There are several things to think about when comparing health insurance, to ensure your health needs are covered. While there are many health insurance providers available in Australia, there are differences in their policies and you need to be aware of these finer details when considering your health insurance policy.
A health insurance comparison can potentially save you money, lower your health insurance premiums and help you avoid out of pocket expenses for treatments.
Here are five policy features to consider when making health insurance comparisons:
1. Excess or Co-payments
Excess or co-payment options are offered as a way to lower premiums on health insurance policies. Excess is the amount you agree to pay towards the cost of hospital treatment, regardless of the number of days you are in hospital. Some policies charge the Excess for your first admission to hospital only, while other policies charge the Excess every time you’re admitted.
Co-payment is the agreed amount you pay in conjunction with your health insurance provider, for every day you are in hospital. Make sure your policy does not make you pay for both, or you could end up paying twice, a lump sum on admission and a further amount for each day you’re in hospital.
Having a nil Excess policy means your premiums will be higher. Include the Excess and Co-payment amounts when making health insurance comparisons.
2. Hospital Cover
Health fund providers offer various combinations of hospital cover, from full or comprehensive cover which may include a private room in a private hospital to basic cover for treatments, theatre fees and accommodation in a public hospital or fewer benefits in a private hospital.
Full hospital cover will have higher premiums, but you can reduce the premiums by opting for Excess or Co-Payment or you can choose not be covered for some procedures.
When making a health insurance comparison on hospital cover, check whether there are exclusions on certain procedures, this can also lower your premiums.
3. Extras Cover
Extras or ancillary cover a range of non-hospital services such as optical, dental, physiotherapy and other alternative therapies. Policies will vary from one health insurance provider to another on the amount you can claim for these services.
You can purchase Extras cover separately or combined with hospital cover. You will want to know what you treatments and services you can claim when making your health insurance comparison and whether your preferred treatment is covered by your health fund provider.
4. Waiting Periods
The Australian government has established maximum waiting periods that health fund providers can impose on policy holders. Usually there is no waiting period if you have an accident after joining a health fund. There is no waiting period if you transfer from one health fund provider to another with the same or lower level of cover. You may have to serve a waiting period if you’ve upgraded your health insurance to a higher level of cover.
Be sure to check and understand the waiting periods for each health fund provider when making your health insurance comparisons.
5. Gap Cover
Some health funds provide Gap cover to ensure you don’t pay for additional medical or hospital charges associated with your treatment. Gap cover occurs when a doctor charges a fee higher than the Medicare Benefit Schedule (MBS). Normally your health fund will cover 25% of the cost while Medicare covers 75% of the cost of treatment. The gap occurs when the cost of your treatment is above the MBS and you need to pay the additional costs.
To avoid incurring Gap expenses you need to confirm with your doctor and hospital that they participate in your chosen health fund’s gap cover. Your doctor must explain all costs prior to you being admitted for treatment and you need to confirm this with your health fund.
Again, when making your health insurance comparison to include Gap cover as part of your evaluation so you don’t get hit with the extra out of pocket expenses.
