Choosing the right policy

With a wide array of insurers, and a bewildering number of policies out in the marketplace, making a simple comparison of private health insurance policies can seem all but impossible. So how do you work out which policy is the right one for you?


Do you need general treatment cover?

The reality is that "extras" cover (also known as extras or ancillary), which includes everything from dental services through to physiotherapy and optical services, doesn't really offer value for money if you’re only an infrequent user of these services. On average, your rebate (the amount you receive back from your fund) only compensates you for about 50% of the cost of dental treatment (although some of the smaller not-for-profit funds return anywhere up to 75%). Even the one time head of the government organisation which oversees private health insurance in Australia has expressed doubts about its value, pointing out you would be better off putting money aside for these services should you eventually need them.

Find out from a prospective insurer exactly what they will and won’t cover.

When you first take out a policy your fund will issue you with what’s known as a Standard Information Statement which outlines your general entitlements; it does not, however, go into all the detail you might require so you will need to contact your fund for more information.

Using comparative websites

In recent years, the Australian market has witnessed the rise of sites that offer to compare all the private health insurance policies out there and provide you with a list of possible options to consider. While they have their place and can simplify the challenging process of sifting through the many hundreds of policies offered by funds, they don’t take every possible policy into account, meaning you won’t get a complete picture of the policies on offer. You will likely find it more effective to go to the government website which offers a detailed, expansive and unbiased comparison of the many products available.

Biggest is not always best

It’s easy to be dazzled by the slick advertising, sophisticated apps and customer service offered by the bigger share holder driven funds and assume their products are superior. However, many of the smaller funds offer polices that provide more detailed, generous cover and give you back far higher rebate amounts than their larger competitors. This is why you should make sure that any search you undertake includes as many different funds as possible because the right policy for you might come from an entirely unexpected quarter.

And remember once you find what you think is the right policy, don’t feel pressured to sign up immediately. Ask for the information to be sent to you, take your time to consider your options and only sign up once you done as much detailed research as possible.

Regularly review your policy

Your health needs change over time and so once you take out a policy, it's always a good idea to check whether it remains a good fit for you and whether you should seek out a new policy, a new fund or both.
  • Private Health Insurance Ombudsman

    Provides access to the Standard Information Statements which every insurer must have available by law, as well as supplying a list of every registered health fund in Australia.

  • Fact Sheet: Essential Questions

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  • Fact Sheet: It's Your Choice

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