When you are considering private health insurance, there are a number of decisions you need to make.
One of the biggest choices is, of course, which kind of private health cover will be best for your unique situation and needs.
In order to choose the most suitable cover for you and your family, it is important to understand the choices available.
Hospital-only health insurance covers the care of a private patient in either a public or private hospital.
Typically, medical care listed on the Medicare Benefits Schedule (MBS) are covered by private hospital insurance.
Additionally, some treatments not listed in the MBS may receive limited cover under private insurance, though it is important to check with your health fund how much cover you will have access to before organising services such as cosmetic surgery or laser eye surgery.
Private hospital insurance often includes the cost of an ambulance trip and gives patients the ability to choose their own doctor.
Patients heading into a private hospital for elective surgery will find this cover particularly useful as a private hospital policy will cover some or all of your accommodation costs.
Staying in a private hospital is often more comfortable than staying in a public facility as you usually get a private room which is rare in a public hospital.
Hospital cover can then be placed into four different categories:
• Top Private Hospital Cover – no restrictions or exclusions on Medicare Benefit Schedule (MBS) items (medical services provided by doctors in a hospital).
• Medium Private Hospital Cover – does not exclude any MBS items but benefits may be limited by restrictions.
• Basic Private Hospital Cover – excludes certain MBS items, with no benefits for restricted items.
• Public Hospital Cover – covers the default treatments in a public hospital only.
Extras (also known as ancillary or general treatment) cover provides benefits for non-medical health services, such as dental, optical or physiotherapy treatments.
These policies can be packaged with hospital cover or purchased separately.
The three general categories of extras policies are:
• Comprehensive – covers most or all health care services, such as dental, optical, chiropractic and pharmaceuticals.
• Medium cover – includes most services excluding orthodontics, health management, hearing aids and other items.
• Basic cover – includes at least one of general dental, optical, physiotherapy and chiropractic.
The option to combine hospital and general insurance policies is offered by many health funds. Some providers will pre-package these policies together, while others allow you to mix and match.
As the most comprehensive cover, this combined health insurance plan often gives patients the option of choosing how many extras they are willing to pay for.
Not all extras are necessary additions to a health insurance policy. For example, a young and healthy individual with 20/20 vision may not feel the need to include optometrist-related services, and pregnancy cover is a redundant extra for males or women past menopause.
How HICA can help
With the ability to mix and match hospital and extras cover, it can be difficult to keep track of all the important details.
Many providers will pay different benefits and follow varied exclusions and caps on particular services. This means that if you assume all policies are the same or similar, you could miss something important and find yourself out of pocket in the future.
HICA can help by offering a complete, obligation-free assessment of your health care needs to identify the policies relevant to your situation.
We then compare health insurance policies and providers to find the cover most suitable to your individual budget.
If you would like to learn more about what private health products are available or need help deciding which policy will be best for your needs, contact the team at HICA today.