Dental – Health Insurance, How Does it Work?

Dental health is an important aspect of overall health and well-being, yet many people struggle to afford necessary dental care due to the cost of the treatment. Having dental as part of your private health insurance can help alleviate the financial burden you may incur from a trip to the dentist but trying to understand how it works can be confusing. In this blog post, we will discuss the basics of dental inclusions with your private health policy and how it can assist you pay for the proper dental care you need.

What is dental health?

⦁ Brushing your teeth twice a day with a fluoride toothpaste to remove plaque and prevent tooth decay.
⦁ Flossing at least once a day to remove food particles from between your teeth.
⦁ Visiting your dentist regularly for check-ups and professional cleanings.
⦁ Limiting your consumption of sugary and acidic foods and drinks to prevent tooth decay.
⦁ Don’t use tobacco products, which can cause tooth staining and gum disease.
⦁ Consider using an antiseptic mouthwash to kill bacteria and freshen your breath.
⦁ Wearing a mouthguard if you play sports to protect your teeth from injury.
⦁ Keeping your gums healthy by maintaining good oral hygiene, quitting smoking, and managing any chronic health conditions that can affect your gums.
⦁ Good nutrition is important for your overall oral health, eat a balanced diet with enough of key nutrients.

What is dental health cover?

First, it’s important to understand that dental health insurance is not the same as regular private health insurance. Dental health insurance, also known as dental coverage or dental benefits, is a separate extras policy that is designed specifically to cover the cost of dental care and makes up part of your private health insurance.

There are two main types of dental cover available: private dental insurance and public dental cover. Private dental insurance is purchased by individuals or families as part of your private health insurance policy, while public dental insurance is offered through state-funded programs and is available to certain groups of people or low-income individuals. Typically, Medicare does not cover most dental procedures such as teeth cleaning, dentures, wisdom teeth extraction, filling, or other routine procedures.

Your private health insurance extras cover typically includes a range of services which can be categorised into four main groups:

⦁ General Dental – oral exams, scale and clean, simple fillings, mouthguards, x-rays, and tooth extractions.
⦁ Major Dental – Tooth extraction, wisdom teeth removal, complex fillings, crowns and bridges, veneers, and dentures.
⦁ Endodontic – root canal therapy and periodontics which includes treatment of gum tissue diseases, infection, and inflammation.
⦁ Orthodontic – correction of teeth and jaws into the right position with braces or Invisalign.

How to Claim?

Claiming is simple, if your dentist is set up digitally and offer HICAPS – you can claim on the spot. Before booking any dental work and making a claim make sure that:

⦁ You’ve served the relevant waiting periods on your private health insurance policy to be able to claim.
⦁ The dental provider is a recognised provider with the health fund and has a provider number.
⦁ You have an itemised invoice that shows the provider ID and item number for the service/s, the charges and how much you’ve paid, and is dated within the last two years.

In conclusion, dental health insurance can help alleviate the financial burden of paying for dental care, but it’s important to understand how it works and what is covered. By comparing different plans and understanding the terms and limits of your private health insurance policy, you can make informed decisions about your dental health and ensure that you are getting the coverage you need. It’s also important to keep in mind that a good oral hygiene, healthy diet, and regular visits to a dentist can help prevent costly dental procedures in the future.

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To compare private health cover that will work for you or speak to one of our friendly team members on 1300 861 413 or hello@health.compare

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Other private health funds in Australia

In Australia, there are more than 30 insurers offering a wide variety of distinct private health products.#These health funds can be broadly categorised into three main types: for-profit, mutual and not-for-profit.

For-profit health funds

are owned by shareholders and are operated to make a profit. They are required to pay dividends to their shareholders and must also meet the same regulatory requirements as other types of health funds.

Not-for-profit health funds

are not operated to make a profit and instead, any surplus is used to improve the services and benefits provided to members. They are also subject to the same regulatory requirements as other types of health funds.

Mutual health funds

are owned and controlled by their members. They are operated on a not-for-profit basis, with any surplus being used to improve the services and benefits provided to members. Mutual health funds must also comply with the same regulatory requirements as other types of health funds.

In addition to these three types of health funds, there are also the government-funded health optionsincluding Medicare and the Pharmaceutical Benefits Scheme (PBS) which provide coverage for certain medical expenses.

Top 10 Private Health insurance companies in Australia by Market Share*

Insurer NameMarket Share
Medibank27.3%
Bupa24.8%
HCF11.9%
nib9.3%
HBF7.3%
Australian Unity2.5%
Teachers Health2.5%
GMHBA2.1%
Defence Health0.4%
CBHS0.1%

When choosing a private health fund, it’s important to consider the type of coverage you need, and the benefits offered by each fund. It’s also important to compare the costs and benefits of different funds, as the cost of premiums can vary significantly between policies.

In conclusion, with over 30 registered health funds in Australia+ as of January 2023, each health fund offers a different set of coverage options and benefits, so it’s important to compare the costs and benefits of different funds to find one that best suits your needs.

To explore your health fund options visit us to compare health insurance in Australia

speak to one of our friendly team members on 1300 861 413 hello@health.compare

References:

#ACCC

* Ombudsman.gov.au

+ PrivateHealth.gov.au

What would the waiting period look like?

To compare health insurance funds and work out which cover is best for you

Speak to one of our friendly team members about your health insurance policies today – Telephone 1300 861 413 or email us at hello@healthmarketing

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New year, New you, have you got the right health cover this year ?

It’s a question on everyone’s mind as we kick off 2023.

The start of a new year is a time for many people to reflect on their health and well-being and make changes that will improve their overall quality of life. One of the most important aspects of maintaining good health is having the right private health cover in place. In Australia, there are several different health cover options available, and it can be difficult to know which one is best for you. Once you have worked out what your health goals are for the new year you can tailor your private health insurance policy to meet those objectives.

Setting goals for good health is helpful, such as:

  • Losing weight
  • Getting in shape
  • Reducing inflammation
  • Improving overall health

Another thing that can help you maintain good health is to have regular check-ups with your doctor. This can help you identify and address any health issues early on before they become more serious. In addition to this, there are also several other things you can do to improve your overall health and well-being.

Some of these include:

  • Eating a healthy and balanced diet
  • Exercising regularly
  • Getting enough sleep
  • Managing stress
  • Not smoking or drinking alcohol excessively

Now is the time, the new year is a great time to take stock of your health and well-being and make positive changes to improve your quality of life. Knowing you have the right private health cover in place, with the correct extras and options that best meets your needs will give you peace of mind. And remember that taking care of yourself is a continuous journey, and it’s never too late to start!

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To compare private health cover that will work best for you  visit http://health.compare/ or speak to one of our friendly team members on 1300 861 413 or email us hello@health.compare

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I’ve never had Private Health, what should I look for?

If you’ve never had private health insurance before, it can be overwhelming to know what to look for and what you should consider when choosing a policy. In this blog post, we’ll go over some of the key things you should consider when looking for private health insurance in Australia.

Some points to consider:

1. What is covered by the policy?

One of the most important things to consider when choosing a private health insurance policy is what is covered. Most policies will cover a range of hospital treatments, such as wisdom teeth removal or joint reconstructions, as well as some extra services like dental check-upsand cleaning or physiotherapy consultations. It’s important to check exactly what is covered by the policy you are considering, as well as any exclusions or limitations.

2. Are there any excesses or co-payments?

An excess is the amount you need to pay towards the cost of your treatment before your admitted into the hospital. Co-payments are fees that some policies apply to help reduce the cost of the premium. It’s important to consider whether you are comfortable with any excesses or co-payment option on your policy, as these can add up over time.

3. What if I’m a single parent?

Feel comfort that you and your child or children are covered for healthcare needs by taking out a private health insurance policy to cover them and yourself as a single parent. This will make it easier for you to stay on top of your kid’s healthcare needs by giving you the option to avoid public hospital waiting lists, save on dental check-ups and more.

4. What is the premium?

The premium is the amount you need to pay each month for your private health insurance. Premiums can vary significantly between policies and providers, so it’s important to compare the premiums of different policies to ensure you are getting the best value for money. Keep in mind that lower premiums may come with higher excesses or co-payments, so you’ll need to weigh up the costs and benefits of different policies.

5. Are there any waiting periods?

Waiting periods are the length of time you need to wait before you can access certain benefits under your policy. For example, there may be a waiting period for pre-existing conditions, or for certain types of treatment. It’s important to check what waiting periods apply to the policy you are considering, as you may need to pay for treatment out-of-pocket during this time.

6. What are the policy limits?

Policy limits refer to the maximum amount that your health insurance policy will cover for certain treatments or services. It’s important to check what the policy limits are for the treatments and services that are important to you, as you may need to pay any costs above the policy limit out-of-pocket.

7. What are the policy’s exclusions and restrictions?

Exclusions and restrictions refer to the treatments or services that are not covered by your policy. It’s important to check what exclusions and restrictions apply to the health insurance policy you are considering, as you may need to pay for these treatments or services out-of-pocket.

8. Do I need to restructure my health insurance policy as a senior?

As the population ages health funds have had to refine their private health insurance offerings for seniors as the risk of falling ill or getting injured increases. Always check your policy in detail to make sure you are covered for certain types of treatments and surgeries. These include surgeries such as heart and vascular surgery, hip surgery, joint replacements, and cataracts.

With so much to consider before going ahead with a private health policy, jump on to compare health insurance policies and work out which cover is best for youor speak to one of our friendly team members on 1300 861 413 hello@health.compare

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Health Fund – Extra’s Benefits

Tips to get more value from your extra’s cover

Here we are in 2023, at the beginning of the new calendar year and it marks the point at which most private health insurance policy extras reset. This means that any benefits you have accumulated over the course of the year, such as those for physiotherapy or dental work, will be reset back to zero. Understanding why this happens, and how to make the most of your benefits, can help ensure that you get the most value out of your private health policy.

Following are some tips to help you make the most of your private health insurance policy extras:

  • Know your policy: The first step to understanding your private health insurance policy is to know what it covers. Review your policy carefully and make note of any extras that are included, such as physiotherapy, natural therapies, chiropractic care, or dental work. Knowing what your policy covers will help you plan how to best use your benefits before they reset.
  • Keep track of your benefits: Keep track of your policy extras throughout the year by checking your policy statements. It’s important to know how much you have left in each category, which will help you plan when to schedule appointments or procedures.
  • Use your benefits before they reset: Because most extras reset on January 1st, it’s important to use as much of your benefits as possible before the end of the year. This means scheduling appointments for physiotherapy, optical or dental work before December 31st or making sure to use any outstanding benefits for things like glasses or contact lenses.

Some policies may have annual or lifetime limits on extras cover, while others may have unlimited or no limits. It’s vital for policyholders to be aware of their specific limits on extras cover and to keep track of their claims throughout the year. Also keep in mind the cheapest health insurance isn’t always the best private health insurance especially when it comes to policy extras, these can vary dramatically.

Policyholders should also be aware that there are different types of extras cover, including general extras cover, which covers a wide range of health services such as dental care and physiotherapy, and specific extras cover, which covers more targeted health services such as psychology or acupuncture. The limits on extras cover may vary depending on the type of cover and the provider.

It’s worth noting that policyholders can sometimes increase their private health insurance limits on extras cover by paying a higher premium, but this will depend on the policy and the provider. Policyholders should carefully consider their needs and budget when deciding whether to increase their limits on extras cover.

Private health insurance extras can be a valuable option for individuals and families who want to have access to a wider range of health services or who want to reduce their out-of-pocket expenses for medical treatment. However, it’s important for policyholders to be aware of the limits on extras cover and to carefully consider their needs and budget when choosing a policy.

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To compare extras and work out which cover is best for you speak to one of our friendly team members about your health insurance policies today. Telephone 1300 861 413 or email us hello@health.compare

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Looking to Compare Health Insurance?

With so many health insurance policy options on the market today in Australia, it can be tricky to know which one is best for you. There are so many choices, not only the amount of health funds in the market but also different combinations of hospital, extra’s and excess cover. In this blog we will cover off why it’s so important to discuss with your provider your options and waiting periods on offer before you sign up.

For example, if you are planning to have a baby within the next 12-18 months , you’ll need to adjust your health insurance policy to ensure the birth of your child is covered under the policy.  Every private health insurance fund has a 12-month waiting period before your baby is due so you will need to consider when to take out cover for the first time or upgrade your cover to ensure this is covered.

Some other factors that may come into play and you should consider based on your situation are:

  • A sports or fitness-related injury
  • Knee surgery or full replacement
  • Needing a hip replacement or other procedure.

Why does it matter having the right health insurance plan?

There’s no all-encompassing product when it comes to private health insurance, so it’s important to find a policy that offers benefits you think you’ll use. As individuals we are never quite prepared for health issues that arrive out of the blue.  Being prepared with an insurance health policy for general cover is always a good idea. Some important points to consider when searching for insurance health polices in NSW are:

  • Who needs to be covered? Just yourself as a single, a couple, a family with 2 adults and children or even single-parent policy with kids. Nowadays, health funds have specific coverage for your individual life situation.
  • Pre-existing Conditions – A pre-existing condition is defined as any ailment, illness, or condition where, in the opinion of a medical adviser appointed by the health insurer, the signs or symptoms of that illness existed any time prior to the 6 months leading up to when the person became covered the health insurance policy.
  • Budget – if you have a particular budget in mind that is affordable to cover yourself or your family, we recommend talking us so we can search across a wide range of fund to find out the best insurance health plan to fit your financial circumstances.
  • Age – Some providers offer specific health policies and packages for those aged 50 and above. Other health care plans have policies more suitable for seniors and retirees aged 65 and up. Never has there been a better time to ensure your policy matches your needs.
  • Inclusions & Exclusions – Each health insurance policy has a range of inclusions and exclusions. These are a list of clinical categories that you can add or remove from your select health policy. It is important to know which of these services you need coverage for as it will be a determining factor in your premium.
  • Waiting Periods – as briefly covered off above, certain procedures and services have waiting periods. These can range from as little as 2 months to as much as 36 months – it’s recommended you check these before signing up for a health insurance policy.

Finding the cheapest health insurance in Australia isn’t always the best insurance for your family.

The cheapest health insurance isn’t necessarily the best insurance and the most expensive is not always the best coverage.  For example, a not-for-profit health insurance provider is one that invests its profits back into its members rather than shareholders. For-profit health funds pay stakeholders with their remaining surplus, while a not-for-profit fund uses that money to better improve and serve their policyholders.

It’s worth shopping around and comparing private health insurance to find the best deal for your individual needs. Nationally, there are more than 30 health plan insurers proposing a wide variety of benefits and health insurance products. There are several policies on the market that will differ depending on where you live and your circumstances. Comparing health fund offers can help you to decide and find a policy that suits your needs.

Whatever your insurance health plans needs are, be sure to arm yourself with the very best research and recommendations before making a final decision. It’s what works best for you or your family and your situation. Remember to review your policy regularly – don’t just set and forget. Visit our website for further resources to assist.

Chat to us Today

To compare health insurance funds and work out which cover is best for you, speak to one of our friendly team members about your health insurance policies today Telephone 1300 861 413 or email us hello@health.compare

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Peace of mind for pregnancy cover with private health insurance

It’s a special time in many couples lives when they make the decision to start planning for a baby. Pregnancy brings a host of new and exciting feelings, taking care of your health is vital during this exciting time. In this month’s blog we’ll give you guidance on everything you need to know about planning for pregnancy and affordable health insurance options.

It all starts with making sure you have the right health insurance policy and adding a little pre-planning. This will give you the ability to choose your obstetrician and then find the hospital you would like to give birth to your little bundle of joy.

What to ask your Private Health fund?

What maternity and obstetric services will be covered in a private hospital on my policy?

With private health insurance you get to choose your hospital (agreement private or public) and your obstetrician to care for you and deliver your newborn. Delivery of your child can be either naturally or via caesarean section. Health insurance plans vary from provider to provider so it’s always a good idea to check the fine print.

What are the waiting periods for pregnancy and birth?

With all health insurance policies, the waiting period is 12-months. This is the time where you cannot claim any pregnancy-related expenses. So don’t forget once you start planning your pregnancy journey, update your policy straight away and by the time baby arrives you will be covered.  

My partner and I are not on the same policy, do we need to upgrade?

There will be a point in time when the policy needs to be upgraded. This can be completed in 1 of 2 ways. Upgrade to a single parent cover to include the new born or to a family level of cover. Depending on your situation this may be easily done over the phone with your private health insurance provider.

Will I be covered to claim on assisted reproductive services like IVF?

Health insurance policies that cover assisted reproductive services will require you to wait 12-month’s to use the service due to the waiting periods. Not all levels of cover will cover both pregnancy and birth and assisted reproductive services. Make sure you check the level of cover before deciding on it.

Healthcare professionals you may need during Pregnancy

Once deciding to have a baby, you may need to visit a few different healthcare professionals. This may be a combination of your doctor, a midwife, and an obstetrician. It depends on what care you require and where you want to give birth.

Your Doctor (GP)

Your GP (general practitioner) is trained in many different aspects of healthcare. You would normally see your doctor when you find out you are pregnant for initial blood tests to confirm the pregnancy.

Midwives

Midwives are health professionals who work with you to provide support, care, and advice during your pregnancy. They often run the antenatal classes you and your partner can attend prior to the birth of your newborn.  They sometimes also check in on you after returning home from hospital.

Obstetrician

Obstetricians are trained doctors that specialise in (medical care before, during and after childbirth). They can deliver babies naturally or via caesarean section. If you want to give birth at a certain hospital, check with your fund and obstetrician to ensure they work out of that hospital.

Anaesthetist

An anaesthetist (a doctor who provides pain relief during surgery) might be involved in your labour. They get involved if you need have an epidural or your baby is delivered via a caesarean. Compare private health insurance funds to see if you can claim fees for an anaesthetist.

Let’s look at your Health Policies Extras cover for Pregnancy

Physiotherapy

With the many changes to your body during pregnancy, you may also experience sore and tired muscles. Seeing a physio can help stretch out and treat any issues. Check the specific physio extras coverage on your private health insurance policy.

Remedial Massage

Relax with a remedial massage to help reduce fluid retention and muscle soreness in the later stages of pregnancy. It’s important to ensure your massage therapist is trained in pregnancy massage, especially if you are in your first trimester.

Gym & Fitness

If your health professional has recommended a gym or fitness program during your pregnancy and it’s deemed medically safe, you may be able to claim gym membership on your extras cover.

Visit your Dentist

Often during pregnancy, the gums are more susceptible to plaque and inflammation or bleeding.  This is due to hormonal changes, visit your dentist for a check-up during your pregnancy.

Taking care of your Mental Wellbeing

Pregnancy can bring mental and emotional changes along the way. It’s an overwhelming time for some and feeling anxious is common. Don’t go at it alone. Talking with a psychologist about how you’re feeling is paramount.

Diet & Nutrition

Now your baby will grow and flourish from the nutrients and food you put into your body. Speak to your midwife or a nutritionist about what to eat and when.

Some important things to keep in mind

Adding your newborn onto your level of cover is important. You want to make sure they are covered at the time of birth. This changes by fund. General rule of thumb is to always upgrade your cover a few months before the birth of your child. To be sure, always confirm directly with the fund.

If you’re looking to upgrade your policy jump on to our website http://health.compare/ and see for yourself which health fund is right for you. We have it all wrapped up into one, easy to navigate comparison portal to make it easy to compare private health insurance.

Chat to us Today

To compare health insurance funds and work out which cover is best for you

Visit http://health.compare/ or speak to one of our friendly team members about your health insurance plans today Telephone 1300 861 413 or email us hello@healthmarketing

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Health Insurance Waiting Periods

Waiting periods for private health insurance are normal, although they do vary when it comes to both Hospital and/or ‘Extra’s’ levels of cover, and can also vary by fund.
 
Let’s take a look at waiting periods across the board and guide you through the basics. For more detailed information on this, we recommend speaking to an expert who can help answer any additional questions. [click here to book a call]
 
What type of waiting periods can be found across the Private Health Industry?
Health insurance is split into effectively two categories: Hospital cover and Extras (This may also be referred to as general treatment or ancillary cover).
 
The waiting periods for Hospital cover are very different to those for extras. Let’s start with the waiting periods for hospital cover.
 
Hospital waiting periods are governed by the Private Health Insurance Ombudsman (PHIO) who outline what the maximum limits will be for specific hospital benefits. The good news is, no waiting period is longer than 12 months for coverage to start. For ‘Hospital Cover,’ the standard waiting periods are as follows:
 
• 12 months for pre-existing conditions or illnesses you showed signs or symptoms of in the 6 months leading up to taking out a hospital policy;
• 12 months for pregnancy and birth (obstetrics). This means you’ll need to consider health insurance for you and your unborn child before you fall pregnant;
• two months for palliative care, rehabilitation, and psychiatric care; and
• two months for other services that require hospitalisation (and aren’t pre-existing conditions or subject to other waiting times).
 
For more information on Pre-Existing conditions click here.
 
What about waiting periods on ‘Extra’s’ cover?

The waiting periods for ‘extra’s’ products are set by the health funds themselves and vary by each insurer.
 
Typically, health funds operate with similar waiting periods for general treatment and optical, that being 2 or 6 months. For more complex items such as major dental, hearing aids, or medical appliances, these waiting periods typically start at 12 months but can be longer depending on the fund. See below for more examples of typical waiting periods:

  • 2 months for general dental benefits and physiotherapy
  • 6 months for optical items, like glasses or contact lenses
  • 12 months for major dental procedures, like crowns or bridges
  • Up to 3 years for some high-cost procedures, such as braces and other orthodontics
     

Why does Private Health Insurance have waiting periods?

Insurers in Australia put waiting periods in place for a number of reasons, the first being governed by the Private Health Insurance Ombudsman (PHIO) and second to make pricing fair for all existing members. If hospital cover didn’t have a waiting period, people could effectively sign up to a level of cover, claim on an expensive service (such as major eye surgery) and then cancel the level of cover before paying anything significant.  
 
By allowing this, the cost of Private Health Insurance would increase significantly, pricing out those wanting to join, as premiums would need to be adjusted accordingly.
 
I already have health insurance, what happens to my waiting periods?

Great question!
 
All waiting periods you have served/serving will transfer with you. This means you don’t have to restart waiting periods because you want to change policies or insurers. The only time a waiting period will apply is if you don’t have that service covered or you’re looking to upgrading your policy to include it moving forward.
 
An example of this would be:

Current Policy Waiting Periods
New Policy Waiting Periods
Bronze Hospital All Served Bronze Hospital
Different Fund
No Waiting Periods
Bronze Hospital All Served Bronze Hospital
New Fund
No Waiting Periods for All Service
Waiting Periods for All Other Added Service
Gold Hospital All Served Gold Hospital
Existing/New Fund
No Waiting Periods
Silver Hospital 4 Months of Pre-existing Served Silver Hospital
New Fund
Additional 8 Months for Pre-existing Cover

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What is Dental Cover?

What is it and how does it work?

Dental coverage comes in two forms, general and major treatment.

These will vary from fund to fund. Typically, general dental will encapsulate services such as:

  • Preventative dental
    • Check-ups
    • Cleaning
    • Plaque removal
  • X-rays
  • Small Fillings

While major dental will pay benefits on more involved treatments like:

  • Crowns
  • Bridge work
  • Endodontics (Root Canal Treatment)
  • Dentures
  • Extraction of teeth
  • Orthodontics (Braces)

What would the waiting period look like?

This is going to depend on several things. Do you currently have cover? Are you new to compare health insurance? The answer to the first question will depend on your situation.

Finding the right level of cover can be confusing when it comes to adding dental. If you’d like to find out more and how this works for your situation, call us here.

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Finding the right level of cover

Navigating your way through the landscape of Private Health Insurance can be confusing and complex.

I’m still young enough, do I need cover for joint replacements? We think we’ve finished with pregnancy, should I take it off now or wait a little bit longer? I don’t know what extra services are, how do I know what I should or shouldn’t have?

These are all great questions.

I’ve never had health insurance; how do I even start?

By talking to us!

It’s a mine field – legislation, tax, age penalties? Do any of these apply to you and if so, why?

What does each level of hospital cover me for? Do I need extras? How do I use them?

These are all common questions and ones we talk about all the time.

I think it’s time for me to switch?

You’ve been thinking of switching for a while, what’s prompted this?

You’ve had a chat with friends at a BBQ? Your current health fund is increasing premiums? You’re at a very different point in my life and it’s time to upgrade my policy?

If you haven’t checked your health insurance in a number of years, it’s time to do it!

Comparing health insurance is not like comparing apples with apples. Every policy and every fund is different. You need to find the right level of cover for you.

So, what should I do?

Have a conversation with an expert.

Most people put comparing health insurance in to the ‘too hard basket.’ It’s something they know they need to do, but the investment at the time doesn’t feel important. Sound familiar?

Take 15 minutes with us to figure out how we can help. If you’re on the right level of cover, what have you lost other than 15 minutes?

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