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How to switch health insurance

Review your health cover, switch and save.

switching health insurance policies
Last updated: 25 March 2019

So you've found a better health insurance policy? Here's how you go about switching health funds.

Why switch health funds?

Every year on 1 April, health insurance premiums go up. This is always a good time to check that the amount you're paying for health cover is justified by what you're getting in return.

Big changes in 2019

Health insurance reform in 2019 may have caused your health insurance to change. If you now have less cover, or if your premiums have gone sky-high, you might want to shop around for a better deal.

You may even want to consider whether it's worth having health insurance at all.

Review your health insurance

Health funds provide a fact sheet called the Private Health Information Statement (PHIS) for each policy, which allows you to compare your cover. You can review these at privatehealth.gov.au

Main considerations when switching health insurance

Benefit limits

Check the benefit limits for specific services. They're usually a fixed amount. Benefit limits are usually listed as a dollar amount, but occasionally you may see a benefit limit listed as a percentage on the PHIS. This means the fund will give you that percentage of the actual cost of the service (for example, 50% of your dental bills). However, if you see a benefit listed as a percentage in a fund's marketing material it may mean something else, so always go by the PHIS.

Lifetime limits

Beware of lifetime limits (some funds have them for orthodontics) and combined annual limits for a range of services, such as $400 for physiotherapy, natural therapies and chiropractic. This means that once you've claimed $400 for physiotherapy (for example), you won't receive anything for the other therapies during that 12-month period.

Extras

For extras cover, consider the services you use most, such as dental, and check the annual limit per person and per family. Sometimes the family limit is only twice the per-person limit, while with other policies it's four times the per-person limit.

Discounts

Check for a discount – some funds provide an up to four percent discount for paying by direct debit or by prepaying your annual premium.

Waiting periods

Before changing policies, check any waiting periods. For extras cover, they're usually two months for most services, 12 months for major dental and 36 months for hearing aids. Funds often waive the shorter waiting periods and may even waive all waiting periods if you're switching from another fund.

Once you've had hospital cover for 12 months you generally don't need to worry about waiting periods as long as you change to a comparable policy. But if you change to a policy with a lower excess or higher cover, you'll have to serve a waiting period for up to 12 months for the additional services covered or savings.

Loyalty bonuses

Some funds have loyalty bonuses that you'll usually lose should you switch to a new fund, though you can always try negotiating with the new fund to maintain the bonus.

Should you downgrade your hospital cover?

Do you have hospital insurance to protect your Lifetime Health Cover (LHC) status so that you don't need to pay a surcharge if you take it up later in life, or perhaps to avoid paying the Medicare levy surcharge (MLS)?

If you're relatively healthy and your only reason for having hospital insurance relates to the LHC or MLS, you could opt for a cheap hospital cover policy and upgrade later, when you need it.

Should you cancel your extras cover?

Unlike with hospital cover, government carrots and sticks don't apply to extras cover, so you can cancel it without any impact on your tax or having to pay more if you wish to take it up again later.

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