The best health insurance isn’t always the cheapest or the most expensive. It’s critical before you compare health insurance policies that you first understand your future health needs. Key areas you need to understand include if you plan to have a baby in the medium term, if you want to be covered for services such as dental and if you want a private room if you’re treated in a hospital.

To simplify selecting policies, GMHBA provides three health insurance policy levels for you to choose from:

  • Gold
  • Silver and
  • Bronze

* The price shown is per week and applies to a {LIFESTAGE} living in VIC with a $500 excess. It excludes LHC loading and includes a Base Tier Government Rebate

What Are The Two Components Of A Health Insurance Policy?

When it comes to comparing health insurance policies, there are two area that often confused Australians.

  1. Hospital Cover

    Hospital cover is the ‘core’ of a health insurance policy and offers coverage for trips to a hospital caused by accidents or sickness. Different health insurance policies will provide different levels of hospital cover, which may impact what private hospitals you can be treated in and the level of service. For example, some policies will allow you to have a private room during a visit.

    What makes hospital cover also critical is that it may help reduce your overall tax. This is because within Australia there is a Medicare levy surcharge which can be as high as 1.5% of your combined income. There is also another component called lifetime health cover loading which can make private health insurance policies more expensive the older you get after 31 if you don’t have hospital cover.

  2. Extras Cover

    Extras cover is the service that is more regularly claimed by most Australians as it’s more regularly used. This can include dental cover, optical cover and services such as physio. Extras cover at GMHBA will ensure you can claim on these services when you visit them. The amount you get back will depend on the health funds policy and in some cases, the actual practice you were treated in.

    It’s critical to note that extras cover will not help you avoid the Medicare levy surcharge or lifetime health cover. Only Australian hospital cover applies to these two government policies.

What Factors Should I Consider When Comparing Health Policies?

Planning ahead and understanding your needs is critical when you compare private health insurance policies. Below is a checklist to guide you as to what are the health insurance products that best suit you.

Do You Plan To Have A Baby?

Many Australians don’t realise that there is a 12 month waiting period when it comes to pregnancy related services. This means that you must have a private health insurance policy that includes maternity cover at least 12 months before you conceive or you won’t be covered. Planning ahead therefore is critical and ensuring you have the best health insurance policy that meets your expectations during this exciting time.

For the majority of Australians that don’t plan to have a baby in the medium term, you should make sure the policy you have or are considering doesn’t have maternity cover. This is a very common mistake, especially for those who have kept their old policy when they had their last child.

What Are Your Private Hospital Expectations?

Health Insurance policies (especially within health funds) can have huge variations when it comes to hospital visits. Some polices require health fund members have policies that only allow you to be treated in public hospitals. Other policies require health fund members also have cheap policies that require you to always stay in a shared room.

It’s critical to consider if you’re happy to be treated in a public hospital or if you prefer to be treated in a private hospital. The next element to consider is if you are happy to share a room (with up to 6 other patients) or prefer a private room.

What Elements Do You Want To Be Covered For?

It’s often hard to work out what treatment(s) you may need in the medium term but you should try to map out what you may require. For example, you may be considering gastric banding, which may only be provided by the more premium policies.

As another example, you may want to be covered for Chiropractic and Osteopathy treatments, which may require a higher priced policy. Naturally, the more policies you may want to be covered for will often increase the premium rate so it pays to think this area through.

How Much Will You be Out-Of-Pocket?

Health cover at the end of the day is a type of ‘insurance’. This therefore helps reduce your financial risk if something goes wrong (in this case sickness or injury). Different health insurance policies give back a different proportion of costs when you require a treatment. You therefore need to make sure you’re happy with the amount you may be out-of-pocket if you have different treatments.

It’s critical to understand the inclusions on policies and the percentage covered when making your final checklist.

Create A Report Card

A health insurance report card that matches your needs is an excellent way to compare health insurance funds and policies. Below we provide our ‘top 10’ items you may want to consider when making a best health insurance report card.

  1. Who needs to be covered under the policy?

    You should consider if it’s just yourself who needs a policy (singles cover) or if your partner (couples cover) and/or family also needs to be covered.

  2. Do You Need Private Hospital Cover?

    Consider if you will be impacted by the Medicare Levy Surcharge in the next financial year and what potential savings hospital cover will achieve. If you’re over 31, also consider the added costs future policies may incur if you don’t have hospital cover due to health cover loading. Finally, understand if you want to be treated in a private hospital.

  3. Is The Health Fund A Not For Profit Insurer?

    Only Not For Profit health insurers such as GMHBA operate solely for members without the requirements to make profits for shareholders. This can lead to high value policies with great benefits to members.

  4. What Are The Policy Inclusions And Waiting Periods?

    It’s critical to review what a policy will and won’t cover and if you require those services. As explained earlier, maternity cover will only be required by a small proportion of Australians. Also, check the waiting periods on different items (especially for extras).

  5. What Are The Health Insurance Products Costs?

    The most expensive Australian health policy isn’t necessarily the best health insurance cover for you. When looking at the price, ask yourself if you will get value for money from this policy. Also, make sure you factor in the rebate you may receive from the government.

  6. Are There Issues If I Switch Funds Or Policies?

    While Australians are protected when switching funds or policies by the government when it comes to waiting periods, there may issues when switching. For example, GMHBA has loyalty bonuses for members which will be lost if you switch funds. Consider this prior to switching.

  7. Which Practices Can I Make A Claim?

    Some health funds and policies require you to go to specific hospitals or practices (eg dentist) to make a claim. If you want to choose the practice that best suits your needs and location a health insurer like GMHBA, which has no such restrictions, may be the best option.

  8. Are There Additional Health Benefits Of A Policy?

    Prevention is better than cure with health insurers often including preventative elements such as gym membership within some policies. Investigate what preventative health benefits exist and if you require them.

  9. How Can You Make A Claim?

    Making a claim can be a confusing process so you want to make sure that the health fund you select has great customer service and an easy to navigate claim process.

  10. What Are The Annual Limits?

    Most health insurance policies have annual limits, especially when it comes to extras such as dental. Make sure these are at a suitable annual level when considering the amount you may claim over the next 12 months.

Overall, it’s beneficial to spend some time before comparing health funds and policies to make sure you get the best value. Your health is your most important asset so make sure you do your research and get the best value policy to suit your needs!