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Health insurance comparisons – the facts

Why don't other websites give you the full picture?

When you buy insurance through iSelect, Compare the Market, or Health Insurance Comparison, they earn a percentage of the premium. If they don't get a commission, they won't show you the policy, even if it's the best one for your needs.

Canstar and Finder earn fees from participating funds, which affects what they show in their comparisons. By default they show you only those funds – you have to uncheck a box to show the funds that don't pay them fees..

How is CHOICE different? Well for a start, we don't take commissions from health funds. You pay us directly to search widely and apply our expert scoring so that we find you the best-value policies that match your needs.

We're also nonprofit, and we're not here to make a sale – so you won't be getting any pushy phone calls or emails from us.

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Current April 2021. More information: insurance comparison sites

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Read our disclaimer


We have provided the health insurance information and tools in this section to help you find a health insurance policy that best suits your needs.

We are not providing you with specific financial advice or endorsing any particular product. We are assisting you with a process which will result in you making your own direct enquiries with health insurance providers and, if necessary, obtaining your own professional financial advice. The information we are providing is not a substitute for those steps. We have included links to some providers for convenience but this is not to be taken as an endorsement of those providers or their products. We don't receive commissions from health insurance providers.

We are not providing you with any form of medical advice regarding your particular circumstances. If you have enquiries about any medical condition, you should see your general practitioner or other appropriate health services professional. The information we have provided is, in most cases, sourced from third parties. While we make every effort to verify this information, we make no assurance about its accuracy or correctness. Again, your review of this information should be followed by your own enquiries with the relevant providers.

For the reasons above, CHOICE disclaims all and any liability for any errors or mis-descriptions in the health insurance information and will not be liable for your use of or reliance on that information or your use of the tools in this section.

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Health insurance FAQ

How does CHOICE compare private health insurance?

Our health insurance experts have drawn on years of experience and knowledge to create a scoring system that we apply to each policy.

We give each policy a "match" score just for you – which indicates how well it matches your needs.

How we score hospital policies

In scoring hospital-only policies, we take into account:

  • what a policy costs 
  • what it covers 
  • how much you’ll be out of pocket
  • the number of hospital agreements your fund has 
  • complaints against the health fund.

How we score extras policies

In scoring extras-only policies, we take into account:

  • what a policy costs 
  • the maximum annual benefits it pays for the therapies you selected
  • benefits for services (e.g. per physiotherapy visit or a hearing aid device once every three years)
  • any waiting periods you have to serve before you can claim
  • complaints against the health fund. 

How we score combined policies

In scoring combined policies (hospital and extras combined into one policy), we combine the scores for hospital and extras. 

We give extra weight to what you’ve told us you need.

For example, if you select ‘full cover’ for hospital but ‘low usage’ for extras we’ll weight hospital as more important than extras, when we calculate the final score.

What does private health insurance cover that Medicare doesn't?

Private health insurance and Medicare cover exactly the same treatments and services. The main difference is in where you’re treated: the public or the private system. 

If you’re a permanent Australian resident, Medicare gives you free or subsidised access to doctors and specialists, and treatment and accommodation (the bed or room) in a public hospital. The standard of care you’ll get here is high.

Having a private hospital insurance policy lets you access treatment in the private system. While you’re more likely to have your own room, can choose your own doctor and avoid the sometimes long waiting lists in public hospitals, you’ll also face out-of-pocket costs, on top of your insurance premiums.

 Public (Medicare)  Private
  • Free treatment in public hospital (small out-of-pocket costs)
  • Covers you in a private hospital (can have large out-of-pocket costs)
  • Most likely a shared room or ward
  • Could have a private room
  • No choice of doctor
  • Can choose your doctor
  • Longer waiting times
What does 'no gap' mean in health insurance?

A gap is the difference between what Medicare recommends (the Medicare Benefits Schedule fee), and what your doctor or hospital actually charges. You'll need to pay the difference (the gap), which is why it's sometimes called an out-of-pocket cost.

Health funds have gap schemes to help cover your out-of-pocket costs, under which they'll pay all, or part, of the gap.

In a ‘no gap’ scheme the insurer sets an upper limit for how much they'll pay over the MBS fee. If your doctor charges above the MBS but under, or up to, the insurer's 'no gap' threshold, you'll have no out-of-pocket costs.

What is an excess in health insurance?

An excess is an amount you can choose to pay out of your own pocket, once per hospital stay, in order to lower your premiums. You’ll only pay the excess if you end up going to hospital, so if you don’t expect to go to hospital during the year (you have no surgery planned), choosing a policy with a higher excess could save you money.

A co-payment is similar to an excess, but instead of paying one lump sum you pay an amount for each day that you stay in hospital. Some co-payments have a yearly cap such as $500 or only apply for a private room. Some are only charged after you've been in hospital for a period of time, e.g. they kick in after five days in hospital.

What is the private health insurance rebate?

The private health insurance rebate is an amount the government contributes towards the cost of your private health insurance premiums.

You can get the private health insurance rebate deducted from the amount of private health insurance premiums you pay to your insurer.

The rebate is means tested, so if your income is higher than the relevant income threshold, you may not receive a rebate. You’ll get a higher rebate if you’re over 65, and higher again if you’re over 70.

What is a pre-existing condition?

A pre-existing condition is an illness or medical condition that you’ve had, or shown signs or symptoms of, in the 6 months before taking out private hospital insurance.

Waiting periods

Insurers will make you serve a 12-month waiting period if you apply to be covered for a pre-existing condition, with some exceptions:

  • Rehabilitation and palliative care have only a 2-month waiting period.
  • Psychiatric services have a 2-month waiting period (may be waived once in your life if you’ve held hospital insurance for at least two months).

Once you’ve served waiting times with one policy you won’t have to serve them again if you switch, even if you have pre-existing conditions.

Do pensioners need health insurance?

As you age you’re more likely to need certain types of treatments and surgeries, like cataracts or knee and hip replacements.

If you want to have these in a private hospital, this will only be covered by the expensive, top-tier (Gold and Silver Plus) policies, so keep this in mind when choosing health insurance for seniors.