware of though, is that HCF will limit your claims if you get your orthodontic work done by a dentist and not an orthodontist. So if you do decide to switch with HCF, double check with the dental practice & HCF customer service team, that you’ll be able to claim your entire yearly limit, and not 50% of it.

hcf invisalign

Still need more info?

If you still need more information regarding Invisalign and private health insurance, speak to a Health Deal health cover consultant & they’ll be able to run you through all your different options and assess which health insurance policy is right for you.


Student Health Insurance: A Complete Guide

Student Health Insurance


Student Health Insurance:
A Complete Guide


Going to university can be one of the most exciting experiences of your life. It is an opportunity to grow as a person, expand your world view and to make new friends & experiences that will last a lifetime.

With all the new changes that are going on in your life, health insurance is probably not one of your top priorities right now. But it is important to at least have some understanding of how it all works and more importantly, if you actually need it.

That’s why Health Deal has created this complete guide, which will cover all the basics for you in one easy to digest place.

For questions surrounding Overseas Student Health Insurance, we recommend you check out a great article by Canstar called “What Is OSHC (Overseas Student Health Cover)”

compare single parent health cover


What is Health Insurance?

You’ve probably heard of some of the big health funds already like Medibank, Bupa and HCF, but what do they actually do? Well, health funds essentially offer two products, hospital cover and extras cover, which help cover the cost of various health services.

Thankfully, health insurance is heavily regulated in favour of consumers, and as such, health funds can not price-discriminate against you on a whole range of things like age, sexual orientation, race, religion and gender. They even can’t discriminate against you for pre-existing conditions or lifestyle choices! 

So, it doesn’t matter if you’ve got a heap of pre-existing ailments, you smoke 20 cigarettes a day, enjoy extreme sports on the weekend or live a healthy plant-based lifestyle, you will end up paying the same base price as everyone else for the same policy!

Hospital Cover Explained

Hospital cover can cover you for hospital procedures at a private hospital, with a doctor of your choice. Even better than choosing your own doctor and hospital, is the fact that you will not be subject to the public hospital waiting lists when you require surgery.

Health funds will generally only cover you for procedures which are “medically necessary” and have a “Medicare Item Number” (a procedure that Medicare also covers). So basically, you can’t get stuff done which Medicare doesn’t cover.

If you are brand new to health insurance you will have to serve a “waiting period” before you can claim for a procedure. Waiting periods are designed so that you can’t simply join a health fund, claim, and then leave. If everyone did this, health insurers would be out of business. 

The waiting periods for hospital cover are as follows:

  • 2 Months for a new condition;
  • 12 Months for a pre-existing condition;
  • 2 Months for palliative care, rehabilitation and in-hospital psychiatry; and
  • 12 Months for pregnancy.

Once you have served the waiting periods on a procedure though, you won’t ever have to re-serve it again if you maintain cover.

Now if you’re unfortunate enough to ever need surgery, you need to make sure that you ask your doctor if s/he will participate in your health fund’s “gap cover”. If they say they will not, you could be looking at having some pretty nasty out-of-pocket expenses, which is not what you need whilst living on a student budget.

Gap Cover Tip! 

If your doctor says s/he will not participate in your health fund’s gap cover, then ask them if there are any health funds which they will participate with. You can switch your coverage to a new health fund straight away, and get the surgery done with your new health fund because when you switch, you do not re-serve any waiting periods, even for pre-existing conditions!

Just bear in mind, it can sometimes take around 10 working days for the heath funds to swap your transfer certificate across and be able to honour your claim. The other option you have, (if you’re not fussy about having a particular doctor), is to speak to your health fund before your procedure to find a doctor who will participate in their gap cover scheme. Of course, it depends on the situation and your preferences as a patient.

What is Extras Cover?

The other type of insurance health funds offer is what is known as “extras cover”. Extras cover will cover you for a whole range of ancillary health services, which you’ve probably used at some point in your life already. You can claim benefits on a whole range of things, such as:

  • Dental visits
  • Physiotherapy
  • Chiropractors
  • Glasses
  • Remedial Massage
  • Podiatry
  • Psychology Visits
  • Speech Therapy
  • Occupational Therapy

  • Gym memberships
  • Weight Loss Plans
  • Yoga
  • Pilates
  • Hearing Aids
  • Medical Appliances
  • Non-PBS scripts
  • Ambulance Cover
  • And more!

ahm health cover

You can buy an extras policy on its own at a fraction of the cost of a hospital plan. Extras can be great for paying for expensive visits to the dentist and various other health services. But more importantly, if you’ve selected the right one for your needs, you can even claim more money back in benefits than what you’ve actually paid in premiums! 

For Example

Let’s say you’re a student earning (well) below $90,000 and living in Melbourne. You can buy an extras policy from AHM called Black 60 for approximately $351.30 for the year (as of April 2018 with the rebate applied). 

But you’d be able to claim 2 check-ups, cleans & fluoride treatments at Pacific Smiles in Melbourne worth about $380 in claims (2 x $190). On top of that though, you can claim $200 on a new pair of glasses, and 60% of the cost of a physio, chiro, osteo and even remedial massage. As you can see, you’ll be well ahead for the year and save yourself a couple hundred dollars by having this plan. It also gives you the added benefit of covering you for emergency ambulance transport!

Ambulance Transport

We really hope you’ll never need an ambulance during your time at university. But unfortunately, accidents can happen, and depending on where you go to university, you’ll need to be aware of each state’s emergency ambulance system.  

Each state has their own set of laws and rules regarding ambulance coverage. Some states have free ambulance coverage (Queensland / Tasmania), but others could leave you hundreds, if not thousands of dollars out of pocket if you don’t have coverage.  A comprehensive guide to ambulance rules can be found on the Private Health Insurance Ombudsman’s website, here.

Mental Health

Thankfully addressing mental health issues is not as taboo as it unfortunately once was. However, an alarming number of students still suffer from mental health issues in silence. In fact, Headspace (the National Youth Mental Health Foundation) has stated that “one of the largest national student surveys into the mental health of Australian students has revealed that close to 70 per cent of respondents rated their mental health as poor or fair. While two-thirds reported high or very high psychological distress over the past 12 months.” (full article here).

If you’re struggling with anxiety, depression or any other mental health issue, and you’re unsure where to look for help, Beyond Blue and Headspace are both excellent places to start if you don’t feel comfortable speaking to your doctor just yet.

Heath insurance can play its role in combating mental health issues by covering you for services such as psychology visits and in-hospital psychiatry if you ever need it.

Sexual Health

At present you cannot claim for condoms or the pill on private health insurance. Fortunately though, if the budget is tight, and you still want to practise safe sex, you can often receive free condoms from various sexual health clinics across the country.

Can you stay on your parents’ plan?

Do your parents have health insurance already? The good news is, you can stay on your parents’ plan up to the age of 25. Even better, if you’re still in university up until the age of 25, it won’t cost them any more money in premiums to keep you on.

When you’ve graduated and no longer in full time education past the age of 21, you can still stay on your parents’ policy until the age of 25, but your parents’ premium will jump up by around 25% in what is known as “Adult Dependant” cover (so be extra nice to them!)

health insurance seniors

So, do I need health insurance?

If you currently don’t have health insurance and you’re unsure whether you need it or not, our advice is that it really depends. Health Deal is a health insurance comparator, so it’s in our interest that you buy a policy, but for students who are generally fit & healthy, it really comes down to personal preference.

If money is tight and you can’t afford a hospital policy, and if you’re happy being in the public system, then maybe a hospital policy isn’t right for you at this moment. On the other hand, if you’ve got a few health ailments, or you generally live a more accident prone / riskier life, then it might be something to consider to give you peace of mind. It should definitely be something that you talk about with either your parents and/or a family friend to make sure it’s right for you.

With that being said though…if you currently don’t have any health insurance, we do strongly suggest you weigh up the benefits of purchasing an extras only plan. Remember, extras policies are a fraction of the cost of hospital policies and will almost always cover you for emergency ambulance as well as dental and other services.

If you do decide to purchase an extras plan, don’t go buying the most expensive plan with the nicest sounding benefits. Instead, buy the plan you’re most confident you’ll claim the most return-on-investment from. Remember you’re paying $X amount for a plan, you want to make sure you claim that back and more in benefits, otherwise it would have been better to have just saved your money!



What is the price of the health insurance policy?

Where to shop for health insurance?

There are dozens of different health funds to choose from, all offering hundreds, if not thousands of different policy combinations. If you want to speak to a consultant, Health Deal represents a panel of different health funds, and we can guide you to a policy that’s the right fit for you at this time in your life. Simply enter your requirements here, and we’ll give you a quick call back and see how we can help.

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