How much does private health insurance cost?

There are many options these days when it comes to private health cover, it can be daunting working out what is the best private health policy for you and your stage of life and what contribution amount fits within your budget.  

The price of private health insurance isn’t set in stone – it’s like a puzzle with different pieces that affect the cost. Things like how much coverage you want, the specific plan you go for, how old you are, and how healthy you’re feeling all play a role. When it comes to the money side, private health insurance costs can range from just a few hundred dollars to top gold cover which can cost thousands per year.. 

So, if you’re thinking about taking out private health insurance, it’s smart to do your homework. Take your time to compare different policies, see what they cover, and understand the costs you might have to handle. That way, you’ll be better prepared to pick a plan that fits your needs and budget. In this month’s blog we will assist by giving you tips to help you navigate and compare private health insurance policies that best suit your budget. 

Important Factors:

  • Private health insurance costs in Australia are influenced by various factors including the level of coverage, age, and the individual’s income.
  • Private health insurance is not mandatory but offers coverage for services not included in the public health insurance system, Medicare.
  • Annual private health insurance premiums can vary widely and may involve additional costs like excess payments and gap expenses.
  • It’s worth noting that the Lifetime Health Cover (LHC) loading is a penalty applied to those who do not secure private health insurance before turning 31.
  • To lower your private health insurance expenses, you can compare policies from different providers and consider choosing higher excess amounts.

We’re a family of 4, how do we get the best coverage that’s within our budget?

Your priorities often revolve around ensuring the well-being of your loved ones. One essential aspect of this is having adequate private health insurance coverage. However, balancing comprehensive coverage with a budget can be challenging.

Assess your family’s needs: Consider your family’s current health status, any ongoing medical conditions, and the likelihood of future healthcare requirements.

Compare plans: There are various private health insurance plans available, each offering different levels of coverage and price points. Taking the time to compare plans from different providers is always the best option.

What influences the cost of private health insurance?

Policies are influenced by various factors, and it’s crucial to understand how these elements can impact your premiums and coverage. Let’s break it down:

1. Income – The government helps with the cost of health insurance by providing a rebate, there are three rebate tiers which are dependent on your income. The less you earn, the higher your government rebate which helps make health insurance more affordable.

2. Health status matters – Your health status also carries some weight. If you’ve got pre-existing medical conditions or chronic illnesses, you might see higher premiums or certain exclusions on your policy. 

4. Location – Healthcare costs can vary quite a bit from one state to another, and that’s something insurance providers take into account. 

5. Type of plan -Now onto the plans themselves. Comprehensive policies tend to cost more than the basic ones that cover only the essentials. You can opt to choose just hospital cover without an extras policy, it’s up to you.

I’m close to retiring, how can I save money on private health?

As you map out your retirement, it’s a smart move to consider how the aging process might impact your health down the track. One thing worth keeping in mind is the cost of healthcare in general, and it’s wise to include it in your budget planning. Here’s a few tips that may assist with your decision making:

  • The Price Tag: Consider the cost of private health insurance itself. Make sure it aligns with your budget and your health needs for the retirement stage of life.
  • Future Health Expenses: Think about the potential costs of treatments or medical care you might need in the future for any pre-existing conditions.
  • Your Health Today: Assess your current health condition. It can help determine how much coverage you might require.
  • Your Desired Level of Care: Think about the kind of care you want. Private health insurance can offer different levels of coverage, so make sure it matches your expectations.

These considerations should help you weigh the pros and cons to make an informed decision about the cost of healthcare in your retirement years.

Ultimately it’s like piecing together a puzzle – your age, gender, health, location, the type of plan you choose, stage of life and most importantly, the fine print in your policy – these factors all play a part in determining how much you pay for your private health coverage.

Our Team are ready to take your call

To compare private health insurance funds and discuss what the best policy is for your budget and stage of life. Our friendly team is standing by to talk you through the options. Call us on  1300 861 413 or email us

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What level of cover do I need for cataract surgery?

What Are Cataracts?

Imagine your eye’s lens becoming cloudy, making everything you see appear blurred or dim. Cataracts are exactly that – a clouding of the eye’s lens. This cloudiness can create problems like difficulty reading, driving at night, or recognising your friend’s smile. Initially, cataracts might develop slowly and not cause significant vision problems, but over time, they can seriously affect your eyesight.

Recognising Cataracts:

  • Clouded or blurred vision
  • Trouble seeing at night
  • Sensitivity to light and glare
  • Needing brighter light for activities
  • Seeing “halos” around lights
  • Frequent changes in eyeglasses or contact lenses
  • Fading or yellowing of colors
  • Double vision in one eye

About Cataract Surgery

Cataract surgery is a highly effective procedure designed to remove the cloudy lens and replace it with an artificial intraocular lens, restoring clear vision. The surgery, typically lasting around 30 minutes, is performed on an outpatient basis, and patients can choose to have both eyes operated on one day or separately. Modern techniques, like phacoemulsification, use ultrasound to break up the cataract for easier removal, ensuring a quick recovery and improved quality of vision.

Private Health Cover and Cataract Surgery

While Medicare covers cataract surgery, public hospital waiting lists can be long – sometimes up to a year. If you have gold or silver tier private health insurance, you might be covered for cataract surgery. It’s important to note that waiting periods apply, typically 12 months, depending on your private health insurance provider.

Cataract Surgery – Medicare vs Private Health Coverage

Medicare Private Health Insurance
Can I avoid public hospital waiting lists?No. Yes.
Can I choose my hospital?No. Yes.
Can I choose my own doctor or surgeon?No. Yes.
Will there be any out-of-pocket costs?No. Yes.


Choosing the Right Lens for Your Cataract Surgery

When it comes to cataract surgery, selecting the right lens can significantly impact your vision and lifestyle. There are several lens options available, each catering to different needs and preferences. Your specialist will run you through the choices and find the perfect fit for you.

Monofocal Lenses: Clear Vision, Slight Dependency on Glasses

Monofocal lenses offer excellent visual clarity but maintain the same power throughout. If you have astigmatism or an irregular cornea and opt for a monofocal lens, you may still require glasses for optimal vision at varying distances – be it for driving, reading, or using a computer.

Toric Lenses: Freedom from Glasses for Specific Activities

For those with regular astigmatism seeking freedom from glasses during specific activities, toric lenses are a viable option. These lenses offset corneal imperfections by incorporating a cylinder power axis. This adjustment enhances your chances of seeing clearly at a specified focal point without relying on glasses, giving you more independence for activities like reading, watching TV, or using a computer.

Both monofocal and toric lenses offer the flexibility to choose your focus – distance, intermediate, or near vision. Additionally, considering monovision or mini-monovision might be suitable, especially if you’ve had experience with monovision contacts or refractive surgery. With this approach, one eye is set for distance vision, while the other is set for intermediate or near vision, providing a broader range of vision.

Multifocal Lenses: Embrace Life without Glasses

Multifocal lenses are a revolutionary option, capable of focusing light at varying distances, including distance, intermediate, and near vision. Ideal for individuals who despise wearing glasses, these lenses also come with astigmatism correction if necessary. However, it’s important to note that multifocal lenses are best suited for individuals with otherwise healthy eyes, without irregular corneas or eye diseases like age-related macular degeneration or retinal scars.

Choosing the right lens for your cataract surgery involves considering your lifestyle, visual preferences, whether you have private health cover or if you need to use Medicare benefits and overall eye health. Discussing your options thoroughly with your ophthalmologist will ensure you make an informed decision, ultimately leading to improved vision.

Your Patient Cataract Surgery Journey

GP Visit – It all begins with a visit to your general practitioner (GP) – your first step on the path to clearer vision. During this appointment, your GP will provide initial guidance and might recommend further investigation for cataracts. Typically, your GP will refer you to an optometrist and, eventually, to a specialist.

Optometrist Appointment – The next stage involves an appointment with the optometrist, a professional skilled in eye care. Using a specialized magnifying light, the optometrist carefully examines your eye’s lens, looking for any signs of cloudiness. This examination can even detect early-stage cataracts, allowing for timely intervention and treatment.

Specialist Appointment – Following the optometrist’s evaluation, you’ll meet with an ophthalmologist, a specialist in eye diseases and surgeries. Ophthalmologists possess the expertise to diagnose cataracts, even in their early phases. During this appointment, they conduct thorough and in-depth tests, generating crucial data that will be used for your eventual surgery.

Biometric Scan – A vital step in this process is the biometric scan, a precise measurement of the corneal power and eye length. This data is instrumental in determining the ideal power for the intraocular lens (IOL) that will be implanted during your surgery. These measurements play a significant role in assisting your surgeon in selecting the most suitable lens implant tailored to your eye’s unique requirements.

If you’re ready to explore your private health insurance options and discuss cataract coverage, our team is here for you. Give us a call at 1300 861 413 or email us at  We’re here to help you see clearly and navigate your way to the best health coverage.

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What state is my health fund from?

Our healthcare system is renowned for its quality and accessibility, largely owing to a unique blend of public and private provisions. The heart of our healthcare system lies in private health insurance plans, which play a vital role in providing Australians with additional health coverage beyond what the public system offers. However, the landscape of private health insurance varies considerably from state to state, making it essential for residents to carefully compare private health insurance options to find the best health coverage for their specific needs. 

In this blog, we will explore the variations of private health insurance in Australia, highlighting the differences you should be aware of when comparing health insurance policies from one state to another.

Understanding Private Health Insurance

As private health insurance is an integral part of our healthcare system, it provides Australians with the opportunity to receive enhanced medical services and faster access to healthcare providers, while also relieving some of the pressure on our public healthcare system. Although the overarching principles of private health insurance are consistent across the country, variations in policies from state to state and regulations can be significantly different. 

The Basics of Private Health Insurance

Private health insurance provides financial assistance for medical expenses that are not covered by Medicare. These expenses can include hospital treatments, specialist consultations, and various extras such as dental and optical care. Choosing the right private health insurance policy is paramount for ensuring that you receive the best healthcare services without putting a strain on your finances.

Comparing Private Health Insurance Plans

When it comes to choosing a private health insurance plan for your state there is no shortage of options. Each plan is designed to cater to different needs, preferences, and budgets. To find the best health coverage, it’s crucial to compare health insurance policies thoroughly. This involves considering factors such as coverage benefits, premium costs, waiting periods, and exclusions.

Private Health is the same Australia wide. All health funds service all of Australia.

Ask the Right Questions

Navigating the maze of private health funds in Australia requires asking the right questions. Consider reaching out to providers individually and discussing your healthcare needs. These professionals are well-versed in the state-specific offerings when it comes to private health insurance and can guide you towards policies that align with your needs. Make sure you enquire about waiting periods, coverage limitations, and any potential out-of-pocket expenses. Understanding the terms and conditions thoroughly is crucial to avoid surprises during times of need.

Comparing Benefits and Exclusions

Comparing private health insurance plans state to state, involves looking beyond the surface-level benefits. While some policies may offer comprehensive coverage for hospital stays, others might excel in providing extras like physiotherapy, chiropractic care, or mental health services. Consider your personal or family’s health needs and choose a policy that covers the services most relevant to you. Additionally, pay close attention to exclusions. Some policies might exclude certain pre-existing conditions, elective surgeries, or high-cost treatments. Understanding these exclusions is vital to prevent unexpected denials of coverage when you need it the most.

Incorporating Lifestyle Factors

Your lifestyle and future also play a significant role in choosing the right private health insurance policy. For instance, if you’re planning to start a family, a policy that covers maternity and childbirth-related expenses would be essential. Similarly, if you’re an active individual who frequently participates in sports, a policy covering physiotherapy and sports injuries could be invaluable. These all vary in cost from state to state as well.

Whatever state you live in, in Australia the key to finding the best private health coverage lies in understanding the variations of each state’s offerings. By comparing private health plans, asking the right questions, and considering state-specific needs and lifestyle factors, you can make informed decisions that ensure optimal healthcare. Remember, your health is your most precious asset, and investing time in understanding your private health insurance options is a step toward safeguarding it effectively. 

Our Team is standing by to take your call.

To compare private health insurance funds and discuss your cover today.

Call us on 1300 861 413 or email us

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What happens if I change my mind about private health insurance?

So, you’re thinking about private health insurance and maybe you’ve got a few questions?  Don’t worry, we’ve got you covered on all you need to know and what you need to do if you change your mind.

Changing Your Mind About Private Health Insurance?

  • Don’t Stress, You Have 30 Days: You can make changes to your policy within 30 days without any hassle, as long as you haven’t made a claim. This means you won’t have to go through waiting periods again if you decide to upgrade your coverage. This cooling off period gives you peace of mind that you’ve made the right choice.

Switching Providers Made Easy:

  • Your New Provider Handles It: If you decide to switch to a new private health insurance provider, they’ll handle the transition for you. They contact your old insurer, cancel your old coverage, and ensure your waiting periods carry over. Plus, your previous insurer will refund any advance premiums you’ve paid.

Waiting Periods and Policy Changes:

  • Check with Your New Private Health Insurer: Waiting periods transfer with you when you switch insurers, so you never have to re-serve a waiting period. If you’re upgrading to services not covered in your previous policy, you might have to wait for a bit before you can claim these benefits.

Cancelling Private Health Insurance:

  • It’s Easy: Cancelling your private health policy is a straightforward process. Depending on your provider, you might need to call them, fill out an online form, or use an online portal to notify them about your cancellation. If you cancel, your private health fund will refund any advance payments you’ve made.

Need Help Deciding?

If you’re still unsure and want to compare the best health coverage options, our team is ready to assist you. Just give us a call at 1300 861 413 or shoot us an email at We’re here to help you find the perfect private health insurance policy tailored just for you.

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Is physiotherapy covered with Health Insurance?

When it comes to physiotherapy coverage on your private health insurancepolicy you’ll need to take out extras cover. Each policy is different so it’s wise to do your extras research and consider the best private health cover for your physio needs. 

What exactly is physiotherapy?

Physiotherapy is all about helping you regain, preserve, and optimise your mobility, functionality, and overall well-being. It’s all about enabling you to move more freely and with less discomfort, but it does this without relying on medications or surgery. Instead, physiotherapy employs physical techniques like massage and exercise.

This approach isn’t just about addressing immediate issues. It can also work wonders for the long term. Regular use and strengthening exercises can slow down the natural process of muscle and bone deterioration. Plus, if you’ve faced injuries or have ongoing medical conditions, physiotherapy can play a crucial role in improving your healing.

What does physiotherapy treat?

Physiotherapy coverage is an extra that private health insurance policies offer. It’s designed to provide benefits when you need to see a physiotherapist. If you’re someone who deals with or anticipates issues related to:

  • Mobility limitations – shoulder injuries, knee pain and injuries
  • Post-accident or injury recovery
  • Pre & Post Surgery treatments
  • Specific chronic conditions
  • Neurological disorders
  • Back and neck pain
  • Sports-related injuries
  • Sporting Injuries
  • Ankle Sprains
  • TMJD (jaw pain)
  • Fracture management (casting, boots and braces)

Then, it might be a smart move to consider getting a dependable extras policy that covers your physiotherapy needs. 

What advantages does physiotherapy bring?

Beyond the obvious perks of boosting your mobility and strength, physiotherapy and strength training offer a host of wide-reaching benefits that can enhance your overall well-being and even extend your lifespan. The stronger you are, the lower the risk of other health conditions. 

What types of physio treatments are covered with an extras policy?

Well, there are many options, and it really depends on your private insurance provider and the level of extras coverage you’ve chosen. If you’ve got a basic extras policy, the coverage might be limited, but if you’ve splurged on a more comprehensive extras plan, you’ll likely have broader coverage.

Let’s break down what you might be able to claim if you have an extras policy that includes physiotherapy:

  1. Initial Consultation and Health Diagnosis: This covers your first visit to the physio, where they assess your condition and come up with a plan.
  2. Follow-Up Consultations: Ongoing visits to the physio to track your progress and make adjustments to your treatment.
  3. Treatment Plan Development: The creation of a structured plan tailored to your specific healthcare needs.
  4. Rehabilitation: If you’re on the road to recovery, this can include the exercises and therapies needed to get you back in action.
  5. Dry Needling: Some policies might even cover specialised treatments like dry needling.

How long are the waiting periods for physiotherapy?

When it comes to the waiting periods for your general treatment, which include your extras coverage for physiotherapy, it’s worth noting that these timelines are determined by your specific private health insurance provider. Waiting periods tend to fall in the range of two to six months for services like physiotherapy. There are however policies that have no waiting periods on physiotherapy meaning you can take the cover out and use the service right away!

To wrap up, when it comes to the question of whether physiotherapy is covered by your private health insurance, the answer lies in your extras cover. Every private health insurance policy is unique, so it’s essential to do your homework and select the right plan to suit your physiotherapy needs.

Physiotherapy, as we’ve explored, is a powerful ally in enhancing your mobility, strength, and overall well-being. It’s a natural approach that avoids the need for medications or surgery, making it not just a solution for immediate issues but a key player in long-term health. From slowing down the aging process of muscles and bones to aiding recovery from injuries and managing chronic conditions, physiotherapy offers a wealth of benefits.

Your choice of extras policy will determine the extent of your coverage. Whether it’s that initial consultation, follow-up sessions, treatment plans, rehabilitation, or even specialised treatments like dry needling, the level of coverage can vary based on the plan you select.

Lastly, keep in mind that waiting periods for physiotherapy, like any other extras, can differ from insurer to insurer. Typically, they fall within the range of two to six months. So, as you navigate the world of physiotherapy coverage, remember that it’s all about finding the right policy to keep you moving forward on your journey to better health and well-being.

Our Team are ready to take your call

To compare private health insurance funds and discuss physio cover today.

Call us on  1300 861 413 or email us

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How do I make a claim on private health insurance?

Welcome to the hassle-free guide to make a private health cover claiming easier! We’re here to simplify the process for you.

Pre-Claim Checklist: 

Before you dive into making a claim, make sure you’ve got these bases covered:

Bank Details: Ensure we have your up-to-date bank details. That’s the secret for a seamless claim process so funds go right into your nominated account.

Know Your Coverage: Take a moment to check that your treatment or service is covered, and you’ve patiently served any waiting periods. Make sure you’re eligible for the services you’re claiming and that you have served relevant waiting periods for each service.

Timing Matters: You can’t claim in advance. So, make sure you’ve already had the treatment or service, and you’re within two years of the date of service.

Read the Fine Print: Read all the Terms and Conditions of your private health insurance, though often overlooked, these are a crucial part of the journey. Make sure you’ve read and agreed to the provider’s T&Cs.

Keep in Mind: Sometimes, your private health provider might need a bit more info to process your claim smoothly. So they may reach out for some extra details.

Ways to Claim: 

Now, let’s explore the avenues you can take to claim back some of your healthcare fees:

Online: If you’re the tech-savvy type, claiming online via your provider’s website on your desktop is the way to go. It’s like online shopping but for your health benefits.

Membership Card: For those who prefer the old-school choice of presenting a physical card, most extras providers offer the convenience of on-the-spot claiming using your membership card in store.

Via Traditional Mail: Simply send your provider a letter with your completed claim form and the original invoices or receipts. 

Mobile App: If you have a smartphone, simply download your provider’s app, and your digital card to make your claim. This option is effortless at health providers with a HICAPS machine.


Q: What’s a Benefit?

A: It’s the reimbursement private health funds give back to you for a service or treatment you’ve had. Think of it as a health bonus – you deserve it!

Q: How Much Will I Get Back from an Extras Claim?

A: The amount depends on a few things, like the item number of the service, your level of cover, and how much you’ve already claimed in the calendar year. 

Q: How Long Does Claim Processing Take?

A:Claims typically take about 7 working days to process. Once we’re done, the private health fund will deposit your benefit into your chosen bank account. 

Still Confused? Talk to Us!

If you’re still unsure how to make a claim for a hospital stay, extras treatment or ambulance journey speak to us today on 1300 861 413 or email us

We will assist you with finding the best private health insurance provider. 🎉🏥💪

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Medicare vs Private Health Insurance

When it comes to medical cover there is a question that’s on most people’s minds, will Medicare cover me or will I need a private health insurance cover?  Medicare is our public health scheme providing free or subsidised healthcare to all Australians that are permanent residents. Medicare is made up of three main areas: hospital, medical and pharmaceutical. 

Each eligible person in Australia is issued a Medicare card to present every time you see a doctor, go to hospital, or get a medical test done. 

Comparing private health insurance plans with Medicare is the best way to ascertain whether you will have the correct cover and whether you require a mix of both Medicare and private health to give you the most affordable private health insurance. In this month’s blog we will cover everything you need to keep in mind when making your final decision.  

The Advantages of Medicare 

No Cost to You – supplemented by the Australian Government 

  • medical services provided by doctors, specialists, and other health professionals (if your doctor bulk bills, you won’t have to pay for anything)
  • Free or at a lower cost prescription medicine
  • Save money on medical costs by registering your family for the Medicare Safety Net 

What is covered by Medicare 

Medicare partially or fully covers:

  • seeing a GP or specialist
  • tests and scans, like x-rays
  • most surgery and procedures performed by doctors in the public system
  • eye tests by optometrists

For instance, when you are visiting your GP and they have a bulk billing service, Medicare will cover the costs of the visit and you will not have any out-of-pocket expenses. It’s always a good idea at the time of booking to ask your medical practice if they bulk bill and if not enquire how much you will get back as a rebate from the overall fee. 

A great reference tool to find a practitioner that bulk bills can be found here, simply choose the service required and add your postcode or location. It will also give you an idea of what providers offer a competitive charge so you have a comprehensive health plan.

What’s not covered by Medicare 

Unfortunately, Medicare does not cover ambulance levies so you will need to find and organise an Ambulance provider or make sure you’re covered through a private health policy for this service. 

Other items not covered under the Medicare scheme:

  • hearing devices
  • workers’ compensation check-ups or life insurance
  • in home nursing assistance
  • most dental services
  • Chinese medicine, alternative therapies, or complementary medicine (unless it has been ordered by a doctor)
  • Glasses and contact lenses.

About the Medicare Safety Net

A provider of larger rebates to those that have substantial healthcare costs, the Medicare Safety Net offers further assistance with out-of-pocket costs. For example, when you spend a certain amount on healthcare over the course of a year and reach the Medicare Safety Net threshold, Medicare will provide a larger rebate for a wide range of services, including:

  • biopsies
  • blood tests
  • healthcare professional consultations
  • pap smears
  • psychiatry
  • radiotherapy
  • scans
  • ultrasounds
  • x-rays.

Mixing Medicare with Private Health Insurance

Even if you have private health insurance you can still access benefits from Medicare. Some customers opt to have their hospital insurance through their private health fund which allows you to have treatment in a private hospital or as a private patient in a public hospital. The private health system is divided into three areas: hospital, extras, and ambulance.

Advantages of private health cover:

  • Nominate your own doctor/ specialist
  • Less waiting time for non-elective surgeries
  • Choice of hospital 

Private health insurance doesn’t cover:

  • GP visits
  • some specialist visits
  • visits to hospital emergency departments, both public and private
  • any x-rays or other scans
  • any blood tests or other pathology tests.

It’s all about Affordability 

Whether you can afford to pay for private health insurance is a big factor. You may choose only to have Medicare cover, due to the cost of private health cover. It really comes down to your budget and what works best for your financial situation.  Medicare is still a great alternative option for your health and well-being.

Some important things to keep in mind

If require non-urgent, elective surgery or treatment the waiting times can be longer in the public Medicare system. So, choosing a private health policy that will cover your surgery and speed up the process may be something to think about.  

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To compare private health insurance  – speak to one of our team members today on 1300 861 413 or email us

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I’ve exhausted my extras this year, what can I do?

Each calendar year, your extras cover on your private health policy resets on January 1. Some funds vary, but mostly all extras policies reset around this time. Extras policies can cover such services as dental, optical, and physiotherapy. So, what can you do if you’ve exhausted all your extras limits for this year? Don’t worry, there are still options available to you. Let’s explore some practical solutions to help out if you’ve used up all your extras cover.

Prioritise essential treatments:

1. When you’ve exhausted your extras limits, it’s important to plan ahead so you know when the limits reset and prioritise your essential treatments. Focus on services that are necessary for your health and well-being. For example, if you have ongoing dental issues, make sure to book your regular check-ups to avoid extra out-of-pocket expenses if you need extra fillings or dental work done. By prioritising essential treatments, you can ensure that you’re taking care of your health while making the most of the coverage you have left before the ailment becomes a major issue.

Source discounted packages from health providers:

2. Look for professionals who offer competitive rates or discounted packages. Some providers may also offer a combination of bulk-billing and payment plans to help out. By researching and comparing different provider options, you might find more affordable alternatives for the health services you need.

Review your policy:

3. Take the time to review your current private health policy. Check if there are any additional benefits or options that you may have overlooked. Some policies offer loyalty bonuses or additional coverage for specific services. By understanding the details of your extras component of your private health policy, you can make informed decisions about utilising your benefits and potentially find hidden perks that you haven’t taken advantage of yet.

Consider waiting until the new year:

4. If you’ve exhausted all your extras limits and can afford to wait, you may consider postponing non-urgent treatments until the new year. By doing so, you’ll be able to take advantage of the refreshed limits and maximise your extras coverage once it resets. 

Seek professional advice:

5. Talk to your private health fund, they can provide guidance based on your specific policy and circumstances. They’ll help you navigate the policy, understand your options, and give suggestions for strategies to make the most of your extras coverage.

Reaching the extras limits on your private health cover doesn’t mean you’re out of options. By prioritising essential treatments, exploring alternative providers, reviewing your policy or waiting until the new year, you can still make the most of your coverage. Remember, the key is to be proactive when it comes to your healthcare needs and plan ahead. 

Chat to us Today

To compare private health insurance extras and discuss what’s  best for you – our friendly team are ready to talk you through the options. Call us on  1300 861 413 or email us

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Just married. Do we need couples’ private health cover?

Just got hitched? You might be wondering whether switching to a couples private health policy is right for you. Well, the good news is, there’s no hard and fast rule that says married couples have to switch to a joint private health insurance policy. Ultimately, the decision is up to you and your spouse, and it will depend on your specific situation.

One of the advantages of opting for a couples private health policy is that it can potentially lower the overall cost of your private health insurance premium compared to having two separate single policies. 

Here are some benefits of couples’ private health insurance to consider:

  1. Lower overall cost: Couples policies may come with lower premiums compared to two individual policies. More convenient, as you’ll only have one policy to pay, and managing just one account will definitely simplify things.
  2. Flexibility: Some private health insurers offer the flexibility to choose a policy with a combined annual limit. This allows each partner to select the extras services that suit their individual needs. For example, one partner could choose to spend more on optical while the other opts to spend more on dental care.
  3. Enhanced coverage for family planning: Couples private health policies tailored towards individuals in their 20s and 30s typically offer more comprehensive coverage for family planning needs such as fertility treatments and pregnancy services.

It’s important to remember that your private health cover needs may change over time due to various factors like getting married, a long-term relationship, starting a family, health conditions, or changes in your lifestyle or life stage. These factors can greatly influence your private health insurance requirements.

For example, if you’re at the stage of planning a family, comparing private health insurance options becomes really important. There are numerous options available when it comes to pregnancy and starting a family. It’s worth noting that pregnancy, birthing, and reproductive services like IVF typically fall under top-tier Gold hospital cover. Some private health insurers may also offer specific Silver Plus policies tailored for couples looking to start a family.

It’s important to keep in mind the waiting periods that come with obstetric services such as pregnancy, birthing, and IVF; they usually have 12-month waiting periods. So, if you want to take advantage of the benefits offered by top-tier cover, it’s essential to take out a policy well ahead of time before you start to try for a baby.

Does couples’ private health cover provide double access to extras treatments?

The answer is no. Usually, when it comes to an extras policy, claim limits still apply per person but some private health providers allow couples to combine their extras annual limits. It’s worth checking with your private health fund if they offer this option. 

Before deciding on a joint private health policy once married, it’s important to ask yourselves these five questions:

What kind of coverage do we need?

1. Even though you’re now married, it’s a good idea to consider your individual health needs and the level of coverage that suits you both best. Take a look at options such as Gold, Silver, Bronze, or Basic levels of hospital cover, ambulance cover, extras cover, or a combined hospital and extras policy. 

What are your partner’s requirements?

2. It’s essential to understand your partner’s health needs as well. Do their requirements align with yours, or would both of you benefit from different types of coverage?

Will your health needs change in the future?

3. Keep in mind that all hospital policies have waiting periods of up to 12 months, and some extras policies may have even longer waiting periods. Consider this if you anticipate changes in your or your partner’s health needs. 

Are either of you subject to LHC loading?

4. If either of you obtained a hospital policy after your 31st birthday and on or after July 1, you’ll need to pay the government’s LHC loading in addition to your hospital policy premiums. This loading fee increases by two percent for each year you didn’t have hospital cover. For a couples hospital policy, the applicable LHC loading will be averaged out between the two of you and added to your premiums. 

Are either of you eligible for the age-based discount?

5. The age-based discount offers premium discounts on certain hospital policies if you take out health insurance before turning 29. On a couples policy, the discount is averaged between both individuals. So, if you qualify for a 10% age-based discount on a singles policy but your partner doesn’t, a couples policy would receive a 5% discount, averaged between the two of you.

As you build a future together, making sure your private health cover aligns with your new life stage and individual needs will give you peace of mind. Find the policy that’s right for you and get the most out of your coverage today by comparing private health plans.

Call our friendly team today on 1300 861 413 or email

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Can private health insurance help with braces and orthodontics?

Are you considering getting braces or orthodontic treatment for yourself or your child? It’s understandable that you may have concerns about the cost, time commitment, and overall inconvenience of the process. However, it’s important to remember that corrective dental braces offer numerous benefits beyond just a perfect smile. They can significantly improve your oral health as well. Braces are commonly recommended during childhood or early adolescence, but adults are increasingly opting for them as well.

If you have orthodontic private health cover it will assist in offsetting the cost of orthodontic treatments like braces, aligners, and retainers. If you want coverage for orthodontics along with other services such as optical and physiotherapy, you should look for an extras private health insurance policy that specifically includes orthodontics. It’s crucial to pay close attention to the benefits and features provided by different policies, and you can conveniently compare them by talking to

What cover do I need for orthodontics?

Usually, you will require a private health insurance plan with extras cover for dental treatment and it’s split into three categories.

  • General dental: Includes cleaning, plaque removal, X-rays and minor fillings
  • Major dental: Includes crowns, bridges and dentures and wisdom teeth extraction
  • Orthodontics

How do you know if you or your child actually require braces or orthodontic work? 

Here are some indications that there is a need for orthodontic treatment:

  • Teeth coming out too early, too late, or irregularly
  • Crowded or misaligned teeth
  • Protruded teeth
  • Excessive overbite or underbite
  • Difficulty chewing
  • Jaw popping, shifting, or clicking
  • Crooked or unevenly spaced teeth
  • Underbites, overbites, or crossbites
  • Limited breathing
  • Gaps between teeth

What are the different types of orthodontic treatments available:

  1. Traditional Metal Braces: These consist of small metal brackets bonded directly to the teeth, along with an archwire that connects all the brackets. The brackets can be either “twin” brackets, requiring coloured, silver, or clear elastic modules for archwire attachment, or “self-ligating” brackets. Each bracket is designed for a specific tooth, considering its unique features and requirements.
  2. Clear Braces: Clear or tooth-colored braces are often used for upper teeth that are more visible when talking and smiling. Patients have the option of clear braces in either twin bracket or self-ligating design, including the option of clear braces for lower front teeth.
  3. Lingual Braces: If you prefer braces that are completely “invisible,” another option is lingual braces. These braces are fitted to the inside or lingual surface of the teeth, which provides custom-made braces for accurate fit and placement. 
  4. Invisalign: Invisalign is an almost invisible alternative to braces. It involves using a series of thin, clear aligners that resemble mouthguards. These aligners are worn full-time, except when eating, and are changed every two weeks to gradually move the teeth to the desired position. 
  5. Plates: Dental plates are removable plastic devices designed to adjust or stabilise teeth using wires and springs. Unlike fixed braces, these plates can be easily taken out of the mouth whenever desired.
  6. Retainers: After undergoing orthodontic treatment, wearing a retainer is recommended to maintain the new shape of your teeth. Retainers can be removable appliances or bonded retainers that are glued to the back of the teeth so they are not visible.

Are braces and orthodontics covered by Medicare?

Generally, Medicare does not cover braces and orthodontic treatments. Dental treatments, in general, are not covered by Medicare, although the Child Dental Benefits schedule does provide some dental coverage for kids. However, orthodontics and braces specifically do not qualify for this coverage through Medicare.

What should I look for in a private health policy for my orthodontic needs?

  1. Take the time to compare different providers online, chat to your dentist and talk to friends and family for referrals. Spending some time researching can potentially save you hundreds of dollars in the long run.
  2. Pay attention to the annual limits of the private health policies you’re considering. The annual limit is the maximum amount you can claim for orthodontic treatment in a year. Higher limits allow you to claim more, but keep in mind that premiums are usually higher as well. 
  3. Lifetime limits are another important factor to consider. Some private health insurers set a maximum lifetime limit for orthodontic coverage. If you anticipate needing extensive orthodontic work, make sure to check the lifetime limit, as it represents the maximum amount you can claim over the course of your policy, regardless of how long you hold it.
  4. Waiting periods is another key factor to take into consideration, usually with most policies – braces or orthodontic work have a 12 month waiting period before you can claim. Check with your private health provider as some waiting periods may vary.
  5. Price is undoubtedly a crucial factor in your decision-making process. However, it’s important to strike a balance between cost and private health coverage. Avoid simply opting for the cheapest policy without thoroughly comparing your options. You might find a better deal elsewhere without compromising the coverage you need. On the other hand, be mindful of your budget and avoid policies that stretch your financial limits.
  6. Consider the additional benefits offered by extras policies. These policies often provide various perks beyond orthodontic coverage. You might enjoy additional discounts on services like massages, physiotherapy appointments, or even gym memberships. 

To find the best provider for braces and orthodontic cover, we recommend comparing online with us. Don’t limit yourself to a familiar brand or rely solely on recommendations from friends. By researching online, you can discover a private health insurance policy that suits you best and potentially save hundreds of dollars. Look at the annual limits for orthodontics, as they determine the maximum amount you can claim in a year. Consider the lifetime limits as well, which indicate the maximum amount you can claim over the duration of the private health policy.

To compare private health insurance that best covers your dental and orthodontic needs – Call us on 1300 861 413 or email hello@healthmarketing

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