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Private Health Insurance Excess
Making an informed private health cover decision
A lot of factors influence health insurance costs in Australia. Insurance premiums, coverage levels, extras, excess, Australian Taxation Office rebates, tax liability, and waiting periods all impact the overall expenses. Making an informed decision about health insurance means finding the right balance between coverage and affordability.
Private health insurance available in Australia
Private health insurance policies fall into three categories: hospital cover, extras cover, or combination cover. The type of health insurance cover you take should reflect your lifestyle, age, income tier, and relationship status now and into the future.
Hospital Cover
There are four common private hospital cover tiers – Basic, Bronze, Silver, and Gold. Depending on your health insurance tier level, you can get a private room and choose your preferred doctor/surgeon for a wide range of hospital treatments, such as:
- Joint replacements
- Heart surgery
- Kidney dialysis
- Treatments for the brain and nervous system
- Cataract surgery
- Palliative care
- Rehabilitation
A base tier level of cover may be all you need for may ailments such as ear, nose, throat, kidney, and bladder issues. However, you will need a higher level of cover for major issues.
Extras Cover
Extras cover can help with services outside of hospital settings, and services not covered by Medicare. Depending on your policy, these might include:
- Dental treatment
- Chiropractic services
- Physiotherapy
- Podiatry
- Medical devices such as hearing aids
- Optical services
- Occupational therapy
- Prescription medication not covered by the Pharmaceutical Benefits Scheme
Some extras policies include home care benefits for services such as injury rehabilitation and administering medication. A GoSwitch price comparison search from our health provider partners will put you in the picture, as inclusions vary from plan to plan.
When do I pay health insurance excess?
You’ll pay excess if you’re admitted to hospital as a private patient. You will need to pay the excess amount upfront before you receive treatment. The remaining costs will be paid by your hospital insurance – although some out-of-pocket costs may apply. If you’re on a selected family cover health insurance scheme, you won’t need to pay the excess for kid’s medical treatments.
Australian residents can select health insurance excess up to $750 per person. For most family health cover, you’ll only pay twice the chosen level of excess per calendar year. Overseas visitors can select a $500 excess or a $0 excess.
If you select a higher excess:
Your premiums will be lower, but you will pay more upfront if you’re admitted to hospital. If you have already paid an excess for a hospital admission in the current calendar year, you may need to pay the difference between the lower excess paid and your new, higher excess for additional hospital services for that year.
While there’s no way of predicting whether you’ll need to go to hospital, you may want to consider a higher excess if you:
- Are young and healthy
- Have never been to hospital before
- Can afford the upfront cost of a higher excess
- Think it’s unlikely that you’ll need to go to hospital
If you select a lower excess:
You’ll pay more for your premiums but won’t have as much to pay upfront if you’re admitted to hospital. Reducing your excess is considered an upgrade to your cover. This means that you’ll have to serve a waiting period before lower excess applies to your health policy. You may want to consider a lower excess if you:
- Have a history of health concerns
- Have made multiple healthcare claims in the past
- Think that you may need hospital treatment at some point
- Can’t afford the upfront cost of a higher excess
Remember to check your excess
Before going to hospital, see if you have an excess for your policy, and factor it in as an upfront cost that you’ll need to pay before your treatment.
More potential health insurance savings
Here are a few ways you can make your health fund save you on out-of-pocket costs.
 | Australian Government Rebate Entitlement | The Australian Government offers a Private Health Insurance Rebate amount to help cover some insurance premium costs. The Private Health Insurance Rebate percentage is income tested, and eligible policyholders over the age of 65 will generally receive a higher rebate. |
 | Medicare Levy Surcharge | This is an amount you may need to pay at tax time if your income threshold is over a certain amount and you don’t hold an eligible private hospital policy for the financial year. |
 | Lifetime Health Cover Loading | This is designed to encourage Australians to take out hospital cover earlier. You will reap the benefits as you age, as premiums increase by 2% for each year you don’t hold hospital insurance cover following your 31st birthday. |
 | Pre-existing conditions | Pre-existing conditions won’t increase health insurance costs or the price of your premium. A pre-existing condition is a medical condition where the signs or symptoms are apparent starting at any time in the 6 months prior to purchasing your health insurance policy. |
Whether an illness or injury is determined pre-existing will be determined by your health insurer’s appointed medical practitioner in consultation with your treating professional.
Why switch with GoSwitch?
GoSwitch searches multiple private health insurance premium deals in seconds so you can get on with choosing an insurance provider that suits your style and budget. If you are looking for singles insurance, single parent health insurance, couples health insurance, insurance for a dependent child, or seniors health insurance, GoSwitch can offer you the best available deals, and our service is 100% free to use.
Simply enter your postcode to get started with a free health insurance price comparison today!
FAQs
What is the best health cover in Australia?
The best health cover depends on your individual needs and the insurance premiums (cost) and excess required to pay when making a hospital claim. Some health insurance products might be great for families, while others are better suited to seniors, singles or couples. GoSwitch can help you compare different policies to find the perfect fit for you.
How much does private health insurance cost?
The cost of private health insurance varies depending on your age, the level of cover, and the for-profit health fund you go with. Some funds offer basic cover for a few hundred dollars a year, while others can cost a few thousand. It’s always best to compare different health funds and policies with GoSwitch to find the one that suits your budget and needs.
How do I get two private health insurance policies?
You can split your health cover between two providers if you prefer. This could mean having hospital cover with one insurer and extras cover with another. GoSwitch can help you compare and combine different hospital policies to find the right mix for you.
Does private health insurance cover dental services?
Dental coverage depends on your specific policy and level of extras cover. Many policies cover routine checkups and basic treatments, while some also cover major dental work like orthodontics. Use GoSwitch to compare policies and see what’s included in each.
What is the best health insurance company to go with?
The best health insurance company for you will depend on your individual needs and the specific health services you’re looking for. Some companies excel in hospital cover, while others offer better value for extras. GoSwitch makes it easy to compare different companies and their offerings so you can find the one that’s right for you.