Health Insurance Companies

There are over 20 health insurance companies in Australia providing private health insurance policies and coverage (at the time of writing), all of which are registered under the Private Health Insurance Act 2007.

These health insurance companies provide policies that cover two main needs for consumers – hospital cover, and extras cover.

First, hospital cover provides payment for part, and sometimes all, of the expenses related to treatments in hospital. Some of these services include operating theatre fees, pathology and radiology services, intensive care, and pharmaceuticals, and of course accommodation in hospitals for the time you’re there. You can choose different levels of cover, which generally means more services will be covered. 

Health insurance companies allow you to make important decisions about your hospital experience when you take out hospital cover. For example, you often get the ability to choose your hospital, to choose a private room, and to choose a doctor. Remember of course that you don’t have to use private health insurance from health insurance companies when you visit a public hospital – you can always be treated as a Medicare public patient.

The other main kind of cover provided by private health insurance companies is extras cover. Extras are the kinds of services and treatments that generally aren’t covered by Medicare. Some of these services include dentists, opticians, physio, and podiatry. There are also important services that are covered – as diverse as weight loss and speech therapy.

Perhaps the most important thing about health insurance companies in Australia is that they literally are not allowed to deny you health insurance coverage – which is very different from the situation in other countries. Health insurance in Australia is “community-rated”, meaning that everyone is entitled to buy the same product at the same price, except only for their Lifetime Health Cover. Health insurance companies in Australia cannot refuse to sell or renew a policy based on your health, or how likely you are to need to claim.

What health insurance companies can do is impose waiting periods for particular services under your policy with them. You are required to serve a waiting period for your first health insurance policy, or when you upgrade your coverage to add more services. However, if you transfer from one health insurance company to another, and don’t upgrade to new services, waiting periods served with your former health insurance company transfer with you. Waiting periods for hospital cover are regulated by the Government, just like prices and price increases for health insurance companies.