Need to know
- Health insurance premiums increased in April, but you can compare and switch at any time to make sure you're getting the best cover and value
- Three health funds – St.Lukes, Health Partners and restricted membership fund CBHS – will only increase their premium on 1 July, so there is still time to prepay your annual premium to lock in existing prices
- Make sure you have the right cover for your needs
Health insurance premiums went up on 1 April, the second increase in six months for many people after COVID-19 delayed price hikes for multiple funds.
Follow our step-by-step action plan to see if your premium went up, decide if you need health insurance, review your cover, and find something better.
The first step is to check how much your premium went up by.
The average health insurance premium increase for this year is 2.74%, which is the lowest since 2001. But there are large differences between the average increases per fund, ranging from 0.5% (St.Lukes) to 5.47% (CBHS Corporate).
Each year your insurer will send you an email or letter to explain any forthcoming changes to your rate and cover.
Check if your excess has changed. Health insurers introduced a $750 excess in 2019, and some people might have seen their $500 excess increased to $750, which is payable if you have to go to hospital.
Will a higher excess save you money?
An excess is a contribution towards each hospital stay that you can choose to pay to reduce your premiums.
- If you're not likely to go to hospital in the next one or two years, opt for an excess to reduce your premium.
- If you think you'll need to go to hospital sooner rather than later, switch to a policy with a lower or nil excess at least 12 months before your hospital stay.
Have a think about whether you actually need either hospital insurance or extras.
You may decide you want private hospital insurance because it could save you money at tax time.
Take our Do I Need Health Insurance? quiz to find out if hospital insurance will save you money at tax time, and how the lifetime health cover (LHC) loading affects you.
If you don't need health insurance for tax reasons you might still want it for peace of mind. Here is what you should consider:
- Are you happy to rely on Medicare and public hospitals that provide excellent care, especially for life-threatening illnesses and emergencies?
- Do you want to use a potentially more comfortable private hospital?
- Is it important for you to choose your own doctor? For example, you might want to choose a plastic rather than a general surgeon for reconstructive surgery after cancer or a burn.
Do you pay too much for extras cover? Should you consider downgrading or dropping it altogether?
According to APRA, the average annual extras premium per person is about $500 but the average annual benefit is $390, so many people spend more on extras than they get back. In 2020, benefits were lower than usual because of restrictions on services due to COVID-19, making it more important than ever to check whether you're getting value from your extras cover.
A lot of people spend more on extras than they get back from their health fund
Extras insurance has no bearing on government surcharges or your tax; it's essentially a budgeting tool to help you cover part of the cost of treatments or services over the year.
Make sure you're still covered for what you need following changes to the tiered system of health cover.
Hospital insurance recently went through big changes. Policies are now classified as:
- Gold – full or top cover health insurance in a private hospital, which includes services such as rehabilitation, pregnancy, and hip/knee replacements
- Silver – medium cover, which includes heart surgery and nearly all cancer surgeries
- Bronze – low cover, which includes treatment for the flu, broken bones, asthma, tonsils, breast and prostate surgery
- Basic – very little cover, if any.
Silver Plus, Bronze Plus and Basic Plus policies cover at least one service more than regular Silver, Bronze or Basic policies.
For example, a Silver Plus policy could also include cover for rehabilitation or cataract surgery, which are services normally only covered under Gold policies.
Make sure you're still covered for what you need.
It's an ideal time to check if your policy is good value for money.
You might be surprised by how much you can save. Our own CHOICE writer Pru Engel was told by her insurer her family would get moved to a new Silver Plus policy with less cover and a higher premium.
Instead, she found a better Silver Plus policy that covers her needs and saves her $1800 per year (without rebate).
Compare health insurance policies and see how your current premium fares against the top policies for your selection.
Most health funds also have hardship measures where they may waive your premium for a time or allow you to suspend your cover. So call your fund if you've lost work or have other economic pressures.
Some funds give you a discount of up to 4% if you pay by direct debit or pay your annual premium in advance.
If your needs have changed or you're looking to save money, you can use our tool to compare health insurance and see what your options are. We've looked at thousands of policies from 36 funds and given ratings based on price, out-of-pocket costs, complaints and more.
Other ways to save money on health insurance
Join a restricted membership health fund
Gold level health policies from restricted health funds can be substantially cheaper than those from open funds.
Restricted funds are open to Australians working in many industries, from police, soldiers, reservists and defence contractors, to transport employees, forestry, electricity and steel workers. Bank employees, health practitioners, teachers and workers of associated industries are also covered. Families (sometimes even siblings) and former employees are also eligible.
Check out Best restricted membership health insurance funds for more information.
See if you qualify for a corporate discount
You could easily qualify for a discount without knowing it. Private health insurance legislation allows health funds to give up to a 12% discount under agreements with companies. The company can then offer cheaper policies, for example, to their staff, members or customers. Discounts may be available through:
- Your employer: Many companies have arranged corporate policies or discounts for their staff with health funds. Ask your employer whether they offer this.
- Your super fund: A number of super funds have arrangements with health insurers.
- Associations and clubs: Some offer health insurance discounts to their members.
- Your mutual bank: Some credit unions and mutual banks have negotiated a discount for their shareholders or customers.